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Cortese L, Fernández Esteberena P, Zanoletti M, Lo Presti G, Aranda Velazquez G, Ruiz Janer S, Buttafava M, Renna M, Di Sieno L, Tosi A, Dalla Mora A, Wojtkiewicz S, Dehghani H, de Fraguier S, Nguyen-Dinh A, Rosinski B, Weigel UM, Mesquida J, Squarcia M, Hanzu FA, Contini D, Mora Porta M, Durduran T. In vivocharacterization of the optical and hemodynamic properties of the human sternocleidomastoid muscle through ultrasound-guided hybrid near-infrared spectroscopies. Physiol Meas 2023; 44:125010. [PMID: 38061053 DOI: 10.1088/1361-6579/ad133a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/07/2023] [Indexed: 12/28/2023]
Abstract
Objective.In this paper, we present a detailedin vivocharacterization of the optical and hemodynamic properties of the human sternocleidomastoid muscle (SCM), obtained through ultrasound-guided near-infrared time-domain and diffuse correlation spectroscopies.Approach.A total of sixty-five subjects (forty-nine females, sixteen males) among healthy volunteers and thyroid nodule patients have been recruited for the study. Their SCM hemodynamic (oxy-, deoxy- and total hemoglobin concentrations, blood flow, blood oxygen saturation and metabolic rate of oxygen extraction) and optical properties (wavelength dependent absorption and reduced scattering coefficients) have been measured by the use of a novel hybrid device combining in a single unit time-domain near-infrared spectroscopy, diffuse correlation spectroscopy and simultaneous ultrasound imaging.Main results.We provide detailed tables of the results related to SCM baseline (i.e. muscle at rest) properties, and reveal significant differences on the measured parameters due to variables such as side of the neck, sex, age, body mass index, depth and thickness of the muscle, allowing future clinical studies to take into account such dependencies.Significance.The non-invasive monitoring of the hemodynamics and metabolism of the sternocleidomastoid muscle during respiration became a topic of increased interest partially due to the increased use of mechanical ventilation during the COVID-19 pandemic. Near-infrared diffuse optical spectroscopies were proposed as potential practical monitors of increased recruitment of SCM during respiratory distress. They can provide clinically relevant information on the degree of the patient's respiratory effort that is needed to maintain an optimal minute ventilation, with potential clinical application ranging from evaluating chronic pulmonary diseases to more acute settings, such as acute respiratory failure, or to determine the readiness to wean from invasive mechanical ventilation.
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Affiliation(s)
- Lorenzo Cortese
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
| | - Pablo Fernández Esteberena
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
| | - Marta Zanoletti
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
- Politecnico di Milano, Dipartimento di Fisica, I-20133 Milano, Italy
| | - Giuseppe Lo Presti
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
| | | | - Sabina Ruiz Janer
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, E-08036 Barcelona, Spain
| | - Mauro Buttafava
- Politecnico di Milano, Dipartimento di Elettronica Informazione e Bioingegneria, I-20133 Milano, Italy
- Now at PIONIRS s.r.l., I-20124 Milano, Italy
| | - Marco Renna
- Politecnico di Milano, Dipartimento di Elettronica Informazione e Bioingegneria, I-20133 Milano, Italy
- Now at Athinoula A. Martinos Center for Biomedical Imaging, MGH, Harvard Medical School, Charlestown, MA 02129, United States of America
| | - Laura Di Sieno
- Politecnico di Milano, Dipartimento di Fisica, I-20133 Milano, Italy
| | - Alberto Tosi
- Politecnico di Milano, Dipartimento di Elettronica Informazione e Bioingegneria, I-20133 Milano, Italy
| | | | - Stanislaw Wojtkiewicz
- University of Birmingham, School of Computer Science, Edgbaston, Birmingham, B15 2TT, United Kingdom
- Now at Nalecz Institute of Biocybernetics and Biomedical Engineering, 02-109 Warsaw, Poland
| | - Hamid Dehghani
- University of Birmingham, School of Computer Science, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | | | | | | | - Udo M Weigel
- HemoPhotonics S.L., E-08860 Castelldefels (Barcelona), Spain
| | - Jaume Mesquida
- Área de Crítics, Parc Taulí Hospital Universitari, E-08208 Sabadell, Spain
| | - Mattia Squarcia
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, E-08036 Barcelona, Spain
- Neuroradiology Department, Hospital Clínic of Barcelona, E-08036 Barcelona, Spain
| | - Felicia A Hanzu
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, E-08036 Barcelona, Spain
- Endocrinology and Nutrition Department, Hospital Clínic of Barcelona, E-08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), E-28029 Madrid, Spain
| | - Davide Contini
- Politecnico di Milano, Dipartimento di Fisica, I-20133 Milano, Italy
| | - Mireia Mora Porta
- IDIBAPS, Fundació Clínic per la Recerca Biomèdica, E-08036 Barcelona, Spain
- Endocrinology and Nutrition Department, Hospital Clínic of Barcelona, E-08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), E-28029 Madrid, Spain
| | - Turgut Durduran
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, E-08860 Castelldefels (Barcelona), Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), E-08010 Barcelona, Spain
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Peters CM, Dempsey JA, Hopkins SR, Sheel AW. Is the Lung Built for Exercise? Advances and Unresolved Questions. Med Sci Sports Exerc 2023; 55:2143-2159. [PMID: 37443459 PMCID: PMC11186580 DOI: 10.1249/mss.0000000000003255] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
ABSTRACT Nearly 40 yr ago, Professor Dempsey delivered the 1985 ACSM Joseph B. Wolffe Memorial Lecture titled: "Is the lung built for exercise?" Since then, much experimental work has been directed at enhancing our understanding of the functional capacity of the respiratory system by applying complex methodologies to the study of exercise. This review summarizes a symposium entitled: "Revisiting 'Is the lung built for exercise?'" presented at the 2022 American College of Sports Medicine annual meeting, highlighting the progress made in the last three-plus decades and acknowledging new research questions that have arisen. We have chosen to subdivide our topic into four areas of active study: (i) the adaptability of lung structure to exercise training, (ii) the utilization of airway imaging to better understand how airway anatomy relates to exercising lung mechanics, (iii) measurement techniques of pulmonary gas exchange and their importance, and (iv) the interactions of the respiratory and cardiovascular system during exercise. Each of the four sections highlights gaps in our knowledge of the exercising lung. Addressing these areas that would benefit from further study will help us comprehend the intricacies of the lung that allow it to meet and adapt to the acute and chronic demands of exercise in health, aging, and disease.
