Impairment of maximal aerobic power with moderate hypoxia in endurance athletes: do skeletal muscle mitochondria play a role?

Limitation of Maximal Heart Rate in Hypoxia: Mechanisms and Clinical Importance

The use of exercise intervention in hypoxia has grown in popularity amongst patients, with encouraging results compared to similar intervention in normoxia. The prescription of exercise for patients largely rely on heart rate recordings (percentage of maximal heart rate (HR_max) or heart rate reserve). It is known that HR_max decreases with high altitude and the duration of the stay (acclimatization). At an altitude typically chosen for training (2,000-3,500 m) conflicting results have been found. Whether or not this decrease exists or not is of importance since the results of previous studies assessing hypoxic training based on HR may be biased due to improper intensity. By pooling the results of 86 studies, this literature review emphasizes that HR_max decreases progressively with increasing hypoxia. The dose–response is roughly linear and starts at a low altitude, but with large inter-study variabilities. Sex or age does not seem to be a major contributor in the HR_max decline with altitude. Rather, it seems that the greater the reduction in arterial oxygen saturation, the greater the reduction in HRmax, due to an over activity of the parasympathetic nervous system. Only a few studies reported HR_max at sea/low level and altitude with patients. Altogether, due to very different experimental design, it is difficult to draw firm conclusions in these different clinical categories of people. Hence, forthcoming studies in specific groups of patients are required to properly evaluate (1) the HR_max change during acute hypoxia and the contributing factors, and (2) the physiological and clinical effects of exercise training in hypoxia with adequate prescription of exercise training intensity if based on heart rate.

Twenty-eight days at 3454-m altitude diminishes respiratory capacity but enhances efficiency in human skeletal muscle mitochondria

Modifications of skeletal muscle mitochondria following exposure to high altitude (HA) are generally studied by morphological examinations and biochemical analysis of expression. The aim of this study was to examine tangible measures of mitochondrial function following a prolonged exposure to HA. For this purpose, skeletal muscle biopsies were obtained from 8 lowland natives at sea level (SL) prior to exposure and again after 28 d of exposure to HA at 3454 m. High-resolution respirometry was performed on the muscle samples comparing respiratory capacity and efficiency. Exercise capacity was assessed at SL and HA. Respirometric analysis revealed that mitochondrial respiratory capacity diminished in complex I- and complex II-specific respiration in addition to a loss of maximal state-3 oxidative phosphorylation capacity from SL to HA, all independent from alterations in mitochondrial content. Leak control coupling, respiratory control ratio, and oligomycin-induced leak respiration, all measures of mitochondrial efficiency, improved in response to HA exposure. SL respiratory capacities correlated with measures of exercise capacity near SL, whereas mitochondrial efficiency correlated best with exercise capacity following HA. This data demonstrate that 1 mo of exposure to HA reduces respiratory capacity in human skeletal muscle; however, the efficiency of electron transport improves.

Effect of aerobic training status on both maximal lactate steady state and critical power

This study aimed at assessing the sensitivity of both maximal lactate steady state (MLSS) and critical power (CP) in populations of different aerobic training status to ascertain whether CP is as sensitive as MLSS to a change in aerobic fitness. Seven untrained subjects (UT) (maximal oxygen uptake = 37.4 ± 6.5 mL·kg–1·min–1) and 7 endurance cyclists (T) (maximal oxygen uptake = 62.4 ± 5.2 mL·kg–1·min–1) performed an incremental test for maximal oxygen uptake estimation and several constant work rate tests for MLSS and CP determination. MLSS, whether expressed in mL·kg–1·min–1 (T: 51.8 ± 5.7 vs. UT: 29.0 ± 6.1) or % maximal oxygen uptake (T: 83.1 ± 6.8 vs. UT: 77.1 ± 4.5), was significantly higher in the T group. CP expressed in mL·kg–1·min–1 (T: 56.8 ± 5.1 vs. UT: 33.1 ± 6.3) was significantly higher in the T group as well but no difference was found when expressed in % maximal oxygen uptake (T: 91.1 ± 4.8 vs. UT: 88.3 ± 3.6). Whether expressed in absolute or relative values, MLSS is sensitive to aerobic training status and a good measure of aerobic endurance. Conversely, the improvement in CP with years of training is proportional to those of maximal oxygen uptake. Thus, CP might be less sensitive than MLSS for depicting an enhancement in aerobic fitness.

Effects of training at mild exercise intensities on quadriceps muscle energy metabolism in patients with chronic obstructive pulmonary disease

AIM

To study the effects of physical training at mild intensities on skeletal muscle energy metabolism in eight patients with chronic obstructive pulmonary disease (COPD) and eight paired healthy sedentary subjects.

METHODS

Energy metabolism of patients and controls vastus lateralis muscle was studied before and after 3 months of cycling training at mild exercises intensities.

