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Raberin A, Manferdelli G, Schorderet F, Bourdillon N, Millet GP. Fitness Level- and Sex-Related Differences in Pulmonary Limitations to Maximal Exercise in Normoxia and Hypoxia. Med Sci Sports Exerc 2024; 56:1398-1407. [PMID: 38530208 DOI: 10.1249/mss.0000000000003433] [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: 03/27/2024]
Abstract
PURPOSE Both maximal-intensity exercise and altitude exposure challenge the pulmonary system that may reach its maximal capacities. Expiratory flow limitation (EFL) and exercise-induced hypoxemia (EIH) are common in endurance-trained athletes. Furthermore, because of their smaller airways and lung size, women, independently of their fitness level, may be more prone to pulmonary limitations during maximal-intensity exercise, particularly when performed in hypoxic conditions. The objective of this study was to investigate the impact of sex and fitness level on pulmonary limitations during maximal exercise in normoxia and their consequences in acute hypoxia. METHODS Fifty-one participants were distributed across four different groups according to sex and fitness level. Participants visited the laboratory on three occasions to perform maximal incremental cycling tests in normoxia and hypoxia (inspired oxygen fraction = 0.14) and two hypoxic chemosensitivity tests. Pulmonary function and ventilatory capacities were evaluated at each visit. RESULTS EIH was more prevalent (62.5% vs 22.2%, P = 0.004) and EFL less common (37.5% vs 70.4%, P = 0.019) in women than men. EIH prevalence was different ( P = 0.004) between groups of trained men (41.7%), control men (6.7%), trained women (50.0%), and control women (75.0%). All EIH men but only 40% of EIH women exhibited EFL. EFL individuals had higher slope ratio ( P = 0.029), higher ventilation (V̇ E ) ( P < 0.001), larger ΔVO 2max ( P = 0.019), and lower hypoxia-related V̇ E increase ( P < 0.001). CONCLUSIONS Women reported a higher EIH prevalence than men, regardless of their fitness level, despite a lower EFL prevalence. EFL seems mainly due to the imbalance between ventilatory demands and capacities. It restricts ventilation, leading to a larger performance impairment during maximal exercise in hypoxic conditions.
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Affiliation(s)
- Antoine Raberin
- Institute of Sport Sciences, University of Lausanne, Lausanne, SWITZERLAND
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Raberin A, Burtscher J, Citherlet T, Manferdelli G, Krumm B, Bourdillon N, Antero J, Rasica L, Malatesta D, Brocherie F, Burtscher M, Millet GP. Women at Altitude: Sex-Related Physiological Responses to Exercise in Hypoxia. Sports Med 2024; 54:271-287. [PMID: 37902936 PMCID: PMC10933174 DOI: 10.1007/s40279-023-01954-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 11/01/2023]
Abstract
Sex differences in physiological responses to various stressors, including exercise, have been well documented. However, the specific impact of these differences on exposure to hypoxia, both at rest and during exercise, has remained underexplored. Many studies on the physiological responses to hypoxia have either excluded women or included only a limited number without analyzing sex-related differences. To address this gap, this comprehensive review conducted an extensive literature search to examine changes in physiological functions related to oxygen transport and consumption in hypoxic conditions. The review encompasses various aspects, including ventilatory responses, cardiovascular adjustments, hematological alterations, muscle metabolism shifts, and autonomic function modifications. Furthermore, it delves into the influence of sex hormones, which evolve throughout life, encompassing considerations related to the menstrual cycle and menopause. Among these physiological functions, the ventilatory response to exercise emerges as one of the most sex-sensitive factors that may modify reactions to hypoxia. While no significant sex-based differences were observed in cardiac hemodynamic changes during hypoxia, there is evidence of greater vascular reactivity in women, particularly at rest or when combined with exercise. Consequently, a diffusive mechanism appears to be implicated in sex-related variations in responses to hypoxia. Despite well-established sex disparities in hematological parameters, both acute and chronic hematological responses to hypoxia do not seem to differ significantly between sexes. However, it is important to note that these responses are sensitive to fluctuations in sex hormones, and further investigation is needed to elucidate the impact of the menstrual cycle and menopause on physiological responses to hypoxia.
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Affiliation(s)
- Antoine Raberin
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Johannes Burtscher
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Tom Citherlet
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Giorgio Manferdelli
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Bastien Krumm
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Nicolas Bourdillon
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Juliana Antero
- Institut de Recherche Bio-Médicale Et d'Épidémiologie du Sport (EA 7329), French Institute of Sport, Paris, France
| | - Letizia Rasica
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Davide Malatesta
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Franck Brocherie
- Laboratory Sport, Expertise and Performance (EA 7370), French Institute of Sport, Paris, France
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Grégoire P Millet
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
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3
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Mainzer G, Zucker-Toledano M, Hanna M, Bar-Yoseph R, Kodesh E. Significant exercise limitations after recovery from MIS-C related myocarditis. World J Pediatr 2023; 19:1149-1154. [PMID: 37127785 PMCID: PMC10150685 DOI: 10.1007/s12519-023-00722-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 03/30/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Myocarditis is one of the presentations of multisystemic inflammatory syndrome in children (MIS-C) following coronavirus disease 2019 (COVID-19). Although the reported short-term prognosis is good, data regarding medium-term functional capacity and limitations are scarce. This study aimed to evaluate exercise capacity as well as possible cardiac and respiratory limitations in children recovered from MIS-C related myocarditis. METHODS Fourteen patients who recovered from MIS-C related myocarditis underwent spirometry and cardiopulmonary exercise testing (CPET), and their results were compared with an age-, sex-, weight- and activity level-matched healthy control group (n = 14). RESULTS All participants completed the CPET with peak oxygen uptake (peak [Formula: see text]), and the results were within the normal range (MIS-C 89.3% ± 8.9% and Control 87.9% ± 13.7% predicted [Formula: see text]). Five post-MIS-C patients (35%) had exercise-related cardio-respiratory abnormalities, including oxygen desaturation and oxygen-pulse flattening, compared to none in the control group. The MIS-C group also had lower peak exercise saturation (95.6 ± 3.5 vs. 97.6 ± 1.1) and lower breathing reserve (17.4% ± 7.5% vs. 27.4% ± 14.0% of MVV). CONCLUSIONS Patients who recovered from MIS-C related myocarditis may present exercise limitations. Functional assessment (e.g., CPET) should be included in routine examinations before allowing a return to physical activity in post-MIS-C myocarditis. Larger, longer term studies assessing functional capacity and focusing on physiological mechanisms are needed.
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Affiliation(s)
- Gur Mainzer
- Pediatric Heart Institute, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 52621, Tel Hashomer, Israel.
- Pediatric Cardiology Department, Hadassah Medical Center, Jerusalem, Israel.
- Pediatric Cardiology Unit, Padeh Medical Center, Poriya, Israel.
| | - Merav Zucker-Toledano
- Pediatric Cardiology Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Moneera Hanna
- Pediatric Pulmonary Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Ronen Bar-Yoseph
- Pediatric Pulmonary Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel
- The Technion Faculty of Medicine, Haifa, Israel
| | - Einat Kodesh
- Pediatric Cardiology Unit, Padeh Medical Center, Poriya, Israel
- Department of Physical Therapy, Faculty of Social Welfare and Health Science, University of Haifa, Haifa, Israel
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4
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Kalinov R, Marinov B, Vladimirova-Kitova L, Hodzhev V, Kostianev S. The six-minute walk test - a reliable test for detection of exercise-related desaturation in patients with chronic obstructive pulmonary disease. Folia Med (Plovdiv) 2023; 65:569-576. [PMID: 37655374 DOI: 10.3897/folmed.65.e85983] [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: 04/29/2022] [Accepted: 01/23/2023] [Indexed: 09/02/2023] Open
Abstract
INTRODUCTION Exercise-induced desaturation is common in patients with moderate to severe chronic obstructive pulmonary disease (COPD). It provides additional information about physical capacity and disease evolution, and it is an important predictor of mortality.