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Affiliation(s)
| | - Jerome A Dempsey
- Population Health Science, John Rankin Laboratory of Pulmonary Medicine, University of Wisconsin-Madison, Madison, WI
| | - Susan R Hopkins
- Department of Radiology, University of California San Diego, La Jolla, CA
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Thurston TS, Weavil JC, Georgescu VP, Wan HY, Birgenheier NM, Morrissey CK, Jessop JE, Amann M. The exercise pressor reflex - a pressure-raising mechanism with a limited role in regulating leg perfusion during locomotion in young healthy men. J Physiol 2023; 601:4557-4572. [PMID: 37698303 PMCID: PMC10592099 DOI: 10.1113/jp284870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/15/2023] [Indexed: 09/13/2023] Open
Abstract
We investigated the role of the exercise pressor reflex (EPR) in regulating the haemodynamic response to locomotor exercise. Eight healthy participants (23 ± 3 years,V ̇ O 2 max ${\dot V_{{{\mathrm{O}}_{\mathrm{2}}}{\mathrm{max}}}}$ : 49 ± 6 ml/kg/min) performed constant-load cycling exercise (∼36/43/52/98%V ̇ O 2 max ${\dot V_{{{\mathrm{O}}_{\mathrm{2}}}{\mathrm{max}}}}$ ; 4 min each) without (CTRL) and with (FENT) lumbar intrathecal fentanyl attenuating group III/IV locomotor muscle afferent feedback and, thus, the EPR. To avoid different respiratory muscle metaboreflex and arterial chemoreflex activation during FENT, subjects mimicked the ventilatory response recorded during CTRL. Arterial and leg perfusion pressure (femoral arterial and venous catheters), femoral blood flow (Doppler-ultrasound), microvascular quadriceps blood flow index (indocyanine green), cardiac output (inert gas breathing), and systemic and leg vascular conductance were quantified during exercise. There were no cardiovascular and ventilatory differences between conditions at rest. Pulmonary ventilation, arterial blood gases and oxyhaemoglobin saturation were not different during exercise. Furthermore, cardiac output (-2% to -12%), arterial pressure (-7% to -15%) and leg perfusion pressure (-8% to -22%) were lower, and systemic (up to 16%) and leg (up to 27%) vascular conductance were higher during FENT compared to CTRL. Leg blood flow, microvascular quadriceps blood flow index, and leg O2 -transport and utilization were not different between conditions (P > 0.5). These findings reflect a critical role of the EPR in the autonomic control of the heart, vasculature and, ultimately, arterial pressure during locomotor exercise. However, the lack of a net effect of the EPR on leg blood flow challenges the idea of this cardiovascular reflex as a key determinant of leg O2 -transport during locomotor exercise in healthy, young individuals. KEY POINTS: The role of the exercise pressor reflex (EPR) in regulating leg O2 -transport during human locomotion remains uncertain. We investigated the influence of the EPR on the cardiovascular response to cycling exercise. Lumbar intrathecal fentanyl was used to block group III/IV leg muscle afferents and debilitate the EPR at intensities ranging from 30% to 100%V ̇ O 2 max ${\dot V_{{{\mathrm{O}}_{\mathrm{2}}}{\mathrm{max}}}}$ . To avoid different respiratory muscle metaboreflex and arterial chemoreflex activation during exercise with blocked leg muscle afferents, subjects mimicked the ventilatory response recorded during control exercise. Afferent blockade increased leg and systemic vascular conductance, but reduced cardiac output and arterial-pressure, with no net effect on leg blood flow. The EPR influenced the cardiovascular response to cycling exercise by contributing to the autonomic control of the heart and vasculature, but did not affect leg blood flow. These findings challenge the idea of the EPR as a key determinant of leg O2 -transport during locomotor exercise in healthy, young individuals.
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Affiliation(s)
- Taylor S. Thurston
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT
| | - Joshua C. Weavil
- Geriatric Research, Education, and Clinical Center, Salt Lake City VAMC, UT
| | - Vincent P. Georgescu
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT
| | - Hsuan-Yu Wan
- Department of Anesthesiology, University of Utah, Salt Lake City, UT
| | | | | | - Jacob E. Jessop
- Department of Anesthesiology, University of Utah, Salt Lake City, UT
| | - Markus Amann
- Department of Anesthesiology, University of Utah, Salt Lake City, UT
- Geriatric Research, Education, and Clinical Center, Salt Lake City VAMC, UT
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Ramsook AH, Dominelli PB, Angus SA, Senefeld JW, Wiggins CC, Joyner MJ. The oxygen transport cascade and exercise: Lessons from comparative physiology. Comp Biochem Physiol A Mol Integr Physiol 2023; 282:111442. [PMID: 37182787 DOI: 10.1016/j.cbpa.2023.111442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/16/2023]
Abstract
Studies of animal physiology not only provide valuable knowledge for the species in question, but also offer insights into human physiology. This thought is best highlighted by the 'Krogh Principle', which states "for many problems there is an animal on which it can be most conveniently studied". This graphical review focuses on three distinct stages of the oxygen transport cascade in which human exercise physiology knowledge has been enhanced by studies carried out in animal models. We begin by exploring ventilation, and the detrimental effects of cold, dry air on the airways in two sets of elite athletes, the cross-country skier and the racing sled dog. We then discuss the transport of oxygen via hemoglobin and the shifts in humans and deer mice with relatively shifted oxygen dissociation curves. Finally, we consider the technical difficulties of measuring respiratory muscle blood flow in exercising humans and how an equine model can provide an understanding of the distribution of blood flow during exercise. These cases illustrate the complementary nature of physiological studies across species.
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Affiliation(s)
- Andrew H Ramsook
- Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Rochester, USA
| | - Paolo B Dominelli
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Sarah A Angus
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Jonathon W Senefeld
- Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Rochester, USA; Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - Chad C Wiggins
- Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Rochester, USA; Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - Michael J Joyner
- Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Rochester, USA; Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN, USA.
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Hammer SM, Bruhn EJ, Bissen TG, Muer JD, Villarraga N, Borlaug BA, Olson TP, Smith JR. Inspiratory and leg muscle blood flows during inspiratory muscle metaboreflex activation in heart failure with preserved ejection fraction. J Appl Physiol (1985) 2022; 133:1202-1211. [PMID: 36227167 PMCID: PMC9639766 DOI: 10.1152/japplphysiol.00141.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 09/29/2022] [Accepted: 10/07/2022] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to determine the cardiovascular consequences elicited by activation of the inspiratory muscle metaboreflex in patients with heart failure with preserved ejection fraction (HFpEF) and controls. Patients with HFpEF (n = 15; 69 ± 10 yr; 33 ± 4 kg/m2) and controls (n = 14; 70 ± 8 yr; 28 ± 4 kg/m2) performed an inspiratory loading trial at 60% maximal inspiratory pressure (PIMAX) until task failure. Mean arterial pressure (MAP) was measured continuously. Near-infrared spectroscopy and bolus injections of indocyanine green dye were used to determine the percent change in blood flow index (%ΔBFI) from baseline to the final minute of inspiratory loading in the vastus lateralis and sternocleidomastoid muscles. Vascular resistance index (VRI) was calculated. Time to task failure was shorter in HFpEF than in controls (339 ± 197 s vs. 626 ± 403 s; P = 0.02). Compared with controls, patients with HFpEF had a greater increase from baseline in MAP (16 ± 7 vs. 10 ± 6 mmHg) and vastus lateralis VRI (76 ± 45 vs. 32 ± 19%) as well as a greater decrease in vastus lateralis %ΔBFI (-32 ± 14 vs. -17 ± 9%) (all, P < 0.05). Sternocleidomastoid %ΔBFI normalized to absolute inspiratory pressure was higher in HFpEF compared with controls (8.0 ± 5.0 vs. 4.0 ± 1.9% per cmH2O·s; P = 0.03). These data indicate that patients with HFpEF exhibit exaggerated cardiovascular responses with inspiratory muscle metaboreflex activation compared with controls.NEW & NOTEWORTHY Respiratory muscle dysfunction is thought to contribute to exercise intolerance in heart failure with preserved ejection fraction (HFpEF); however, the underlying mechanisms are unknown. In the present study, patients with HFpEF had greater increases in leg muscle vascular resistance index and greater decreases in leg muscle blood flow index compared with controls during inspiratory resistive breathing (to activate the metaboreflex). Furthermore, respiratory muscle blood flow index responses normalized to pressure generation during inspiratory resistive breathing were exaggerated in HFpEF compared with controls.
