Cardio-respiratory responses to hypoxia combined with CO 2 inhalation during maximal exercise

Influence of graded hypercapnia on endurance exercise performance in healthy humans

Military and/or emergency services personnel may be required to perform high-intensity physical activity during exposure to elevated inspired carbon dioxide (CO2). Although many of the physiological consequences of hypercapnia are well characterized, the effects of graded increases in inspired CO2 on self-paced endurance performance have not been determined. The aim of this study was to compare the effects of 0%, 2%, and 4% inspired CO2 on 2-mile run performance, as well as physiological and perceptual responses during time trial exercise. Twelve physically active volunteers (peak oxygen uptake = 49 ± 5 mL·kg-1·min-1; 3 women) performed three experimental trials in a randomized, single-blind, crossover manner, breathing 21% oxygen with either 0%, 2%, or 4% CO2. During each trial, participants completed 10 min of walking at ∼40% peak oxygen uptake followed by a self-paced 2-mile treadmill time trial. One participant was unable to complete the 4% CO2 trial due to lightheadedness during the run. Compared with the 0% CO2 trial, run performance was 5 ± 3% and 7 ± 3% slower in the 2% and 4% CO2 trials, respectively (both P < 0.001). Run performance was significantly slower with 4% versus 2% CO2 (P = 0.046). The dose-dependent performance impairments were accompanied by stepwise increases in mean ventilation, despite significant reductions in running speed. Dyspnea and headache were significantly elevated during the 4% CO2 trial compared with both the 0% and 2% trials. Overall, our findings show that graded increases in inspired CO2 impair endurance performance in a stepwise manner in healthy humans.

CO2-Enriched Air Inhalation Modulates the Ventilatory and Metabolic Responses of Endurance Runners During Incremental Running in Hypobaric Hypoxia

Cao, Yinhang, Naoto Fujii, Tomomi Fujimoto, Yin-Feng Lai, Takeshi Ogawa, Tsutomu Hiroyama, Yasushi Enomoto, and Takeshi Nishiyasu. CO₂-enriched air inhalation modulates the ventilatory and metabolic responses of endurance runners during incremental running in hypobaric hypoxia. High Alt Med Biol. 23:125-134, 2022. Aim: We measured the effects of breathing CO₂-enriched air on ventilatory and metabolic responses during incremental running exercise under moderately hypobairc hypoxic (HH) conditions. Materials and Methods: Ten young male endurance runners [61.4 ± 6.0 ml/(min·kg)] performed incremental running tests under three conditions: (1) normobaric normoxia (NN), (2) HH (2,500 m), and (3) HH with 5% CO₂ inhalation (HH+CO₂). The test under NN was always performed first, and then, the two remaining tests were completed in random and counterbalanced order. Results: End-tidal CO₂ partial pressure (55 ± 3 vs. 35 ± 1 mmHg), peak ventilation (163 ± 14 vs. 152 ± 12 l/min), and peak oxygen uptake [52.3 ± 5.5 vs. 50.5 ± 4.9 ml/(min·kg)] were all higher in the HH+CO₂ than HH trial (all p < 0.01), respectively. However, the duration of the incremental test did not differ between HH+CO₂ and HH trials. Conclusion: These data suggest that chemoreflex activation by breathing CO₂-enriched air stimulates breathing and aerobic metabolism during maximal intensity exercise without affecting exercise performance in male endurance runners under a moderately hypobaric hypoxic environment.

Effect of 3% CO2 inhalation on respiratory exchange ratio and cardiac output during constant work-rate exercise

BACKGROUND

The aim of this study was to examine whether the decrease in respiratory exchange ratio (RER) during constant work-rate exercise (CWE) with 3% carbon dioxide (CO<inf>2</inf>) inhalation could be caused by the combination of the decrease in CO<inf>2</inf> output (V̇CO<inf>2</inf>) and the increase in oxygen uptake (V̇O<inf>2</inf>). In addition, we investigated the effect of 3% CO<inf>2</inf> inhalation on cardiac output (Q̇) during CWE.

METHODS

Seven males (V̇O<inf>2max</inf>: 44.1±6.4 mL/min/kg) carried out transitions from low-load cycling (baseline; 40w) to light intensity exercise (45% V̇O<inf>2 max</inf>; 89.3±12.5 W) and heavy intensity exercise (80% V̇O<inf>2max</inf>; 186.5±20.2 W) while inhaling normal air (Air) or an enriched CO<inf>2</inf> gas (3% CO<inf>2</inf>, 21% O<inf>2</inf>, balance N<inf>2</inf>). Each exercise session was 6 min, and respiratory responses by Douglas bag technique and cardiac responses by thoracic bio-impedance method were measured during the experiment.