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Manferdelli G, Narang BJ, Bourdillon N, Debevec T, Millet GP. Physiological Responses to Exercise in Hypoxia in Preterm Adults: Convective and Diffusive Limitations in the O 2 Transport. Med Sci Sports Exerc 2023; 55:482-496. [PMID: 36459101 DOI: 10.1249/mss.0000000000003077] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
PURPOSE Premature birth induces long-term sequelae on the cardiopulmonary system, leading to reduced exercise capacity. However, the mechanisms of this functional impairment during incremental exercise remain unclear. Also, a blunted hypoxic ventilatory response was found in preterm adults, suggesting an increased risk for adverse effects of hypoxia in this population. This study aimed to investigate the oxygen cascade during incremental exercise to exhaustion in both normoxia and hypobaric hypoxia in prematurely born adults with normal lung function and their term born counterparts. METHODS Noninvasive measures of gas exchange, cardiac hemodynamics, and both muscle and cerebral oxygenation were continuously performed using metabolic cart, transthoracic impedance, and near-infrared spectroscopy, respectively, during an incremental exercise test to exhaustion performed at sea level and after 3 d of high-altitude exposure in healthy preterm ( n = 17; gestational age, 29 ± 1 wk; normal lung function) and term born ( n = 17) adults. RESULTS At peak, power output, oxygen uptake, stroke volume indexed for body surface area, and cardiac output were lower in preterm compared with term born in normoxia ( P = 0.042, P = 0.027, P = 0.030, and P = 0.018, respectively) but not in hypoxia, whereas pulmonary ventilation, peripheral oxygen saturation, and muscle and cerebral oxygenation were similar between groups. These later parameters were modified by hypoxia ( P < 0.001). Hypoxia increased muscle oxygen extraction at submaximal and maximal intensity in term born ( P < 0.05) but not in preterm participants. Hypoxia decreased cerebral oxygen saturation in term born but not in preterm adults at rest and during exercise ( P < 0.05). Convective oxygen delivery was decreased by hypoxia in term born ( P < 0.001) but not preterm adults, whereas diffusive oxygen transport decreased similarly in both groups ( P < 0.001 and P < 0.001, respectively). CONCLUSIONS These results suggest that exercise capacity in preterm is primarily reduced by impaired convective, rather than diffusive, oxygen transport. Moreover, healthy preterm adults may experience blunted hypoxia-induced impairments during maximal exercise compared with their term counterparts.
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Affiliation(s)
| | | | - Nicolas Bourdillon
- Institute of Sport Sciences, University of Lausanne, Lausanne, SWITZERLAND
| | | | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, SWITZERLAND
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Carin R, Deglicourt G, Rezigue H, Martin M, Nougier C, Boisson C, Dargaud Y, Joly P, Renoux C, Connes P, Stauffer E, Nader E. Effects of a Maximal Exercise Followed by a Submaximal Exercise Performed in Normobaric Hypoxia (2500 m), on Blood Rheology, Red Blood Cell Senescence, and Coagulation in Well-Trained Cyclists. Metabolites 2023; 13:metabo13020179. [PMID: 36837797 PMCID: PMC9964623 DOI: 10.3390/metabo13020179] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 01/27/2023] Open
Abstract
Acute normoxic exercise impacts the rheological properties of red blood cells (RBC) and their senescence state; however, there is a lack of data on the effects of exercise performed in hypoxia on RBC properties. This crossover study compared the effects of acute hypoxia vs. normoxia on blood rheology, RBC senescence, and coagulation during exercise. Nine trained male cyclists completed both a session in normoxia (FiO2 = 21%) and hypoxia (FiO2 = 15.3% ≈ 2500 m). The two sessions were randomly performed, separated by one week, and consisted of an incremental and maximal exercise followed by a 20 min exercise at the first ventilatory threshold (VT1) on a home-trainer. Blood samples were taken before and after exercise to analyze hematological parameters, blood rheology (hematocrit, blood viscosity, RBC deformability and aggregation), RBC senescence markers (phosphatidylserine (PS) and CD47 exposure, intraerythrocyte reactive oxygen species (ROS), and calcium content), and blood clot viscoelastic properties. Hemoglobin oxygen saturation (SpO2) and blood lactate were also measured. In both conditions, exercise induced an increase in blood viscosity, hematocrit, intraerythrocyte calcium and ROS content, and blood lactate concentration. We also observed an increase in blood clot amplitude, and a significant drop in SpO2 during exercise in the two conditions. RBC aggregation and CD47 exposure were not modified. Exercise in hypoxia induced a slight decrease in RBC deformability which could be related to the slight increase in mean corpuscular hemoglobin concentration (MCHC). However, the values of RBC deformability and MCHC after the exercise performed in hypoxia remained in the normal range of values. In conclusion, acute hypoxia does not amplify the RBC and coagulation changes induced by an exercise bout.
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Affiliation(s)
- Romain Carin
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team “Vascular Biology and Red Blood Cell”, Universié Claude Bernard Lyon 1, Université de Lyon, 69007 Lyon, France
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris, France
| | - Gabriel Deglicourt
- Exploration Fonctionnelle Respiratoire, Médecine du Sport et de l’activité Physique, Hospices Civils de Lyon, Hôpital de la Croix Rousse, 69004 Lyon, France
| | - Hamdi Rezigue
- Service d’hématologie-hémostase, Hospices Civils de Lyon, 69002 Bron, France
| | - Marie Martin
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team “Vascular Biology and Red Blood Cell”, Universié Claude Bernard Lyon 1, Université de Lyon, 69007 Lyon, France
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris, France
| | - Christophe Nougier
- Service d’hématologie-hémostase, Hospices Civils de Lyon, 69002 Bron, France
- EA 4609-Hémostase et Thrombose, SFR Lyon Est, Université Claude Bernard Lyon I, 69100 Lyon, France
| | - Camille Boisson
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team “Vascular Biology and Red Blood Cell”, Universié Claude Bernard Lyon 1, Université de Lyon, 69007 Lyon, France
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris, France
| | - Yesim Dargaud
- Service d’hématologie-hémostase, Hospices Civils de Lyon, 69002 Bron, France
- EA 4609-Hémostase et Thrombose, SFR Lyon Est, Université Claude Bernard Lyon I, 69100 Lyon, France
| | - Philippe Joly
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team “Vascular Biology and Red Blood Cell”, Universié Claude Bernard Lyon 1, Université de Lyon, 69007 Lyon, France
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris, France
- Service de Biochimie et de Biologie Moléculaire, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, 69002 Bron, France
| | - Céline Renoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team “Vascular Biology and Red Blood Cell”, Universié Claude Bernard Lyon 1, Université de Lyon, 69007 Lyon, France
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris, France
- Service de Biochimie et de Biologie Moléculaire, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, 69002 Bron, France
| | - Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team “Vascular Biology and Red Blood Cell”, Universié Claude Bernard Lyon 1, Université de Lyon, 69007 Lyon, France
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris, France
| | - Emeric Stauffer
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team “Vascular Biology and Red Blood Cell”, Universié Claude Bernard Lyon 1, Université de Lyon, 69007 Lyon, France
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris, France
- Exploration Fonctionnelle Respiratoire, Médecine du Sport et de l’activité Physique, Hospices Civils de Lyon, Hôpital de la Croix Rousse, 69004 Lyon, France
| | - Elie Nader
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team “Vascular Biology and Red Blood Cell”, Universié Claude Bernard Lyon 1, Université de Lyon, 69007 Lyon, France
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 79015 Paris, France
- Correspondence:
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Abe M, Ushio K, Ishii Y, Nakashima Y, Iwaki D, Fukuhara K, Takahashi M, Mikami Y. A method of determining anaerobic threshold from percutaneous oxygen saturation. Sci Rep 2022; 12:20081. [PMID: 36418407 PMCID: PMC9684533 DOI: 10.1038/s41598-022-24271-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/14/2022] [Indexed: 11/24/2022] Open
Abstract
The anaerobic threshold (AT) is the point of the aerobic-to-anaerobic metabolic switch. Despite the many clinical applications of AT, this measurement requires sophisticated equipment and skills. Here, we investigated a simple measurement method for AT using percutaneous oxygen saturation (SpO2) and pulse rate (PR) with a pulse oximeter in a study of exercise stress on healthy volunteers. Twenty individuals (ten men and ten women) were included in the study. Various respiratory parameters, including AT, were measured using conventional analytical methods. The SpO2 threshold (ST) was calculated using the SpO2-Slope method. The mean ± standard deviations SpO2 at ST was 97.8% ± 0.3% in men and 99.0 ± 0.3% in women. The concordance and interchangeability between ST and various five different types of AT, the ventilatory equivalent for oxygen (VE/VO2_AT), V-Slope (V-Slope_AT), ventilatory equivalent (VE_AT), respiratory exchange ratio (R_AT), and partial pressure of end-tidal oxygen (PETO2_AT) were generally high, with positive correlation coefficients in the range of [0.68-0.80]. These findings suggest that the SpO2-Slope method with a pulse oximeter may be a useful and simple method to determine AT compared to conventional methods.
