{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T09:58:25Z","timestamp":1775469505069,"version":"3.50.1"},"reference-count":25,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:00:00Z","timestamp":1675728000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>We sought to assess whether noninvasive ventilation (NIV) as an adjunct with high-intensity exercise (HIEx) is more effective than exercise alone or exercise + sham on respiratory and peripheral oxygenation and vascular function in subjects with coexisting COPD and heart failure (HF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      On separate days, subjects performed incremental cardiopulmonary exercise testing and 3 constant load tests: HIEx, HIEx+NIV, and HIEx+sham (bi-level mode, Astral 150). Subjects were randomized with a 1:1 block allocation for the HIEx+NIV group and HIEx+sham group until the limit of tolerance (Tlim). Peripheral and respiratory oxygenation were assessed by oxyhemoglobin (O\n                      <jats:sub>2<\/jats:sub>\n                      Hb) and deoxyhemoglobin (Hb) using near-infrared spectroscopy in the respiratory and peripheral musculature. Vascular function was assessed by endothelial function using the flow-mediated vasodilation (FMD) method.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      There was a significant increase in FMD (mm), FMD (%), and shear stress in the HIEx+NIV group when compared to HIEx or HIEx+sham (\n                      <jats:italic toggle=\"yes\">P &lt;<\/jats:italic>\n                      .05). Less extraction of O\n                      <jats:sub>2<\/jats:sub>\n                      (Hb) in the peripheral and respiratory muscles was observed in the HIEx+NIV group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05). We also found correlations between peripheral muscle oxygenation (O\n                      <jats:sub>2<\/jats:sub>\n                      Hb) at the moment 80% of Tlim (r = 0.71,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .009) and peak of Tlim (100%) (r = 0.76,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .004) with absolute FMD (mm) immediately after HIEx+NIV.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>NIV as an adjunct to HIEx can acutely unload the respiratory musculature with better redistribution of available blood flow and beneficially modulate endothelial function. These results may influence the approach to cardiopulmonary rehabilitation in patients with coexisting COPD-HF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.10315","type":"journal-article","created":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T11:15:25Z","timestamp":1675768525000},"page":"320-329","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["The Effect of Adding Noninvasive Ventilation to High-Intensity Exercise on Peripheral and Respiratory Muscle Oxygenation"],"prefix":"10.1177","volume":"68","author":[{"given":"C\u00e1ssia","family":"da Luz Goulart","sequence":"first","affiliation":[{"name":"Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565\u2013905, Sao Carlos, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fl\u00e1via Rossi","family":"Caruso","sequence":"additional","affiliation":[{"name":"Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565\u2013905, Sao Carlos, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana S","family":"Garcia de Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565\u2013905, Sao Carlos, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00edlvia Cristina","family":"Garcia de Moura","sequence":"additional","affiliation":[{"name":"Cardiovascular Physical Therapy Laboratory, Physiotherapy Department, Federal University of S\u00e3o Carlos, Rod Washington Luis, KM 235, Monjolinho, CEP: 13565\u2013905, Sao Carlos, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aparecida Maria","family":"Catai","sequence":"additional","affiliation":[{"name":"Cardiovascular Physical Therapy Laboratory, Physiotherapy Department, Federal University of S\u00e3o Carlos, Rod Washington Luis, KM 235, Monjolinho, CEP: 13565\u2013905, Sao Carlos, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Polliana","family":"Batista dos Santos","sequence":"additional","affiliation":[{"name":"Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565\u2013905, Sao Carlos, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c9rika Z","family":"Kabbach","sequence":"additional","affiliation":[{"name":"Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565\u2013905, Sao Carlos, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ross","family":"Arena","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renata","family":"Gon\u00e7alves Mendes","sequence":"additional","affiliation":[{"name":"Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565\u2013905, Sao Carlos, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Audrey","family":"Borghi-Silva","sequence":"additional","affiliation":[{"name":"Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, CEP: 13565\u2013905, Sao Carlos, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,2,7]]},"reference":[{"key":"e_1_3_2_2_2","first-page":"1","article-title":"Effect of high-intensity exercise on cerebral, respiratory, and peripheral muscle oxygenation of HF and COPD-HF patients","volume":"000","author":"Goulart C da L","year":"2020","unstructured":"Goulart C da L, , Ar\u00eaas GPT, , Caruso FR, , Ara\u00fajo ASG, , de Moura SCG, , Catai AM, et al. Effect of high-intensity exercise on cerebral, respiratory, and peripheral muscle oxygenation of HF and COPD-HF patients. Heart Lung, 2020; 000:1-8.","journal-title":"Heart Lung"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.91520.2007"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2007.090167"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2014.11.005"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-018-9719-7"},{"key":"e_1_3_2_7_2","first-page":"1","article-title":"Noninvasive ventilation improves exercise tolerance and peripheral vascular function after high-intensity exercise in COPD-HF patients","volume":"173","author":"Goulart C","year":"2020","unstructured":"Goulart C, , Caruso F, , Ara\u00fajo A, , Ar\u00eaas G, , Moura S, , Catai A, et al. Noninvasive ventilation improves exercise tolerance and peripheral vascular function after high-intensity exercise in COPD-HF patients. Respir Med, 2020; 173:1.","journal-title":"Respir Med"},{"issue":"1","key":"e_1_3_2_8_2","first-page":"1","article-title":"Noninvasive ventilation acutely improves endothelial function in exacerbated COPD patients","volume":"181","author":"Heubel AD","year":"2020","unstructured":"Heubel AD, , Kabbach EZ, , Schafauser NS, , Phillips SA, , Pires Di Lorenzo VA, , Borghi Silva A, et al. Noninvasive ventilation acutely improves endothelial function in exacerbated COPD patients. 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