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Affiliation(s)
- Shane M Hammer
- Department of Cardiovascular Medicine, https://ror.org/03zzw1w08Mayo Clinic, Rochester, Minnesota
- School of Kinesiology, Applied Health and Recreation, Oklahoma State University, Stillwater, Oklahoma
| | - Eric J Bruhn
- Department of Cardiovascular Medicine, https://ror.org/03zzw1w08Mayo Clinic, Rochester, Minnesota
| | - Thomas G Bissen
- Department of Cardiovascular Medicine, https://ror.org/03zzw1w08Mayo Clinic, Rochester, Minnesota
| | - Jessica D Muer
- Department of Cardiovascular Medicine, https://ror.org/03zzw1w08Mayo Clinic, Rochester, Minnesota
| | - Nicolas Villarraga
- Department of Cardiovascular Medicine, https://ror.org/03zzw1w08Mayo Clinic, Rochester, Minnesota
| | - Barry A Borlaug
- Department of Cardiovascular Medicine, https://ror.org/03zzw1w08Mayo Clinic, Rochester, Minnesota
| | - Thomas P Olson
- Department of Cardiovascular Medicine, https://ror.org/03zzw1w08Mayo Clinic, Rochester, Minnesota
| | - Joshua R Smith
- Department of Cardiovascular Medicine, https://ror.org/03zzw1w08Mayo Clinic, Rochester, Minnesota
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Oueslati F, Saey D, Vézina FA, Nadreau É, Martin M, Maltais F. Acute Cardiopulmonary and Muscle Oxygenation Responses to Normocapnic Hyperpnea Exercise in COPD. Med Sci Sports Exerc 2022; 54:47-56. [PMID: 34334721 DOI: 10.1249/mss.0000000000002760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to investigate cardiorespiratory responses and intercostal muscle oxygenation during normocapnic hyperpnea exercise in chronic obstructive pulmonary disease (COPD). METHODS Twenty-two patients with COPD performed a cardiopulmonary cycling exercise test to assess peak oxygen consumption (V˙O2peak) and minute ventilation (V˙Epeak). They also performed a normocapnic hyperpnea exercise alone, at 50%-60% of V˙Epeak to exhaustion, using a respiratory device (Spirotiger) connected to a gas analyzer to monitor V˙O2, V˙E, and end-tidal CO2 partial pressure. Cardiac output, and intercostal and vastus lateralis muscle oxygenation were continuously measured during exercise using finger photoplethysmography and near-infrared spectroscopy, respectively. Arterial blood gases (arterial PCO2) and inspiratory capacity were obtained at rest and at the end of hyperpnea exercise. RESULTS The hyperpnea exercise lasted 576 ± 277 s at a V˙E of 34.5 ± 12.1 L·min-1 (58% ± 6% of V˙Epeak), a respiratory rate of 22 ± 4 breaths per minute, and a tidal volume of 1.43 ± 0.43 L. From rest to the end of hyperpnea exercise, V˙O2 increased by 0.35 ± 0.16 L·min-1 (P < 0.001), whereas end-tidal CO2 partial pressure and arterial PCO2 decreased by ~2 mm Hg (P = 0.031) and ~5 mm Hg (P = 0.002, n = 13), respectively. Moreover, inspiratory capacity fell from 2.44 ± 0.84 L at rest to 1.96 ± 0.59 L (P = 0.002). During the same period, heart rate and cardiac output increased from 69 ± 12 bpm and 4.94 ± 1.15 L·min-1 at rest to 87 ± 17 bpm (P = 0.002) and 5.92 ± 1.58 L·min-1 (P = 0.007), respectively. During hyperpnea exercise, intercostal deoxyhemoglobin and total hemoglobin increased by 14.26% ± 13.72% (P = 0.001) and 8.69% ± 12.49% (P = 0.003) compared with their resting value. However, during the same period, vastus lateralis oxygenation remained stable (P > 0.05). CONCLUSIONS In patients with COPD, normocapnic hyperpnea exercise provided a potent cardiorespiratory physiological stimulus, including dynamic hyperinflation, and increased intercostal deoxyhemoglobin consistent with enhanced requirement for muscle O2 extraction.
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Affiliation(s)
- Ferid Oueslati
- Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, CANADA
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Melo LT, Rodrigues A, Cabral EE, Tanaka T, Goligher EC, Brochard L, Reid WD. Prefrontal cortex activation during incremental inspiratory loading in healthy participants. Respir Physiol Neurobiol 2021; 296:103827. [PMID: 34808586 DOI: 10.1016/j.resp.2021.103827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 10/01/2021] [Accepted: 11/11/2021] [Indexed: 11/28/2022]
Abstract
We aimed to investigate whether changes in prefrontal cortex (PFC) oxyhemoglobin (O2Hb) and deoxyhemoglobin (HHb) associates with inspiratory muscle effort during inspiratory threshold loading (ITL) in healthy participants. Participants performed an incremental ITL. Breathing pattern, partial pressure of end-tidal CO2 (PETCO2), mouth pressure and O2Hb and HHb over the right dorsolateral PFC, sternocleidomastoid (SCM), and diaphragm/intercostals (Dia/IC) were monitored. Fourteen healthy participants (8 men; 29 ± 5 years) completed testing. Dyspnea was higher post- than pre-ITL (5 ± 1 vs. 0 ± 1, respectively; P<0.05). PFC O2Hb increased (P < 0.001) and HHb decreased (P = 0.001) at low loads but remained stable with increasing ITL intensities. PFC total hemoglobin increased at task failure compared to rest. SCM HHb increased throughout increasing intensities. SCM and Dia/IC total hemoglobin increased in the at task failure compared to rest. PETCO2 did not change (P = 0.528). PFC is activated early during the ITL but does not show central fatigue at task failure despite greater dyspnea and an imbalance of SCM oxygen demand and delivery.