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Affiliation(s)
- Masatsugu Abe
- FANCL Corporation Research Institute, 2-13 Kamishinano, Totsuka-ku, Yokohama, Kanagawa 244-0806 Japan
| | - Kai Ushio
- grid.470097.d0000 0004 0618 7953Department of Rehabilitation Medicine, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551 Japan
| | - Yuri Ishii
- FANCL Corporation Research Institute, 2-13 Kamishinano, Totsuka-ku, Yokohama, Kanagawa 244-0806 Japan
| | - Yuki Nakashima
- grid.470097.d0000 0004 0618 7953Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Daisuke Iwaki
- grid.470097.d0000 0004 0618 7953Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Kouki Fukuhara
- grid.470097.d0000 0004 0618 7953Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Makoto Takahashi
- grid.257022.00000 0000 8711 3200Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yukio Mikami
- grid.470097.d0000 0004 0618 7953Department of Rehabilitation Medicine, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551 Japan
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Reiterer M, Eakin A, Johnson RS, Branco CM. Hyperoxia Reprogrammes Microvascular Endothelial Cell Response to Hypoxia in an Organ-Specific Manner. Cells 2022; 11:cells11162469. [PMID: 36010546 PMCID: PMC9406746 DOI: 10.3390/cells11162469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/27/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022] Open
Abstract
Organ function relies on microvascular networks to maintain homeostatic equilibrium, which varies widely in different organs and during different physiological challenges. The endothelium role in this critical process can only be evaluated in physiologically relevant contexts. Comparing the responses to oxygen flux in primary murine microvascular EC (MVEC) obtained from brain and lung tissue reveals that supra-physiological oxygen tensions can compromise MVEC viability. Brain MVEC lose mitochondrial activity and undergo significant alterations in electron transport chain (ETC) composition when cultured under standard, non-physiological atmospheric oxygen levels. While glycolytic capacity of both lung and brain MVEC are unchanged by environmental oxygen, the ability to trigger a metabolic shift when oxygen levels drop is greatly compromised following exposure to hyperoxia. This is particularly striking in MVEC from the brain. This work demonstrates that the unique metabolism and function of organ-specific MVEC (1) can be reprogrammed by external oxygen, (2) that this reprogramming can compromise MVEC survival and, importantly, (3) that ex vivo modelling of endothelial function is significantly affected by culture conditions. It further demonstrates that physiological, metabolic and functional studies performed in non-physiological environments do not represent cell function in situ, and this has serious implications in the interpretation of cell-based pre-clinical models.
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Affiliation(s)
- Moritz Reiterer
- Patrick G Johnston Centre for Cancer Research, Queen’s University, Belfast BT9 7AE, UK
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge CB2 3EG, UK
| | - Amanda Eakin
- Patrick G Johnston Centre for Cancer Research, Queen’s University, Belfast BT9 7AE, UK
| | - Randall S. Johnson
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge CB2 3EG, UK
| | - Cristina M. Branco
- Patrick G Johnston Centre for Cancer Research, Queen’s University, Belfast BT9 7AE, UK
- Correspondence:
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Ferretti G, Fagoni N, Taboni A, Vinetti G, di Prampero PE. A century of exercise physiology: key concepts on coupling respiratory oxygen flow to muscle energy demand during exercise. Eur J Appl Physiol 2022; 122:1317-1365. [PMID: 35217911 PMCID: PMC9132876 DOI: 10.1007/s00421-022-04901-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/25/2022] [Indexed: 12/26/2022]
Abstract
After a short historical account, and a discussion of Hill and Meyerhof's theory of the energetics of muscular exercise, we analyse steady-state rest and exercise as the condition wherein coupling of respiration to metabolism is most perfect. The quantitative relationships show that the homeostatic equilibrium, centred around arterial pH of 7.4 and arterial carbon dioxide partial pressure of 40 mmHg, is attained when the ratio of alveolar ventilation to carbon dioxide flow ([Formula: see text]) is - 21.6. Several combinations, exploited during exercise, of pertinent respiratory variables are compatible with this equilibrium, allowing adjustment of oxygen flow to oxygen demand without its alteration. During exercise transients, the balance is broken, but the coupling of respiration to metabolism is preserved when, as during moderate exercise, the respiratory system responds faster than the metabolic pathways. At higher exercise intensities, early blood lactate accumulation suggests that the coupling of respiration to metabolism is transiently broken, to be re-established when, at steady state, blood lactate stabilizes at higher levels than resting. In the severe exercise domain, coupling cannot be re-established, so that anaerobic lactic metabolism also contributes to sustain energy demand, lactate concentration goes up and arterial pH falls continuously. The [Formula: see text] decreases below - 21.6, because of ensuing hyperventilation, while lactate keeps being accumulated, so that exercise is rapidly interrupted. The most extreme rupture of the homeostatic equilibrium occurs during breath-holding, because oxygen flow from ambient air to mitochondria is interrupted. No coupling at all is possible between respiration and metabolism in this case.
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Affiliation(s)
- Guido Ferretti
- Dipartimento di Medicina Molecolare e Traslazionale, Università di Brescia, Brescia, Italy.
- Département d'Anesthésiologie, Pharmacologie et Soins Intensifs, Université de Genève, Genève, Switzerland.
| | - Nazzareno Fagoni
- Dipartimento di Medicina Molecolare e Traslazionale, Università di Brescia, Brescia, Italy
| | - Anna Taboni
- Département d'Anesthésiologie, Pharmacologie et Soins Intensifs, Université de Genève, Genève, Switzerland
| | - Giovanni Vinetti
- Dipartimento di Medicina Molecolare e Traslazionale, Università di Brescia, Brescia, Italy
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10
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Coyle MA, Goss CS, Manz WJ, Greenshields JT, Chapman RF, Stager JM. Nedocromil sodium and diphenhydramine HCl ameliorate exercise-induced arterial hypoxemia in highly trained athletes. Physiol Rep 2022; 10:e15149. [PMID: 35001564 PMCID: PMC8743671 DOI: 10.14814/phy2.15149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 10/25/2021] [Accepted: 11/04/2021] [Indexed: 06/14/2023] Open
Abstract
INTRODUCTION Exercise-induced arterial hypoxemia (EIAH) has been observed in highly trained endurance athletes during near maximal exercise, which may be influenced by a histamine-mediated inflammatory response at the pulmonary capillary-alveolar membrane. In order to test this hypothesis, we examined whether the mast cell stabilizer nedocromil sodium (NS) and H1 -receptor antagonist diphenhydramine HCL (DH) would ameliorate EIAH and mitigate the drop in arterial oxyhemoglobin saturation (Sa O2 ) during intensive exercise. METHODS Seven highly trained male cross country runners (age, 21 ± 2 years; V̇O2max , 74.7 ± 3.5 ml·kg-1 ·min-1 ) participated in the study. All subjects completed a maximal exercise treadmill test to exhaustion, followed by three 5-min constant-load exercise bouts at 70%, 80%, and 90% V̇O2max . Prior to testing, subjects received either placebo (PL), NS, or DH. RESULTS Compared to PL, there was a significant treatment effect on Sa O2 (p < 0.001) for both NS and DH during both constant-load exercise and at V̇O2max . Post hoc tests revealed Sa O2 values, compared to PL, were significantly higher at V̇O2max and during DH trials and higher with NS at constant-load intensities except at 70% (p = 0.13). CONCLUSION The findings provide further evidence that histamine contributes directly or indirectly to the development of EIAH during intense exercise in highly trained athletes.