RESULTS

Ventilation for 3% CO<inf>2</inf> was higher than for air through the experiment (P<0.05). Steady and non-steady state RER and V̇CO<inf>2</inf> for 3% CO<inf>2</inf> were less than for air in both light and heavy intensities (P<0.05), but V̇O<inf>2</inf> and Q̇ did not differ between the two conditions.

CONCLUSIONS

3% CO<inf>2</inf> inhalation induced the decrease in RER during CWE at light and heavy intensities, which was due to the decrease in V̇CO<inf>2</inf>. The promoted ventilation with 3% CO<inf>2</inf> did not lead to the increase in V̇O<inf>2</inf>. Moreover, 3% CO<inf>2</inf> inhalation did not affect Q̇ during CWE at light and heavy intensities.

Pulmonary hemodynamics responses to hypoxia and/or CO2 inhalation during moderate exercise in humans

In this study, we hypothesized that adding CO₂ to an inhaled hypoxic gas mixture will limit the rise of pulmonary artery pressure (PAP) induced by a moderate exercise. Eight 20-year-old males performed four constant-load exercise tests on cycle at 40% of maximal oxygen consumption in four conditions: ambient air, normobaric hypoxia (12.5% O₂), inhaled CO₂ (4.5% CO₂), and combination of hypoxia and inhaled CO₂. Doppler echocardiography was used to measure systolic (s)PAP, cardiac output (CO). Total pulmonary resistance (TPR) was calculated. Arterialized blood pH was 7.40 at exercise in ambient and hypoxia conditions, whereas CO₂ inhalation and combined conditions showed acidosis. sPAP increases from rest in ambient air to exercise ranged as follows: ambient + 110%, CO₂ inhalation + 135%, combined + 184%, hypoxia + 217% (p < 0.001). CO was higher when inhaling O₂-poor gas mixtures with or without CO₂ (~ 17 L min^-1) than in the other conditions (~ 14 L min^-1, p < 0.001). Exercise induced a significant decrease in TPR in the four conditions (p < 0.05) but less marked in hypoxia (- 19% of the resting value in ambient air) than in ambient (- 33%) and in both CO₂ inhalation and combined condition (- 29%). We conclude that (1) acute CO₂ inhalation did not significantly modify pulmonary hemodynamics during moderate exercise. (2) CO₂ adjunction to hypoxic gas mixture did not modify CO, despite a higher CaO₂ in combined condition than in hypoxia. (3) TPR was lower in combined than in hypoxia condition, limiting sPAP increase in combined condition.

Upregulation of SRF Is Associated With Hypoxic Pulmonary Hypertension by Promoting Viability of Smooth Muscle Cells via Increasing Expression of Bcl-2

The aim of study was to investigate the involvement of hypoxia-induced upregulation of serum response factor (SRF) and its downstream effector, B cell leukemia-2 (Bcl-2), in hypoxia-induced pulmonary hypertension (PH). Immunohistochemistry analysis and western blot analysis were used to detect the levels of SRF and Bcl-2 in rats exposed to hypoxia. Furthermore, the regulatory relationship between SRF and Bcl-2 was investigated in PASMCs using real-time PCR and western-blot analysis. We found that mPAP (mean pulmonary arterial pressure) and WA (the ratio of vascular wall area to external diameter) were increased after exposure to hypoxia, while LA (the ratio of vascular lumen area to total area) decreased after exposure to hypoxia. The immunohistochemistry analysis displayed a substantial increase in SRF and Bcl-2 in pulmonary arterial walls after 14 days of hypoxia. And the western blotting showed that SRF and Bcl-2 protein levels were much higher after 7 days of hypoxia and then remained at a high level. And then the levels of SRF and Bcl-2 in pulmonary artery smooth muscle cells (PASMCs) exposed to hypoxia were substantially suppressed following introduction of SRF siRNA, and the level of Bcl-2 was remarkably inhibited by Bcl-2 siRNA, while Bcl-2 siRNA had no effect on SRF level. Finally, SRF siRNA, and Bcl-2 siRNA significantly reduced viability of PASMCs exposed to hypoxia, and enhanced apoptosis of PASMCs exposed to hypoxia. These data validated that SRF responded to hypoxia, which subsequently was involved in pulmonary hypertension by abnormally promoting viability of PASMCs via modulating expression of Bcl-2. J. Cell. Biochem. 118: 2731-2738, 2017. © 2017 Wiley Periodicals, Inc.