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Affiliation(s)
- Luana T Melo
- Department of Physical Therapy, University of Toronto, Ontario, Canada; Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Antenor Rodrigues
- Department of Physical Therapy, University of Toronto, Ontario, Canada; Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
| | - Elis Emmanuelle Cabral
- Department of Physical Therapy, University of Toronto, Ontario, Canada; Performance Lab, Pneumocardiovascular and Respiratory Muscles (PneumoCardioVascular Lab/HUOL), Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Rio Grande do Norte, Brazil
| | - Takako Tanaka
- Department of Physical Therapy, University of Toronto, Ontario, Canada; Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ewan C Goligher
- Division of Respirology, Department of Medicine, University Health Network, Toronto, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; Department of Physiology, University of Toronto, Toronto, Canada
| | - Laurent Brochard
- Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada
| | - W Darlene Reid
- Department of Physical Therapy, University of Toronto, Ontario, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
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Niro F, Dubuc B, Gaynor-Sodeifi K, Jensen D. Effect of end-inspiratory lung volume and breathing pattern on neural activation of the diaphragm and extra-diaphragmatic inspiratory muscles in healthy adults. J Appl Physiol (1985) 2021; 131:1679-1690. [PMID: 34734781 DOI: 10.1152/japplphysiol.01118.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study examined the effect of changes in end-inspiratory lung volume (EILV) and breathing pattern on neural activation of the crural diaphragm (EMGDIA) and of the sternocleidomastoid (EMGSCM), scalene (EMGSCA) and external intercostal muscles (EMGINT) at constant ventilation (V̇E). Twelve healthy adults performed a series of 30-sec breathing trials at a constant V̇E corresponding to 15% of their maximum voluntary ventilation while (i) altering EILV at a constant breathing pattern and (ii) altering breathing pattern at a constant EILV. Using a real-time visual display of each participant's spirogram, EILV was voluntarily targeted at 65% (EILV65%), 75% (EILV75%), 85% (EILV85%) and 95% (EILV95%) of each participant's inspired vital capacity, while breathing frequency (fR) was targeted at 15, 35 and 50 breaths/min using a metronome. The tidal volume needed for a participant to maintain V̇E constant across trials was achieved via changes in end-expiratory lung volume. A multipair esophageal electrode catheter was used to record EMGDIA, while surface electrodes were used to record EMGSCM, EMGSCA and EMGINT. On average, EMGDIA, EMGSCM, EMGSCA and EMGINT increased as a function of increasing EILV at constant V̇E, independent of changes in breathing pattern. The magnitudes of these increases were particularly notable in the transition from EILV85% to EILV95%, especially for EMGSCM and EMGSCA. In healthy adults, as EILV increases towards total lung capacity, progressive compensatory increases in neural activation of the diaphragm and extra-diaphragmatic inspiratory muscles are needed to support V̇E, independent of changes in breathing pattern.
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Affiliation(s)
- Frank Niro
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Benjamin Dubuc
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Kaveh Gaynor-Sodeifi
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Dennis Jensen
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Translational Research in Respiratory Diseases Program, Montreal, Quebec, Canada.,Research Centre for Physical Activity and Health, Faculty of Education, McGill University, Montréal, Quebec, Canada
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Louvaris Z, Rodrigues A, Dacha S, Gojevic T, Janssens W, Vogiatzis I, Gosselink R, Langer D. High-intensity exercise impairs extradiaphragmatic respiratory muscle perfusion in patients with COPD. J Appl Physiol (1985) 2020; 130:325-341. [PMID: 33119468 DOI: 10.1152/japplphysiol.00659.2020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The study investigated whether high-intensity exercise impairs inspiratory and expiratory muscle perfusion in patients with chronic obstructive pulmonary disease (COPD). We compared respiratory local muscle perfusion between constant-load cycling[sustained at 80% peak work rate (WRpeak)] and voluntary normocapnic hyperpnea reproducing similar work of breathing (WoB) in 18 patients [forced expiratory volume in the first second (FEV1): 58 ± 24% predicted]. Local muscle blood flow index (BFI), using indocyanine green dye, and fractional oxygen saturation (%StiO2) were simultaneously assessed by near-infrared spectroscopy (NIRS) over the intercostal, scalene, rectus abdominis, and vastus lateralis muscles. Cardiac output (impedance cardiography), WoB (esophageal/gastric balloon catheter), and diaphragmatic and extradiaphragmatic respiratory muscle electromyographic activity (EMG) were also assessed throughout cycling and hyperpnea. Minute ventilation, breathing pattern, WoB, and respiratory muscle EMG were comparable between cycling and hyperpnea. During cycling, cardiac output and vastus lateralis BFI were significantly greater compared with hyperpnea [by +4.2 (2.6-5.9) L/min and +4.9 (2.2-7.8) nmol/s, respectively] (P < 0.01). Muscle BFI and %StiO2 were, respectively, lower during cycling compared with hyperpnea in scalene [by -3.8 (-6.4 to -1.2) nmol/s and -6.6 (-8.2 to -5.1)%], intercostal [by -1.4 (-2.4 to -0.4) nmol/s and -6.0 (-8.6 to -3.3)%], and abdominal muscles [by -1.9 (-2.9 to -0.8) nmol/s and -6.3 (-9.1 to -3.4)%] (P < 0.001). The difference in respiratory (scalene and intercostal) muscle BFI between cycling and hyperpnea was associated with greater dyspnea (Borg CR10) scores (r = -0.54 and r = -0.49, respectively, P < 0.05). These results suggest that in patients with COPD, 1) locomotor muscle work during high-intensity exercise impairs extradiaphragmatic respiratory muscle perfusion and 2) insufficient adjustment in extradiaphragmatic respiratory muscle perfusion during high-intensity exercise may partly explain the increased sensations of dyspnea.NEW & NOTEWORTHY We simultaneously assessed the blood flow index (BFI) in three respiratory muscles during hyperpnea and high-intensity constant-load cycling sustained at comparable levels of work of breathing and respiratory neural drive in patients with COPD. We demonstrated that high-intensity exercise impairs respiratory muscle perfusion, as intercostal, scalene, and abdominal BFI increased during hyperpnea but not during cycling. Insufficient adjustment in respiratory muscle perfusion during exercise was associated with greater dyspnea sensations in patients with COPD.