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Affiliation(s)
- Michael A. Coyle
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| | - Curtis S. Goss
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| | - Wesley J. Manz
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
- Department of Orthopaedic SurgeryEmory University School of MedicineAtlantaGeorgiaUSA
| | - Joel T. Greenshields
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
- Dr. Lawrence D. Rink Center for Sports Medicine and TechnologyDepartment of Intercollegiate AthletesIndiana UniversityBloomingtonIndianaUSA
| | - Robert F. Chapman
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| | - Joel M. Stager
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
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11
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Burtscher M, Viscor G. How important is V̇O 2max when climbing Mt. Everest (8,849 m)? Respir Physiol Neurobiol 2021; 297:103833. [PMID: 34952230 DOI: 10.1016/j.resp.2021.103833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/12/2021] [Accepted: 12/20/2021] [Indexed: 11/18/2022]
Abstract
The maximal rate of oxygen uptake (V̇O2max) of humans declines with increasing altitude, but represents the upper limit of aerobic endurance performance at low and high altitude as well. Before Reinhold Messner and Peter Habeler climbed Mt. Everest first (1978) without supplemental oxygen, physiologists have doubted whether this would be possible due to insufficient V̇O2max remaining when approaching the summit (8849 m). Subsequently, several studies evaluated the decline in the V̇O2max levels at real and simulated extreme altitudes. However, the potential influence of the preexisting individual sea level V̇O2max remained largely unconsidered. Based on available studies and case observations, here we discuss the observed and expected decline of V̇O2max up to 8849 m dependent on the individual sea level V̇O2max. It is concluded that a high sea level V̇O2max and an only moderate decline of arterial oxygen saturation and associated V̇O2max with increasing altitude, due to appropriate acclimatization and ascent strategies, enable certain mountaineers to climb 8,000er summits and even the Everest without supplemental oxygen.
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Affiliation(s)
- Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria.
| | - Ginés Viscor
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, University of Barcelona, Barcelona, Spain
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12
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Implication of Blood Rheology and Pulmonary Hemodynamics on Exercise-Induced Hypoxemia at Sea Level and Altitude in Athletes. Int J Sport Nutr Exerc Metab 2021; 31:397-405. [PMID: 34303308 DOI: 10.1123/ijsnem.2021-0013] [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: 01/19/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/18/2022]
Abstract
This study aimed to investigate the changes in blood viscosity, pulmonary hemodynamics, nitric oxide (NO) production, and maximal oxygen uptake (V˙O2max) during a maximal incremental test conducted in normoxia and during exposure to moderate altitude (2,400 m) in athletes exhibiting exercise-induced hypoxemia at sea level (EIH). Nine endurance athletes with EIH and eight without EIH (NEIH) performed a maximal incremental test under three conditions: sea level, 1 day after arrival in hypoxia, and 5 days after arrival in hypoxia (H5) at 2,400 m. Gas exchange and oxygen peripheral saturation (SpO2) were continuously monitored. Cardiac output, pulmonary arterial pressure, and total pulmonary vascular resistance were assessed by echocardiography. Venous blood was sampled before and 3 min after exercise cessation to analyze blood viscosity and NO end-products. At sea level, athletes with EIH exhibited an increase in blood viscosity and NO levels during exercise while NEIH athletes showed no change. Pulmonary hemodynamics and aerobic performance were not different between the two groups. No between-group differences in blood viscosity, pulmonary hemodynamics, and V˙O2max were found at 1 day after arrival in hypoxia. At H5, lower total pulmonary vascular resistance and greater NO concentration were reported in response to exercise in EIH compared with NEIH athletes. EIH athletes had greater cardiac output and lower SpO2 at maximal exercise in H5, but no between-group differences occurred regarding blood viscosity and V˙O2max. The pulmonary vascular response observed at H5 in EIH athletes may be involved in the greater cardiac output of EIH group and counterbalanced the drop in SpO2 in order to achieve similar V˙O2max than NEIH athletes.
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13
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Petek BJ, Gustus SK, Wasfy MM. Cardiopulmonary Exercise Testing in Athletes: Expect the Unexpected. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2021; 23. [DOI: 10.1007/s11936-021-00928-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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14
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Durand F, Raberin A. Exercise-Induced Hypoxemia in Endurance Athletes: Consequences for Altitude Exposure. Front Sports Act Living 2021; 3:663674. [PMID: 33981992 PMCID: PMC8107360 DOI: 10.3389/fspor.2021.663674] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/25/2021] [Indexed: 11/26/2022] Open
Abstract
Exercise-induced hypoxemia (EIH) is well-described in endurance-trained athletes during both maximal and submaximal exercise intensities. Despite the drop in oxygen (O2) saturation and provided that training volumes are similar, athletes who experience EIH nevertheless produce the same endurance performance in normoxia as athletes without EIH. This lack of a difference prompted trainers to consider that the phenomenon was not relevant to performance but also suggested that a specific adaptation to exercise is present in EIH athletes. Even though the causes of EIH have been extensively studied, its consequences have not been fully characterized. With the development of endurance outdoor activities and altitude/hypoxia training, athletes often train and/or compete in this stressful environment with a decrease in the partial pressure of inspired O2 (due to the drop in barometric pressure). Thus, one can reasonably hypothesize that EIH athletes can specifically adapt to hypoxemic episodes during exercise at altitude. Although our knowledge of the interactions between EIH and acute exposure to hypoxia has improved over the last 10 years, many questions have yet to be addressed. Firstly, endurance performance during acute exposure to altitude appears to be more impaired in EIH vs. non-EIH athletes but the corresponding physiological mechanisms are not fully understood. Secondly, we lack information on the consequences of EIH during chronic exposure to altitude. Here, we (i) review research on the consequences of EIH under acute hypoxic conditions, (ii) highlight unresolved questions about EIH and chronic hypoxic exposure, and (iii) suggest perspectives for improving endurance training.
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Affiliation(s)
- Fabienne Durand
- Images Espace Dev, Université de Perpignan Via Domitia, Perpignan, France
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15
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Dempsey JA, La Gerche A, Hull JH. Is the healthy respiratory system built just right, overbuilt, or underbuilt to meet the demands imposed by exercise? J Appl Physiol (1985) 2020; 129:1235-1256. [PMID: 32790594 DOI: 10.1152/japplphysiol.00444.2020] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
In the healthy, untrained young adult, a case is made for a respiratory system (airways, pulmonary vasculature, lung parenchyma, respiratory muscles, and neural ventilatory control system) that is near ideally designed to ensure a highly efficient, homeostatic response to exercise of varying intensities and durations. Our aim was then to consider circumstances in which the intra/extrathoracic airways, pulmonary vasculature, respiratory muscles, and/or blood-gas distribution are underbuilt or inadequately regulated relative to the demands imposed by the cardiovascular system. In these instances, the respiratory system presents a significant limitation to O2 transport and contributes to the occurrence of locomotor muscle fatigue, inhibition of central locomotor output, and exercise performance. Most prominent in these examples of an "underbuilt" respiratory system are highly trained endurance athletes, with additional influences of sex, aging, hypoxic environments, and the highly inbred equine. We summarize by evaluating the relative influences of these respiratory system limitations on exercise performance and their impact on pathophysiology and provide recommendations for future investigation.