RESULTS

The total amount of work accomplished was about 4059 ± 336 kJ in patients with COPD and 7531 ± 1693 kJ in control subjects. This work corresponds to a mechanical power set at 65.2 ± 7.5% of the maximum power for patients with COPD and 52 ± 3.3% of the maximum power in control group. Despite this low level of exercise intensities, we observed an improvement in mitochondrial oxidative phosphorylation through the creatine kinase system revealed by the increased apparent K(m) for ADP (from 105.5 ± 16.1 to 176.9 ± 26.5 μm, P < 0.05 in the COPD group and from 126.9 ± 16.8 to 177.7 ± 17.0, P > 0.05 in the control group). Meanwhile, maximal mechanical and metabolic power increased significantly from 83.1 ± 7.1 to 91.3 ± 7.4 Watts (P < 0.05) and from 16 ± 0.8 to 18.7 ± 0.98 mL O(2) kg(-1) min(-1) (P < 0.05) only in the COPD group.

CONCLUSION

This study shows that physical training at mild intensity is able to induce comparable changes in skeletal muscles oxidative energy metabolism in patients with COPD and sedentary healthy subjects, but different changes of maximal mechanical and metabolic power.

Physiological strain associated with high-intensity hypoxic intervals in highly trained young runners

To examine the physiological strain associated with hypoxic high intensity interval training (HHIT), 8 highly trained young runners (age, 18.6 ± 5.3 years) randomly performed, 5 × 3-minute intervals in either normoxic (N, 90% of the velocity associated with VO(2max), vVO(2max)) or hypoxic (H, simulated 2,400-m altitude, 84% of νVO(2max)) conditions. Cardiorespiratory (ventilation [V(E)], oxygen consumption [V(O2)], heart rate [HR], oxygen saturation [SpO(2)]), rating of central perceived exertion (RPE(C)) responses, changes in neutrophils, erythropoietin (EPO), blood lactate ([La]) and, bicarbonate ([HCO(-)(3)]), vagal-related indices of HR variability (natural logarithm of the square root of the mean of the sum of the squares of differences [Ln rMSSD]) and maximal sprint and jump performances were compared after each session. Compared with N, H was associated with similar V(E) (Cohen's d ± 90% confidence limits, 0.0 ± 0.4, with % chances of higher/similar/lower values of 15/61/24) but at least lower VO(2) (-0.8 ± 0.4, 0/0/100), HR (-0.4 ± 0.4, 1/21/78), and SpO(2) (-1.8 ± 0.4, 0/0/100). Rating of perceived exertion was very likely higher (+0.5 ± 0.4, 92/8/0). Changes in [HCO(3)] (-0.6 ± 0.8, 5/13/83), [La] (+0.2 ± 0.4, 52/42/5), and EPO (+0.2 ± 0.4, 55/40/5) were at least possibly greater after H compared with those after N, whereas changes in neutrophils were likely lower (-0.5 ± 0.7, 4/15/81). Changes in 20-m sprint time (+0.20 ± 0.23, 49/50/1) were possibly lower after H. There was no clear difference in the changes in Ln rMSSD (+0.2 ± 1.7, 48/18/34) and jump (+0.3 ± 0.9, 60/25/15). In conclusion, although perceived as harder, HHIT is not associated with an exaggerated physiological stress in highly trained young athletes. The present results also confirm that HHIT may not be optimal for training both the cardiorespiratory and neuromuscular determinants of running performance in this population.

Influence of moderate hypoxia on tolerance to high-intensity exercise

It remains uncertain as how the reduction in systemic oxygen transport limits high-intensity exercise tolerance. 11 participants (5 males; age 35 ± 10 years; peak [Formula: see text] 3.5 ± 0.4 L min(-1)) performed cycle ergometry to the limit of tolerance: (1) a ramp test to determine ventilatory threshold (VT) and peak [Formula: see text]; (2) three to four constant-load tests in order to model the linear P-t (-1) relationship for estimation of intercept (critical power; CP) and slope (AWC). All tests were performed in a random order under moderate hypoxia (FiO(2) = 0.15) and normoxia. The linearity of the P-t (-1) relationship was retained under hypoxia, with a systematic reduction in CP (220 ± 25 W vs. 190 ± 28 W; P < 0.01) but no significant difference in AWC (11.7 ± 5.5 kJ vs. 12.1 ± 4.4 kJ; P > 0.05). However, large individual variations in the change of the latter were observed (-36 to +66%). A significant relationship was found between the % change in CP (r = 0.80, P < 0.01) and both peak [Formula: see text] (CP: r = -0.65, P < 0.05) and VT values recorded under normoxia (CP: r = -0.65, P < 0.05). The present study demonstrates the aerobic nature of the intercept of the P-t (-1) relationship, i.e. CP. However, the extreme within-individual changes in AWC do not support the original assumption that AWC reflects a finite energy store. Lower hypoxia-induced decrements in CP were observed in aerobically fitter participants. This study also demonstrates the greater ability these participants have to exercise at supra-CP but close to CP workloads under moderate hypoxia.