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Affiliation(s)
- Zafeiris Louvaris
- Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium.,Clinical Department of Respiratory Diseases, UZ Leuven, BREATHE Department CHROMETA, KU Leuven, Leuven, Belgium
| | - Antenor Rodrigues
- Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium.,Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina, Brazil.,Research Aimed at Muscle Performance Laboratory (RAMP), Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - Sauwaluk Dacha
- Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium.,Faculty of Associated Medical Sciences, Department of Physical Therapy, Chiang Mai University, Chiang Mai, Thailand
| | - Tin Gojevic
- Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium
| | - Wim Janssens
- Clinical Department of Respiratory Diseases, UZ Leuven, BREATHE Department CHROMETA, KU Leuven, Leuven, Belgium
| | - Ioannis Vogiatzis
- Faculty of Health and Life Sciences, Department of Sport, Exercise, and Rehabilitation, Northumbria University Newcastle, Newcastle, United Kingdom
| | - Rik Gosselink
- Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium.,Clinical Department of Respiratory Diseases, UZ Leuven, BREATHE Department CHROMETA, KU Leuven, Leuven, Belgium
| | - Daniel Langer
- Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium.,Clinical Department of Respiratory Diseases, UZ Leuven, BREATHE Department CHROMETA, KU Leuven, Leuven, Belgium
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10
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Ramsook AH, Peters CM, Leahy MG, Archiza B, Mitchell RA, Jasinovic T, Koehle MS, Guenette JA, Sheel AW. Near-infrared spectroscopy measures of sternocleidomastoid blood flow during exercise and hyperpnoea. Exp Physiol 2020; 105:2226-2237. [PMID: 33111424 DOI: 10.1113/ep089045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/26/2020] [Indexed: 01/20/2023]
Abstract
NEW FINDINGS What is the central question of this study? How does sternocleidomastoid blood flow change in response to increasing ventilation and whole-body exercise intensity? What is the main finding and its importance? Sternocleidomastoid blood flow increased with increasing ventilation. For a given ventilation, sternocleidomastoid blood flow was lower during whole-body exercise compared to resting hyperpnoea. These findings suggest that locomotor muscle work exerts an effect on respiratory muscle blood flow that can be observed in the sternocleidomastoid. ABSTRACT Respiratory muscle work influences the distribution of blood flow during exercise. Most studies have focused on blood flow to the locomotor musculature rather than the respiratory muscles, owing to the complex anatomical arrangement of respiratory muscles. The purpose of this study was to examine how accessory respiratory (i.e. sternocleidomastoid, and muscles in the intercostal space) muscle blood flow changes in response to locomotor muscle work. Seven men performed 5 min bouts of constant load cycling exercise trials at 30%, 60% and 90% of peak work rate in a randomized order, followed by 5 min bouts of voluntary hyperpnoea (VH) matching the ventilation achieved during each exercise (EX) trial. Blood-flow index (BFI) of the vastus lateralis, sternocleidomastoid (SCM) and seventh intercostal space (IC) were estimated using near-infrared spectroscopy and indocyanine green and expressed relative to resting levels. BFISCM was greater during VH compared to EX (P = 0.002) and increased with increasing exercise intensity (P = 0.036). BFISCM reached 493 ± 219% and 301 ± 215% rest during VH and EX at 90% peak work rate, respectively. BFIIC increased to 242 ± 178% and 210 ± 117% rest at 30% peak work rate during VH and EX, respectively. No statistically significant differences in BFIIC were observed with increased work rate during VH or EX (both P > 0.05). Moreover, there was no observed difference in BFIIC between conditions (P > 0.05). BFISCM was lower for a given minute ventilation during EX compared to VH, suggesting that accessory respiratory muscle blood flow is influenced by whole-body exercise.
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Affiliation(s)
- Andrew H Ramsook
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Heart Lung Innovation, University of British Columbia and St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Carli M Peters
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael G Leahy
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bruno Archiza
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
| | - Reid A Mitchell
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Heart Lung Innovation, University of British Columbia and St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Tin Jasinovic
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael S Koehle
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jordan A Guenette
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Heart Lung Innovation, University of British Columbia and St Paul's Hospital, Vancouver, British Columbia, Canada.,School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
| | - A William Sheel
- Centre for Heart Lung Innovation, University of British Columbia and St Paul's Hospital, Vancouver, British Columbia, Canada.,School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
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11
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More Impaired Dynamic Ventilatory Muscle Oxygenation in Congestive Heart Failure than in Chronic Obstructive Pulmonary Disease. J Clin Med 2019; 8:jcm8101641. [PMID: 31591369 PMCID: PMC6832638 DOI: 10.3390/jcm8101641] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 09/30/2019] [Accepted: 10/02/2019] [Indexed: 12/25/2022] Open
Abstract
Patients with chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) often have dyspnea. Despite differences in primary organ derangement and similarities in secondary skeletal muscle changes, both patient groups have prominent functional impairment. With similar daily exercise performance in patients with CHF and COPD, we hypothesized that patients with CHF would have worse ventilatory muscle oxygenation than patients with COPD. This study aimed to compare differences in tissue oxygenation and blood capacity between ventilatory muscles and leg muscles and between the two patient groups. Demographic data, lung function, and maximal cardiopulmonary exercise tests were performed in 134 subjects without acute illnesses. Muscle oxygenation and blood capacity were measured using frequency-domain near-infrared spectroscopy (fd-NIRS). We enrolled normal subjects and patients with COPD and CHF. The two patient groups were matched by oxygen-cost diagram scores, New York Heart Association functional classification scores, and modified Medical Research Council scores. COPD was defined as forced expired volume in one second and forced expired vital capacity ratio ≤0.7. CHF was defined as stable heart failure with an ejection fraction ≤49%. The healthy subjects were defined as those with no obvious history of chronic disease. Age, body mass index, cigarette consumption, lung function, and exercise capacity were different across the three groups. Muscle oxygenation and blood capacity were adjusted accordingly. Leg muscles had higher deoxygenation (HHb) and oxygenation (HbO2) and lower oxygen saturation (SmO2) than ventilatory muscles in all participants. The SmO2 of leg muscles was lower than that of ventilatory muscles because SmO2 was calculated as HbO2/(HHb+HbO2), and the HHb of leg muscles was relatively higher than the HbO2 of leg muscles. The healthy subjects had higher SmO2, the patients with COPD had higher HHb, and the patients with CHF had lower HbO2 in both muscle groups throughout the tests. The patients with CHF had lower SmO2 of ventilatory muscles than the patients with COPD at peak exercise (p < 0.01). We conclud that fd-NIRS can be used to discriminate tissue oxygenation of different musculatures and disease entities. More studies on interventions on ventilatory muscle oxygenation in patients with CHF and COPD are warranted.
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12
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Laveneziana P, Albuquerque A, Aliverti A, Babb T, Barreiro E, Dres M, Dubé BP, Fauroux B, Gea J, Guenette JA, Hudson AL, Kabitz HJ, Laghi F, Langer D, Luo YM, Neder JA, O'Donnell D, Polkey MI, Rabinovich R, Rossi A, Series F, Similowski T, Spengler C, Vogiatzis I, Verges S. ERS statement on respiratory muscle testing at rest and during exercise. Eur Respir J 2019; 53:13993003.01214-2018. [DOI: 10.1183/13993003.01214-2018] [Citation(s) in RCA: 227] [Impact Index Per Article: 45.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 02/18/2019] [Indexed: 12/12/2022]
Abstract
Assessing respiratory mechanics and muscle function is critical for both clinical practice and research purposes. Several methodological developments over the past two decades have enhanced our understanding of respiratory muscle function and responses to interventions across the spectrum of health and disease. They are especially useful in diagnosing, phenotyping and assessing treatment efficacy in patients with respiratory symptoms and neuromuscular diseases. Considerable research has been undertaken over the past 17 years, since the publication of the previous American Thoracic Society (ATS)/European Respiratory Society (ERS) statement on respiratory muscle testing in 2002. Key advances have been made in the field of mechanics of breathing, respiratory muscle neurophysiology (electromyography, electroencephalography and transcranial magnetic stimulation) and on respiratory muscle imaging (ultrasound, optoelectronic plethysmography and structured light plethysmography). Accordingly, this ERS task force reviewed the field of respiratory muscle testing in health and disease, with particular reference to data obtained since the previous ATS/ERS statement. It summarises the most recent scientific and methodological developments regarding respiratory mechanics and respiratory muscle assessment by addressing the validity, precision, reproducibility, prognostic value and responsiveness to interventions of various methods. A particular emphasis is placed on assessment during exercise, which is a useful condition to stress the respiratory system.