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Affiliation(s)
- Jerome A Dempsey
- John Robert Sutton Professor of Population Health Sciences, John Rankin Laboratory of Pulmonary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - Andre La Gerche
- Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, Australia.,National Center for Sports Cardiology, St. Vincent's Hospital, Melbourne, Fitzroy, Australia
| | - James H Hull
- Department of Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom.,Institute of Sport, Exercise and Health (ISEH), University College London, United Kingdom
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16
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Kiani A, Eslaminejad A, Shafeipour M, Razavi F, Seyyedi SR, Sharif-Kashani B, Emami H, Bakhshayesh-Karam M, Abedini A. Spirometry, cardiopulmonary exercise testing and the six-minute walk test results in sarcoidosis patients. SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 2020; 36:185-194. [PMID: 32476953 DOI: 10.36141/svdld.v36i3.7663] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 03/05/2019] [Indexed: 11/02/2022]
Abstract
Background The 6-minute walking test, cardiopulmonary exercise testing, and spirometry are useful tools for evaluation of respiratory impairment and functional capacity in patients with lung disease. Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Objectives Since the pulmonary involvement can affect the quality of life in sarcoidosis patients, this study is aimed to evaluate the tests mentioned above in order to examine the functional capacity of sarcoidosis patients in different stages as well as the cause of exercise intolerance. Methods This cross-sectional study was carried out on 50 Iranian patients with sarcoidosis. Patients were classified into three groups based on the findings of the chest radiography as well as the pulmonary CT scan, reported by an expert radiologist. Pulmonary, cardiac, and activity function have been evaluated in the patients, using cardiopulmonary exercise testing, the 6-minutes walking test, and spirometry. Results In cardiopulmonary exercise testing, percent-predicted peak VO2 (57.75±15.49, p=0.015) and percent-predicted O2 pulse (70.54±17.37, p=0.013) were significantly lower in the third group, in comparison with the others. Also, VE/CO2 (AT) (34.99±5.67, p=0.000) was significantly higher in the third group, in comparison with the other ones. Percent-predicted VO2 showed a strong positive correlation with age (r=0.377, p=0.009), TSH (r= 0.404, p=0.007), and percent-predicted FVC (r=0.443, p=0.002). In addition, O2 pulse had a positive correlation with BMI (r=0.324, p=0.026), percent-predicted FVC (r=0.557, p= 0.000), and percent-predicted FEV1 (r=0.316, p=0.032). Conclusions According to this study, ventilatory limitation, pulmonary involvement, and deconditioning are the main causes of activity limitations in sarcoidosis patients.
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Affiliation(s)
- Arda Kiani
- Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Eslaminejad
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Shafeipour
- Departments of Pulmonology, Kerman University Of Medical Science, Kerman, Iran
| | - Fatemeh Razavi
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyyed Reza Seyyedi
- Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Babak Sharif-Kashani
- Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Habib Emami
- Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehrdad Bakhshayesh-Karam
- Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atefeh Abedini
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
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17
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Stensrud T, Rossvoll Ø, Mathiassen M, Melau J, Illidi C, Østgaard HN, Hisdal J, Stang J. Lung function and oxygen saturation after participation in Norseman Xtreme Triathlon. Scand J Med Sci Sports 2020; 30:1008-1016. [PMID: 32153035 DOI: 10.1111/sms.13651] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 02/29/2020] [Accepted: 03/02/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine evidence of exercise-induced bronchoconstriction (EIB) defined as ≥10% reduction in forced expiratory volume in one second (FEV1 ) and exercise-induced arterial hypoxemia (EIAH) defined as ≥4% reduction in oxygen saturation (SpO2 ) from before to after participation in the Norseman Xtreme Triathlon. Secondarily, to assess whether changes in FEV1 and SpO2 are related to respiratory symptoms, training volume, and race time. METHODS In this quasi-experimental non-controlled study, we included 63 triathletes (50♂/13♀) aged 40.3 (±9.0) years (mean ± SD). Fifty-seven (46♂/11♀) measured lung function and 54 (44♂/10♀) measured SpO2 before the race, 8-10 minutes after the race (post-test 1) and the day after the race (post-test 2). Respiratory symptoms and training volume were recorded with modified AQUA questionnaire. ANOVA for repeated measures was used to detect differences in lung function and SpO2 . Statistical significance was accepted at 0.05 level. RESULTS Twenty-six participants (46%) presented with EIB at post-test 1 and 16 (28%) at post-test 2. Lung function variables were significantly reduced from baseline to post-test 1 and 2. Thirty-five participants (65%) showed evidence of mild to moderate EIAH. No significant correlations were observed except a weak correlation between maximal reduction in FEV1 and respiratory symptoms (r = 0.35, P = .016). CONCLUSION Our results demonstrated that 46% of the participants presented with EIB and 65% showed evidence of EIAH after the Norseman Xtreme Triathlon. Changes in FEV1 and SpO2 were not correlated to weekly training hours or race time. We observed a weak correlation between maximal reduction in FEV1 and respiratory symptoms.
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Affiliation(s)
- Trine Stensrud
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Øyvind Rossvoll
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Jørgen Melau
- Prehospital Division, Vestfold Hospital Trust, Tønsberg, Norway
| | - Camilla Illidi
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Centre of Health, Exercise and Performance, College of health & Life Sciences, Brunel University, London, UK
| | - Hege N Østgaard
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Jonny Hisdal
- Department of vascular surgery, Oslo University Hospital, Oslo, Norway.,Department of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Julie Stang
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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18
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Durand F, Gaston AF, Vicenzi M, Deboeck G, Subirats E, Faoro V. Noninvasive Pulmonary Hemodynamic Evaluation in Athletes With Exercise-Induced Hypoxemia. Chest 2020; 157:1568-1578. [PMID: 32081649 DOI: 10.1016/j.chest.2020.01.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/22/2019] [Accepted: 01/31/2020] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Pulmonary capillary stress failure is potentially involved in exercise-induced hypoxemia (ie, a significant fall in hemoglobin oxygen saturation [Spo2]) during sea level exercise in endurance-trained athletes. It is unknown whether there are specific properties of pulmonary vascular function in athletes exhibiting oxygen desaturation. METHODS Ten endurance-trained athletes with exercise-induced hypoxemia (EIH), nine endurance-trained athletes with no exercise-induced hypoxemia (NEIH), and 10 untrained control subjects underwent an incremental exercise stress echocardiography coupled with lung diffusion capacity for carbon monoxide (Dlco) and lung diffusion capacity for nitric oxide (Dlno) testing. Functional adaptation of the pulmonary circulation was evaluated with measurements of mean pulmonary arterial pressure (mPAP), pulmonary capillary pressure, pulmonary vascular resistance (PVR), cardiac output (Qc), and pulmonary vascular distensibility (alpha) mathematically determined from the curvilinearity of the multi-point mPAP/Qc relation. RESULTS EIH athletes exhibited a lower exercise-induced PVR decrease compared with the untrained and NEIH groups (P < .001). EIH athletes showed higher maximal mPAP compared with NEIH athletes (45.4 ± 0.9 mm Hg vs 41.6 ± 0.9 mm Hg, respectively; P = .003); there was no difference between the NEIH and untrained subjects. Alpha was lower in the EIH group compared with the NEIH group (P < .05). Maximal mPAP, Pcap, and alpha were correlated with the fall of Spo2 during exercise (P < .01, P < .01, and P < .05). Dlno and Dlco increased with exercise in all groups, with no differences between groups. Dlno/Qc was correlated to the exercise-induced Spo2 changes (P < .05). CONCLUSIONS EIH athletes exhibit higher maximal pulmonary vascular pressures, lower vascular distensibility, or exercise-induced changes in PVR compared with NEIH subjects, in keeping with pulmonary capillary stress failure or intrapulmonary shunting hypotheses.
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Affiliation(s)
- Fabienne Durand
- Laboratoire Européen Performance, Santé Altitude, EA4604-Université de Perpignan Via Domitia, Département STAPS, Font-Romeu, France; Catedra de medicina de muntanya I del medi natural I de simulacio clinica, Universitat de Girona, Girona, Spain.
| | - Anne-Fleur Gaston
- Laboratoire Européen Performance, Santé Altitude, EA4604-Université de Perpignan Via Domitia, Département STAPS, Font-Romeu, France; Unité de Physiologie des Exercices et Activités en Conditions Extrêmes, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Marco Vicenzi
- Cardio-Pulmonary Exercise Laboratory, Faculty of Motorskill Science, Université Libre de Bruxelles, Brussels, Belgium; Cardiovascular Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Department of Clinical Sciences and Community Health, Milan, Italy
| | - Gael Deboeck
- Cardio-Pulmonary Exercise Laboratory, Faculty of Motorskill Science, Université Libre de Bruxelles, Brussels, Belgium
| | - Enric Subirats
- Laboratoire Européen Performance, Santé Altitude, EA4604-Université de Perpignan Via Domitia, Département STAPS, Font-Romeu, France; Catedra de medicina de muntanya I del medi natural I de simulacio clinica, Universitat de Girona, Girona, Spain
| | - Vitalie Faoro
- Cardio-Pulmonary Exercise Laboratory, Faculty of Motorskill Science, Université Libre de Bruxelles, Brussels, Belgium
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19
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Brousse V, Pondarre C, Arnaud C, Kamden A, de Montalembert M, Boutonnat-Faucher B, Bourdeau H, Charlot K, Grévent D, Verlhac S, da Costa L, Connes P. One-Fifth of Children with Sickle Cell Anemia Show Exercise-Induced Hemoglobin Desaturation: Rate of Perceived Exertion and Role of Blood Rheology. J Clin Med 2020; 9:jcm9010133. [PMID: 31947773 PMCID: PMC7019952 DOI: 10.3390/jcm9010133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/18/2019] [Accepted: 12/28/2019] [Indexed: 01/08/2023] Open
Abstract
Perceived exertion is an important self-limiting factor influencing functional capacity in patients with sickle cell anemia (SCA). Exercise-related hemoglobin desaturation (EHD) may occur during a six-minute walking test (6MWT) and could influence the perceived rate of exertion. The aims of this study were (1) to compare the 6MWT responses (heart rate, perceived rate of exertion, and distance covered) between SCA children with and without EHD, and (2) to test the associations between EHD and several biological/physiological parameters. Nine of 51 SCA children (18%) at steady state (mean age 11.9 ± 3.8 years) exhibited EHD at the end of the 6MWT. The rate of perceived exertion increased with exercise in the two groups, but reached higher values in the EHD group. Heart rate and performance during the 6MWT did not differ between the two groups. The magnitude of change in SpO2 during the 6MWT was independently associated with the red blood cell (RBC) deformability and RBC aggregates strength. This study demonstrates that SCA children with EHD during a 6MWT have a higher rate of perceived exertion than non-EHD children despite a similar physiological demand, and that abnormal RBC rheology determinants appear to be significant contributors.
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Affiliation(s)
- Valentine Brousse
- Service de Pédiatrie Générale et Maladies infectieuses, Hôpital Necker Enfants Malades, AP-HP, 75015 Paris, France (B.B.-F.)
- LABEX GR-Ex, F-75015 Paris, France (P.C.)
- UMR_S1134, Inserm, Institut National de la transfusion sanguine, 75015 Paris, France
- Correspondence:
| | - Corinne Pondarre
- Service de Pédiatrie, Centre Intercommunal de Créteil, 94000 Créteil, France; (C.P.); (C.A.)
| | - Cecile Arnaud
- Service de Pédiatrie, Centre Intercommunal de Créteil, 94000 Créteil, France; (C.P.); (C.A.)
| | - Annie Kamden
- Service de Pédiatrie, Centre Intercommunal de Créteil, 94000 Créteil, France; (C.P.); (C.A.)
| | - Mariane de Montalembert
- Service de Pédiatrie Générale et Maladies infectieuses, Hôpital Necker Enfants Malades, AP-HP, 75015 Paris, France (B.B.-F.)
- LABEX GR-Ex, F-75015 Paris, France (P.C.)
| | - Benedicte Boutonnat-Faucher
- Service de Pédiatrie Générale et Maladies infectieuses, Hôpital Necker Enfants Malades, AP-HP, 75015 Paris, France (B.B.-F.)
| | - Hélène Bourdeau
- Service d’Hématologie Biologique, Hôpital Robert Debré, AP-HP, 75019 Paris, France;
| | - Keyne Charlot
- Unité de Physiologie des Exercices et Activités en Conditions Extrêmes, Département Environnements Opérationnels Institut de Recherche Biomédicale des Armées, 91220 Brétigny-sur-Orge, France;
| | - David Grévent
- Service d’Imagerie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, F-75015 Paris, France;
| | - Suzanne Verlhac
- Service de Radiologie, Centre Intercommunal de Créteil, 94000 Créteil, France;
| | - Lydie da Costa
- LABEX GR-Ex, F-75015 Paris, France (P.C.)
- UMR_S1134, Inserm, Institut National de la transfusion sanguine, 75015 Paris, France
- Service d’Hématologie Biologique, Hôpital Robert Debré, AP-HP, 75019 Paris, France;
- Paris University, F-75010 Paris, France
| | - Philippe Connes
- LABEX GR-Ex, F-75015 Paris, France (P.C.)
- Equipe «Biologie Vasculaire et du Globule Rouge», Laboratoire LIBM EA7424, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
- Institut Universitaire de France, 75015 Paris, France
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20
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Azevedo RDA, Béjar Saona JE, Inglis EC, Iannetta D, Murias JM. The effect of the fraction of inspired oxygen on the NIRS-derived deoxygenated hemoglobin "breakpoint" during ramp-incremental test. Am J Physiol Regul Integr Comp Physiol 2019; 318:R399-R409. [PMID: 31850819 DOI: 10.1152/ajpregu.00291.2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
During ramp-incremental (RI) exercise to exhaustion, the near-infrared spectroscopy-derived deoxygenated hemoglobin ([HHb]) signal in the vastus lateralis muscle shows a linear increase up to a point at which a plateau-like response is manifested ([HHb]bp). This study investigated if 1) the [HHb]bp is affected by different fractions of inspired O2 (FIO2) [hypoxia (16%; HYPO); normoxia (21%; NORM); hyperoxia (30%; HYPER)]; and 2) an abrupt change to hyperoxic-inspired gas just before the occurrence of the [HHb]bp (HYPERSWITCH) would affect the [HHb] plateau-like response. Ten physically active male participants reported to the laboratory on four separate occasions to perform an RI test to exhaustion in NORM, HYPO, and HYPER and an RI test to exhaustion with an abrupt increase in FIO2 (30%; HYPERSWITCH) 15 W before the power output (PO) associated with [HHb]bp in normoxia. PO, [HHb], tissue O2 (StO2), and pulse O2 saturation (SpO2) were recorded continuously. Peak PO was significantly lower in HYPO (290 ± 21 W) and higher in HYPER (321 ± 22 W) and HYPERSWITCH (320 ± 19 W) compared with NORM (311 ± 18 W). The PO associated with [HHb]bp was not different between NORM and HYPER (246 ± 23 vs. 247 ± 24 W), but it was lower in HYPO (198 ± 31 W) than NORM and HYPER. The PO associated with the [HHb]bp in HYPERSWITCH (240 ± 23) was not different compared with NORM. HYPER and HYPERSWITCH resulted in greater StO2 and SpO2 compared with NORM. These results suggest that the [HHb]bp response is not dependent of O2 driving pressure and that other physiological mechanisms might determine its occurrence.
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Affiliation(s)
| | | | | | - Danilo Iannetta
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Juan M Murias
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
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21
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Impact of a 10 km running trial on eryptosis, red blood cell rheology, and electrophysiology in endurance trained athletes: a pilot study. Eur J Appl Physiol 2019; 120:255-266. [PMID: 31776697 DOI: 10.1007/s00421-019-04271-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 11/22/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Blood rheology is a key determinant of blood flow and tissue perfusion. There are still large discrepancies regarding the effects of an acute running exercise on blood rheological properties and red blood cell (RBC) physiology. We investigated the effect of a 10 km running trial on markers of blood rheology and RBC physiology in endurance trained athletes. METHODS Blood was sampled before and after the exercise to measure lactate and glucose, hematological and hemorheological parameters (blood viscosity, RBC deformability, and aggregation), eryptosis markers (phosphatidylserine and CD47 exposure, RBC reactive oxygen species), RBC-derived microparticles (RBC-MPs), and RBC electrophysiological activity. Weight was measured before and after exercise. Peripheral oxygen saturation and heart rate were monitored before and during the trial. RESULTS Blood lactate and glucose levels increased after exercise and subjects significantly lost weight. All athletes experienced a significant fall in oxygen saturation. Mean corpuscular volume (MCV) was increased from 95.1 ± 3.2 to 96.0 ± 3.3 and mean corpuscular hemoglobin concentration (MCHC) decreased after exercise suggesting a slight RBC rehydration. Exercise increased RBC deformability from 0.344 ± 0.04 to 0.378 ± 0.07, decreased RBC aggregates strength and blood viscosity, while hematocrit (Hct) remained unaffected. While RBC electrophysiological recording suggested a modulation in RBC calcium content and/or chloride conductance, eryptosis markers and RBC-MPs were not modified by the exercise. CONCLUSION A 10 km acute running exercise had no effect on RBC senescence and membrane blebbing. In contrast, this exercise increased RBC deformability, probably through rehydration process which resulted in a decrease in blood viscosity.