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13
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Dos Reis IMM, Ohara DG, Januário LB, Basso-Vanelli RP, Oliveira AB, Jamami M. Surface electromyography in inspiratory muscles in adults and elderly individuals: A systematic review. J Electromyogr Kinesiol 2019; 44:139-155. [PMID: 30658230 DOI: 10.1016/j.jelekin.2019.01.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 07/21/2018] [Accepted: 01/09/2019] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Electromyography (EMG) helps to evaluate disorders and pulmonary behavior, as impairments in respiratory muscle function are associated with the development of diseases. There is a wide range of methods and protocols used to record and analyze EMG obtained from respiratory muscles, demonstrating a lack of standardization. OBJECTIVE To identify the most common procedures used to record surface EMG (sEMG) of inspiratory muscles in adults and elderly individuals through a systematic review (primary), and to evaluate the quality of the report presented by the studies (secondary). METHOD Studies published from January 1995 until June 2018 were searched for in the Web of Science, PubMed, LILACS, EBSCO and Embase databases. Only studies evaluating sEMG of inspiratory muscles were included. RESULTS The electronic search retrieved a total of 6697 titles and 92 of them were included. A great variability on the methods applied to both recording and processing/analyzing data was found. Therefore, the synthesis of practical/clinical evidence to support immediate recommendations was impaired. In general, the descriptions presented by the studies are poor. CONCLUSION The most common procedures used for sEMG were identified. Methodological studies with objective comparisons were fundamental for improving standardization, given the impossibility of recommendations from this review.
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Affiliation(s)
- Ivanize Mariana Masselli Dos Reis
- Department of Physical Therapy, Biological and Health Sciences Center, Federal University of São Carlos (UFSCar), São Carlos/SP, Brazil; Spirometry and Respiratory Physiotherapy Laboratory (LEFiR) at UFSCar, São Carlos/SP, Brazil.
| | - Daniela Gonçalves Ohara
- Department of Physical Therapy, Biological and Health Sciences Center, Federal University of São Carlos (UFSCar), São Carlos/SP, Brazil; Federal University of Amapá (UNIFAP), Macapá/AP, Brazil
| | - Letícia Bergamin Januário
- Department of Physical Therapy, Biological and Health Sciences Center, Federal University of São Carlos (UFSCar), São Carlos/SP, Brazil; Laboratory of Clinical and Occupational Kinesiology (LACO) at UFSCar, São Carlos/SP, Brazil
| | - Renata Pedrolongo Basso-Vanelli
- Department of Physical Therapy, Biological and Health Sciences Center, Federal University of São Carlos (UFSCar), São Carlos/SP, Brazil; University Hospital of UFSCar, São Carlos/SP, Brazil
| | - Ana Beatriz Oliveira
- Department of Physical Therapy, Biological and Health Sciences Center, Federal University of São Carlos (UFSCar), São Carlos/SP, Brazil; Laboratory of Clinical and Occupational Kinesiology (LACO) at UFSCar, São Carlos/SP, Brazil
| | - Mauricio Jamami
- Department of Physical Therapy, Biological and Health Sciences Center, Federal University of São Carlos (UFSCar), São Carlos/SP, Brazil; Spirometry and Respiratory Physiotherapy Laboratory (LEFiR) at UFSCar, São Carlos/SP, Brazil
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14
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Chrzanowski SM, Vohra RS, Lee-McMullen BA, Batra A, Spradlin RA, Morales J, Forbes S, Vandenborne K, Barton ER, Walter GA. Contrast-Enhanced Near-Infrared Optical Imaging Detects Exacerbation and Amelioration of Murine Muscular Dystrophy. Mol Imaging 2018; 16:1536012117732439. [PMID: 29271299 PMCID: PMC5985549 DOI: 10.1177/1536012117732439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Assessment of muscle pathology is a key outcome measure to measure the success of
clinical trials studying muscular dystrophies; however, few robust minimally invasive
measures exist. Indocyanine green (ICG)-enhanced near-infrared (NIR) optical imaging
offers an objective, minimally invasive, and longitudinal modality that can quantify
pathology within muscle by imaging uptake of ICG into the damaged muscles. Dystrophic mice
lacking dystrophin (mdx) or gamma-sarcoglycan (Sgcg−/−) were compared to
control mice by NIR optical imaging and magnetic resonance imaging (MRI). We determined
that optical imaging could be used to differentiate control and dystrophic mice, visualize
eccentric muscle induced by downhill treadmill running, and restore the membrane integrity
in Sgcg−/− mice following adeno-associated virus (AAV) delivery of recombinant
human SGCG (desAAV8hSGCG). We conclude that NIR optical imaging is comparable to MRI and
can be used to detect muscle damage in dystrophic muscle as compared to unaffected
controls, monitor worsening of muscle pathology in muscular dystrophy, and assess
regression of pathology following therapeutic intervention in muscular dystrophies.
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Affiliation(s)
- Stephen M Chrzanowski
- 1 Department of Physiology and Functional Genomics, University of Florida, Gainesville, FL, USA
| | - Ravneet S Vohra
- 1 Department of Physiology and Functional Genomics, University of Florida, Gainesville, FL, USA
| | | | - Abhinandan Batra
- 3 Department of Physical Therapy, University of Florida, Gainesville, FL, USA
| | - Ray A Spradlin
- 4 Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Jazmine Morales
- 4 Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Sean Forbes
- 3 Department of Physical Therapy, University of Florida, Gainesville, FL, USA
| | - Krista Vandenborne
- 3 Department of Physical Therapy, University of Florida, Gainesville, FL, USA
| | - Elisabeth R Barton
- 4 Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Glenn A Walter
- 1 Department of Physiology and Functional Genomics, University of Florida, Gainesville, FL, USA
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15
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Cabral EEA, Fregonezi GAF, Melo L, Basoudan N, Mathur S, Reid WD. Surface electromyography (sEMG) of extradiaphragm respiratory muscles in healthy subjects: A systematic review. J Electromyogr Kinesiol 2018; 42:123-135. [PMID: 30077087 DOI: 10.1016/j.jelekin.2018.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 07/04/2018] [Accepted: 07/17/2018] [Indexed: 11/27/2022] Open
Abstract
The aim of this systematic review was to examine procedures used and outcome measures reported from surface EMG (sEMG) of extradiaphragm inspiratory muscles in healthy people. Relevant articles were searched using the concepts "electromyography (EMG)", "respiratory muscles (sternocleidomastoid [SM], scalene, intercostal [IC] and parasternal)" and "healthy" in the electronic databases: MEDLINE, PubMed, EMBASE, Cochrane CENTRAL and Database of Systematic Reviews, CINAHL, SPORTDiscus, LILACS, and PEDro. Twenty-five papers were included and quality assessment was performed using an adapted Downs and Black checklist. Twenty-eight percent of included papers were classified as moderate quality and the rest were low quality. The SM was the muscle most often investigated. Description of EMG techniques were often incomplete for features such as the procedure before electrode placement, description of the surface electrodes, the EMG detection mode and amplification. Of note, descriptions of the IC muscle electrode positioning varied widely. Comparison of outcomes among studies was challenging because of the very diverse EMG outcomes reported. There are many controversies regarding methods and technique used to assess sEMG of extradiaphragm inspiratory muscles. Therefore, studies with higher methodological quality utilizing standardized EMG procedures including electrode positioning will enable accurate and reliable comparison among studies of the extradiaphragm inspiratory muscles.