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Raberin A, Meric H, Mucci P, Lopez Ayerbe J, Durand F. Muscle and cerebral oxygenation during exercise in athletes with exercise-induced hypoxemia: A comparison between sea level and acute moderate hypoxia. Eur J Sport Sci 2019; 20:803-812. [PMID: 31526237 DOI: 10.1080/17461391.2019.1669717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The objective of the present study was to evaluate the influence of exercise-induced hypoxemia (EIH) on muscle and cerebral oxygenation responses during maximal exercise in normoxia and in acute moderate hypoxia (fraction of inspired oxygen: 15.3%, 2400 m). EIH was defined as a drop in hemoglobin saturation of at least 4% for at least three consecutive minutes during maximal exercise at sea level. Twenty-five athletes performed incremental treadmill tests to assess maximal oxygen consumption (VO2max) in normoxia and in hypoxia. Oxygenation of the vastus lateralis muscle and the left prefrontal cortex of the brain was monitored using near-infrared spectroscopy. During the normoxic test, 15 athletes exhibited EIH; they displayed a larger change in muscle levels of oxyhemoglobin (ΔO2Hb) (p = 0.04) and a greater change in cerebral levels of deoxyhemoglobin (ΔHHb) (p = 0.02) than athletes without EIH (NEIH group). During the hypoxic test, muscle ΔO2Hb was lower in the EIH group than in the NEIH group (p = 0.03). At VO2max, hypoxia was associated with a smaller cerebral ΔO2Hb in both groups, and a greater cerebral ΔHHb compared to normoxia in the NEIH group only (p = 0.02). No intergroup differences in changes in muscle oxygenation were observed. The severity of O2 arterial desaturation was negatively correlated with changes in total muscle hemoglobin in normoxia (r = -0.48, p = 0.01), and positively correlated with the cerebral ΔHHb in normoxia (r = 0.45, p = 0.02). The occurrence of EIH at sea level was associated with specific muscle and cerebral oxygenation responses to exercise under both normoxia and moderate hypoxia.
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Affiliation(s)
- Antoine Raberin
- LEPSA, EA 4604, Université de Perpignan Via Domitia, Font Romeu, France
| | - Henri Meric
- LEPSA, EA 4604, Université de Perpignan Via Domitia, Font Romeu, France
| | - Patrick Mucci
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, EA 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, France
| | | | - Fabienne Durand
- LEPSA, EA 4604, Université de Perpignan Via Domitia, Font Romeu, France
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Riganas C, Papadopoulou Z, Margaritelis NV, Christoulas K, Vrabas IS. Inspiratory muscle training effects on oxygen saturation and performance in hypoxemic rowers: Effect of sex. J Sports Sci 2019; 37:2513-2521. [DOI: 10.1080/02640414.2019.1646582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Christos Riganas
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
- Ergophysiology Laboratory, Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Zacharoula Papadopoulou
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
- Ergophysiology Laboratory, Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikos V. Margaritelis
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
- Intensive Care Unit, 424 General Military Hospital of Thessaloniki, Thessaloniki, Greece
| | - Kosmas Christoulas
- Ergophysiology Laboratory, Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis S. Vrabas
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
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Paquette M, Bieuzen F, Billaut F. Muscle Oxygenation Rather Than VO2max as a Strong Predictor of Performance in Sprint Canoe-Kayak. Int J Sports Physiol Perform 2018; 13:1299-1307. [PMID: 29745773 DOI: 10.1123/ijspp.2018-0077] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 04/23/2018] [Accepted: 04/25/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE To characterize the relationships between muscle oxygenation and performance during on- and off-water tests in highly trained sprint canoe-kayak athletes. METHODS A total of 30 athletes (19 kayakers and 11 canoeists) performed a maximal incremental test on a canoe or kayak ergometer for determination of VO2max and examination of the relation between peak power output (PPO) and physiological parameters. A subset of 21 athletes also performed a 200- and a 500- (for women) or 1000-m (for men) on-water time trial (TT). Near-infrared spectroscopy monitors were placed on the latissimus dorsi, biceps brachii, and vastus lateralis during all tests to assess changes in muscle O2 saturation (SmO2) and deoxyhemoglobin concentration ([HHb]). The minimum O2 oxygenation (SmO2min) and maximal O2 (Δ[HHb] extraction) were calculated for all subjects. RESULTS PPO was most strongly correlated with VO2max (R = .9), but there was also a large correlation between PPO and both SmO2min and Δ[HHb] in latissimus dorsi (R = -.5, R = .6) and vastus lateralis (R = -.6, R = .6, all P < .05). Multiple regression showed that 90% of the variance in 200-m performance was explained by both Δ[HHb] and SmO2min in the 3 muscles combined (P < .01) and 71% of the variance in 500-/1000-m performance was explained by Δ[HHb] in the 3 muscles (P < .01). This suggests that O2 extraction is a better predictor of performance than VO2max in sprint canoe-kayak. CONCLUSIONS These results highlight the importance of peripheral adaptations in both short and long events and stress the relevance of adding muscle oxygenation measurements during testing and racing in sprint canoe-kayak.
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Nader E, Guillot N, Lavorel L, Hancco I, Fort R, Stauffer E, Renoux C, Joly P, Germain M, Connes P. Eryptosis and hemorheological responses to maximal exercise in athletes: Comparison between running and cycling. Scand J Med Sci Sports 2018; 28:1532-1540. [PMID: 29356101 DOI: 10.1111/sms.13059] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2018] [Indexed: 12/20/2022]
Abstract
We compared the effects of cycling and running exercise on hemorheological and hematological properties, as well as eryptosis markers. Seven endurance-trained subjects randomly performed a progressive and maximal exercise test on a cycle ergometer and a treadmill. Blood was sampled at rest and at the end of the exercise to analyze hematological and blood rheological parameters including hematocrit (Hct), red blood cell (RBC) deformability, aggregation, and blood viscosity. Hemoglobin saturation (SpO2), blood lactate, and glucose levels were also monitored. Red blood cell oxidative stress, calcium content, and phosphatidylserine exposure were determined by flow cytometry to assess eryptosis level. Cycling exercise increased blood viscosity and RBC aggregation whereas it had no significant effect on RBC deformability. In contrast, blood viscosity remained unchanged and RBC deformability increased with running. The increase in Hct, lactate, and glucose concentrations and the loss of weight at the end of exercise were not different between running and cycling. Eryptosis markers were not affected by exercise. A significant drop in SpO2 was noted during running but not during cycling. Our study showed that a progressive and maximal exercise test conducted on a cycle ergometer increased blood viscosity while the same test conducted on a treadmill did not change this parameter because of different RBC rheological behavior between the 2 tests. We also demonstrated that a short maximal exercise does not alter RBC physiology in trained athletes. We suspect that exercise-induced hypoxemia occurring during running could be at the origin of the RBC rheological behavior differences with cycling.