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Affiliation(s)
- Elis E A Cabral
- Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN, Brazil; PneumoCardioVascular Lab, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares (EBSERH), UFRN, Natal, RN, Brazil
| | - Guilherme A F Fregonezi
- Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN, Brazil; PneumoCardioVascular Lab, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares (EBSERH), UFRN, Natal, RN, Brazil
| | - Luana Melo
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Nada Basoudan
- Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Sunita Mathur
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - W Darlene Reid
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; Toronto Rehabilitation Institute, Toronto, ON, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
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16
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Louvaris Z, Habazettl H, Wagner H, Zakynthinos S, Wagner P, Vogiatzis I. Near-infrared spectroscopy using indocyanine green dye for minimally invasive measurement of respiratory and leg muscle blood flow in patients with COPD. J Appl Physiol (1985) 2018; 125:947-959. [PMID: 29927736 DOI: 10.1152/japplphysiol.00959.2017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Reliability of near-infrared spectroscopy, measuring indocyanine green (ICG) for minimally invasive assessment of relative muscle blood flow during exercise has been examined in fit young individuals but not in chronic obstructive pulmonary disease (COPD). Here we ask whether it could be used to evaluate respiratory and locomotor muscle perfusion in COPD patients. Vastus lateralis muscle blood flow (MBF, the reference method calculated from arterial and muscle ICG concentration curves) and a blood flow index [BFI, calculated using only the (same) muscle ICG concentration curves] were compared in 10 patients (forced expiratory volume in 1 s: 51 ± 6% predicted) at rest and during cycling at 25, 50, 75, and 100% of peak work rate (WRpeak). Intercostal muscle MBF and BFI were also compared during isocapnic hyperpnea at rest, reproducing ventilation levels up to those at WRpeak. Intercostal and vastus lateralis BFI increased with increasing ventilation during hyperpnea (from 2.5 ± 0.3 to 4.5 ± 0.7 nM/s) and cycling load (from 1.0 ± 0.2 to 12.8 ± 1.9 nM/s), respectively. There were strong correlations between BFI and MBF for both intercostal ( r = 0.993 group mean data, r = 0.872 individual data) and vastus lateralis ( r = 0.994 group mean data, r = 0.895 individual data). Fold changes from rest in BFI and MBF did not differ for either the intercostal muscles or the vastus lateralis. Group mean BFI data showed strong interrelationships with respiratory and cycling workload, and whole body metabolic demand ( r ranged from 0.913 to 0.989) simultaneously recorded during exercise. We conclude that BFI is a reliable and minimally invasive tool for evaluating relative changes in respiratory and locomotor muscle perfusion from rest to peak exercise in COPD patient groups. NEW & NOTEWORTHY We show that noninvasive near-infrared spectroscopic (NIRS) detection of indocyanine green dye (ICG) after peripheral venous injection adequately reflects intercostal and locomotor muscle perfusion during exercise and hyperpnea in patients with chronic obstructive pulmonary disease (COPD). Mean, individual, and fold change responses from rest to exercise or hyperpnea correlated closely with the reference method, which requires arterial sampling. NIRS-ICG is a reliable, robust, and essentially noninvasive tool for assessing relative changes in intercostal and locomotor muscle perfusion in COPD patient groups.
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Affiliation(s)
- Zafeiris Louvaris
- GP Livanos and M Simou Laboratories, Department of Critical Care Medicine and Pulmonary Services, Medical School of Athens University, Evangelismos Hospital , Athens , Greece.,Department of Physical Education and Sports Sciences, National and Kapodistrian University of Athens , Athens , Greece.,Faculty of Kinesiology and Rehabilitation Sciences, Division of Respiratory Rehabilitation, Department Rehabilitation Sciences KU Leuven, University Hospitals Leuven , Leuven , Belgium
| | - Helmut Habazettl
- Institute of Physiology, Charite-University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health , Berlin , Germany.,Institute of Anesthesiology, German Heart Institute Berlin , Berlin , Germany
| | - Harrieth Wagner
- Department of Medicine, University of California San Diego , La Jolla, California
| | - Spyros Zakynthinos
- GP Livanos and M Simou Laboratories, Department of Critical Care Medicine and Pulmonary Services, Medical School of Athens University, Evangelismos Hospital , Athens , Greece
| | - Peter Wagner
- Department of Medicine, University of California San Diego , La Jolla, California
| | - Ioannis Vogiatzis
- GP Livanos and M Simou Laboratories, Department of Critical Care Medicine and Pulmonary Services, Medical School of Athens University, Evangelismos Hospital , Athens , Greece.,Department of Physical Education and Sports Sciences, National and Kapodistrian University of Athens , Athens , Greece.,Faculty of Health and Life Sciences, Department of Sport, Exercise, and Rehabilitation, Northumbria University , Newcastle , United Kingdom
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17
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Chino K, Ohya T, Katayama K, Suzuki Y. Diaphragmatic shear modulus at various submaximal inspiratory mouth pressure levels. Respir Physiol Neurobiol 2018; 252-253:52-57. [PMID: 29567109 DOI: 10.1016/j.resp.2018.03.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/09/2018] [Accepted: 03/19/2018] [Indexed: 02/07/2023]
Abstract
This study assessed the shear modulus of the diaphragm at various submaximal inspiratory mouth pressure levels by ultrasound shear wave elastography. In 14 healthy male subjects, diaphragmatic shear moduli were assessed at end expiration during resting breathing and at submaximal inspiratory tasks at 15, 30, 45, 60, and 75% of the maximal inspiratory mouth pressure. The shear modulus increased along with mouth pressure, and the mouth-pressure-shear-modulus relationship fit the second-order polynomial regression equation (r2 = 0.99 ± 0.01; all subjects, r2 ≥ 0.95) better than it did the simple linear regression equation (r2 = 0.94 ± 0.05; 8/14 subjects, r2 ≥ 0.95). The second regression coefficient in the second-order polynomial equation was a negative value in 10 of 14 subjects, which indicates that the second-order polynomial regression equation opened downwards. These findings suggest that the diaphragmatic shear modulus increases along with inspiratory mouth pressure, but the rate of increase slows when the pressure reaches higher levels.
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Affiliation(s)
- Kentaro Chino
- Department of Sports Science, Japan Institute of Sports Sciences, Tokyo, Japan.
| | - Toshiyuki Ohya
- Department of Sports Science, Japan Institute of Sports Sciences, Tokyo, Japan; School of Health and Sport Sciences, Chukyo University, Aichi, Japan
| | - Keisho Katayama
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan; Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yasuhiro Suzuki
- Department of Sports Science, Japan Institute of Sports Sciences, Tokyo, Japan
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18
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Dominelli PB, Archiza B, Ramsook AH, Mitchell RA, Peters CM, Molgat-Seon Y, Henderson WR, Koehle MS, Boushel R, Sheel AW. Effects of respiratory muscle work on respiratory and locomotor blood flow during exercise. Exp Physiol 2017; 102:1535-1547. [DOI: 10.1113/ep086566] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 08/21/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Paolo B. Dominelli
- School of Kinesiology; University of British Columbia; Vancouver BC Canada
| | - Bruno Archiza
- School of Kinesiology; University of British Columbia; Vancouver BC Canada
- Department of Physical Therapy; Federal University of São Carlos; São Carlos São Paulo Brazil
| | - Andrew H. Ramsook
- Centre for Heart Lung Innovation, Providence Health Care Research Institute; University of British Columbia; Vancouver BC Canada
| | - Reid A. Mitchell
- Centre for Heart Lung Innovation, Providence Health Care Research Institute; University of British Columbia; Vancouver BC Canada
| | - Carli M. Peters
- School of Kinesiology; University of British Columbia; Vancouver BC Canada
| | | | | | - Michael S. Koehle
- School of Kinesiology; University of British Columbia; Vancouver BC Canada
- Faculty of Medicine; University of British Columbia; Vancouver BC Canada
| | - Robert Boushel
- School of Kinesiology; University of British Columbia; Vancouver BC Canada
| | - A. William Sheel
- School of Kinesiology; University of British Columbia; Vancouver BC Canada
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19
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Tanaka T, Basoudan N, Melo LT, Wickerson L, Brochard LJ, Goligher EC, Reid WD. Deoxygenation of inspiratory muscles during cycling, hyperpnoea and loaded breathing in health and disease: a systematic review. Clin Physiol Funct Imaging 2017; 38:554-565. [PMID: 28940670 DOI: 10.1111/cpf.12473] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 08/28/2017] [Indexed: 11/26/2022]
Abstract
Assessing inspiratory muscle deoxygenation and blood flow can provide insight into anaerobic stress, recruitment strategies and mechanisms of inspiratory muscle limitation. Therefore, this review aimed to synthesize measurements of inspiratory muscle oxyhaemoglobin (O2 Hb), deoxyhaemoglobin (HHb), blood volume and flow of the inspiratory muscles acquired via near-infrared spectroscopy (NIRS) during cycling, hyperpnoea and loaded breathing in healthy non-athletes, healthy athletes and patients with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF). Searches were performed on Medline and Medline in-process, EMBASE, Central, Sportdiscus, PubMed and Compendex. Reviewers independently abstracted articles and assessed their quality using the modified Downs and Black checklist. Of the 644 articles identified, 21 met the inclusion criteria. Studies evaluated non-athletes (n = 9), athletes (n = 5), COPD (n = 2) and CHF (n = 5). The sample was 90% male and 73% were non-athletes and athletes. Interventions included cycle ergometry, hyperpnoea, loaded breathing, elbow flexor loading and combined loaded breathing and ergometry. Athletes and patients with CHF or COPD demonstrated deoxygenation of inspiratory accessory muscles that was often an opposite or exaggerated pattern compared to non-athletes. O2 Hb decreased and HHb increased significantly in inspiratory muscles during cycle ergometry and loaded breathing with accentuated changes during combined ergometry and loaded breathing. During different regimens of hyperpnoea or loaded breathing, comparisons of inspiratory muscles demonstrated that the sternocleidomastoid deoxygenated more than the intercostals, parasternals or scalenes. Evaluating inspiratory muscle deoxygenation via NIRS can inform mechanisms of inspiratory muscle limitation in non-athletes, athletes and patients with CHF or COPD.
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Affiliation(s)
- Takako Tanaka
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Nada Basoudan
- College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Luana T Melo
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Lisa Wickerson
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Laurent J Brochard
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.,Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ewan C Goligher
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.,Department of Medicine, Division of Respirology, University Health Network and Mount Sinai Hospital, Toronto, ON, Canada
| | - W Darlene Reid
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute, University Hospital Network, Toronto, ON, Canada
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20
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Oueslati F, Girard O, Tabka Z, Ahmaidi S. Excess VO2 during ramp exercise is positively correlated to intercostal muscles deoxyhemoglobin levels above the gas exchange threshold in young trained cyclists. Respir Physiol Neurobiol 2016; 228:83-90. [PMID: 26996071 DOI: 10.1016/j.resp.2016.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 03/02/2016] [Accepted: 03/15/2016] [Indexed: 11/16/2022]
Abstract
We assessed respiratory muscles oxygenation responses during a ramp exercise to exhaustion and further explored their relationship with the non-linear increase of VO2 (VO2 excess) observed above the gas-exchange threshold. Ten male cyclists completed a ramp exercise to exhaustion on an electromagnetically braked cycle-ergometer with a rate of increment of 30Wmin(-1) with continuous monitoring of expired gases (breath-by-breath) and oxygenation status of intercostal muscles. Maximal inspiratory and expiratory pressure measurements were taken at rest and at exhaustion. The VO2 excess represents the difference between VO2max observed and VO2max expected using linear equation between the VO2 and the intensity before gas-exchange threshold. The deoxyhemoglobin remained unchanged until 60% of maximal aerobic power (MAP) and thereafter increased significantly by 37±18% and 40±22% at 80% and 100% of MAP, respectively. Additionally, the amplitude of deoxyhemoglobin increase between 60 and 100% of MAP positively correlated with the VO2 excess (r=0.69, p<0.05). Compared to exercise start, the oxygen tissue saturation index decreased from 80% of MAP (-4.8±3.2%, p<0.05) onwards. At exhaustion, maximal inspiratory and expiratory pressures declined by 7.8±16% and 12.6±10% (both p<0.05), respectively. In summary, our results suggest a significant contribution of respiratory muscles to the VO2 excess phenomenon.
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Affiliation(s)
- Ferid Oueslati
- EA-3300, APERE, Sport Sciences Department, University of Picardie Jules Verne, Amiens, France; UR12ES06, Medicine Department, University of Sousse, Sousse, Tunisia; Faculty of Sciences of Bizerte, University of Carthage, Tunisia.
| | - Olivier Girard
- Institute of Sport Sciences University of Lausanne (ISSUL), University of Lausanne, Lausanne, Switzerland
| | - Zouhair Tabka
- UR12ES06, Medicine Department, University of Sousse, Sousse, Tunisia
| | - Said Ahmaidi
- EA-3300, APERE, Sport Sciences Department, University of Picardie Jules Verne, Amiens, France
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21
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Limitations of respiratory muscle and vastus lateralis blood flow during continuous exercise. Respir Physiol Neurobiol 2012; 181:302-7. [DOI: 10.1016/j.resp.2012.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 04/02/2012] [Accepted: 04/03/2012] [Indexed: 11/24/2022]
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