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Affiliation(s)
- E Nader
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Équipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - N Guillot
- Univ-Lyon, CarMeN Laboratory, INSERM 1060, INRA 1397, Université Claude Bernard Lyon 1, INSA Lyon, Villeurbanne, France
| | - L Lavorel
- Hospices Civils de Lyon, Service d'Exploration Fonctionnelle Respiratoire, Hôpital Croix Rousse, Lyon, France
| | - I Hancco
- Hospices Civils de Lyon, Service d'Exploration Fonctionnelle Respiratoire, Hôpital Croix Rousse, Lyon, France
| | - R Fort
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Équipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Hospices Civils de Lyon, Service de Médecine Interne, Hôpital Edouard Herriot, Lyon, France
| | - E Stauffer
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Équipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Hospices Civils de Lyon, Centre de Médecine du Sommeil et des Maladies Respiratoires, Hôpital Croix Rousse, Lyon, France
| | - C Renoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Équipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Hospices Civils de Lyon, Centre de Biologie et de Pathologie Est, Biochimie des Pathologies Erythrocytaires, Bron, France
| | - P Joly
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Équipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Hospices Civils de Lyon, Centre de Biologie et de Pathologie Est, Biochimie des Pathologies Erythrocytaires, Bron, France
| | - M Germain
- Hospices Civils de Lyon, Service d'Exploration Fonctionnelle Respiratoire, Hôpital Croix Rousse, Lyon, France
| | - P Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Équipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Institut Universitaire de France (IUF), Paris, France
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Respiratory Effects of Thoracic Load Carriage Exercise and Inspiratory Muscle Training as a Strategy to Optimize Respiratory Muscle Performance with Load Carriage. ACTA ACUST UNITED AC 2017; 5:49-64. [PMID: 29630067 DOI: 10.1007/s40362-017-0046-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Many occupational and recreational settings require the use of protective and/or load-bearing apparatuses worn over the thoracic cavity, known as thoracic load carriage (LC). Compared to normal, unloaded exercise, thoracic LC exercise places an additional demand on the respiratory and limb locomotor systems by altering ventilatory mechanics as well as circulatory responses to exercise, thus accelerating the development of fatigue in the diaphragm and accessory respiratory muscles compared to unloaded exercise. This may be a consequence of the unique demands of thoracic LC, which places an additional mass load on the thoracic cavity and can restrict chest wall expansion. Therefore it is important to find effective strategies to ameliorate the detrimental effects of thoracic LC. Inspiratory muscle training is an intervention that aims to increase the strength and endurance of the diaphragm and accessory inspiratory muscle and may therefore be a useful strategy to optimize performance with thoracic LC.
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Allergies and Exercise-Induced Bronchoconstriction in a Youth Academy and Reserve Professional Soccer Team. Clin J Sport Med 2017; 27:450-456. [PMID: 28829345 DOI: 10.1097/jsm.0000000000000393] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES A high prevalence of respiratory allergies and exercise-induced bronchoconstriction (EIB) has been reported among endurance athletes. This study was designed to analyze the frequency of sensitization to respiratory allergens and EIB in young soccer players. DESIGN Prospective cohort design. SETTING Youth academy and reserve professional soccer team during the seasons 2012 to 2013 and 2013 to 2014. PARTICIPANTS Eighty-five soccer players (mean age: 20 ± 4 years) participated. INTERVENTION Players underwent skin prick tests (SPTs) during the seasons 2012 to 2013 and 2013 to 2014. Spirometry and a eucapnic voluntary hyperpnea test were performed on soccer players during the first season 2012 to 2013 (n = 51) to detect EIB. Two self-administered questionnaires on respiratory history and allergic symptoms (European Community Respiratory Health Survey and Allergy Questionnaire for Athletes) were also distributed during both seasons (n = 59). MAIN OUTCOME MEASURES The number of positive SPTs, exercise-induced respiratory symptoms, presence of asthma, airway obstruction, and EIB. RESULTS Forty-nine percent of players were sensitized to at least one respiratory allergen, 33% reported an allergic disease, 1 player presented airway obstruction at rest, and 16% presented EIB. Factors predictive of EIB were self-reported exercise-induced symptoms and sensitization to at least 5 allergens. CONCLUSIONS Questioning players about exercise-induced respiratory symptoms and allergies as well as spirometry at the time of the inclusion medical checkup would improve management of respiratory health of soccer players and would constitute inexpensive preliminary screening to select players requiring indirect bronchial provocation test or SPTs. CLINICAL RELEVANCE This study showed that despite low frequencies, EIB and allergies are underdiagnosed and undertreated in young soccer players.
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Grünig H, Nikolaidis PT, Moon RE, Knechtle B. Diagnosis of Swimming Induced Pulmonary Edema-A Review. Front Physiol 2017; 8:652. [PMID: 28912730 PMCID: PMC5583207 DOI: 10.3389/fphys.2017.00652] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 08/16/2017] [Indexed: 12/16/2022] Open
Abstract
Swimming induced pulmonary edema (SIPE) is a complication that can occur during exercise with the possibility of misdiagnosis and can quickly become life threatening; however, medical literature infrequently describes SIPE. Therefore, the aim of this review was to analyse all individual cases diagnosed with SIPE as reported in scientific sources, with an emphasis on the diagnostic pathways and the key facts resulting in its diagnosis. Due to a multifactorial and complicated pathophysiology, the diagnosis could be difficult. Based on the actual literature, we try to point out important findings regarding history, conditions, clinical findings, and diagnostic testing helping to confirm the diagnosis of SIPE. Thirty-eight cases from seventeen articles reporting the diagnosis of SIPE were selected. We found remarkable differences in the individual described diagnostic pathways. A total of 100% of the cases suffered from an acute onset of breathing problems, occasionally accompanied by hemoptysis. A total of 73% showed initial hypoxemia. In most of the cases (89%), an initial chest X-Ray or chest CT was available, of which one-third (71%) showed radiological signs of pulmonary edema. The majority of the cases (82%) experienced a rapid resolution of symptoms within 48 h, the diagnostic hallmark of SIPE. Due to a foreseeable increase in participation in swimming competitions and endurance competitions with a swimming component, diagnosis of SIPE will be important, especially for medical teams caring for these athletes.
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Affiliation(s)
- Hannes Grünig
- Institut für Radiologie, Luzerner KantonsspitalLuzern, Switzerland
| | | | - Richard E. Moon
- Center for Hyperbaric Medicine and Environmental Physiology, Department of Anesthesiology, Duke University Medical CenterDurham, NC, United States
| | - Beat Knechtle
- Gesundheitszentrum St. GallenSt. Gallen, Switzerland
- Institute of Primary Care, University of ZurichZurich, Switzerland
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29
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Constantini K, Tanner DA, Gavin TP, Harms CA, Stager JM, Chapman RF. Prevalence of Exercise-Induced Arterial Hypoxemia in Distance Runners at Sea Level. Med Sci Sports Exerc 2017; 49:948-954. [PMID: 28009787 DOI: 10.1249/mss.0000000000001193] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE It has been reported that ~50% of endurance-trained men demonstrate exercise-induced arterial hypoxemia (EIAH) during heavy exercise. However, this often-cited prevalence rate comes from a single study using a cohort of 25 highly trained men who completed maximal cycle ergometry. As arterial oxyhemoglobin saturation (SpO2) during maximal exercise is reported to be significantly lower during treadmill versus cycle ergometry in the same subjects, we hypothesized that the prevalence of EIAH would be greater than previously reported (and commonly referenced) in a larger cohort of highly endurance-trained men during maximal treadmill running. METHODS Data from 124 highly trained male distance runners (V˙O2max range = 60.3-84.7 mL·kg·min) were retrospectively examined from previously published studies completed in the Indiana University Human Performance Laboratory. Subjects completed a constant speed, progressive-grade treadmill exercise test to volitional exhaustion, and arterial oxyhemoglobin saturation (SaO2ear) in all subjects was estimated using the same oximeter (Hewlett Packard 47201A). RESULTS Using similar inclusion criteria as previously published for highly trained (V˙O2max > 68 mL·kg·min) and for EIAH (SaO2ear ≤ 91%), 55 of 79 subjects (70%) exhibited exercise-induced arterial desaturation. Across all 124 subjects, 104 (84%) demonstrated at least moderate EIAH (SaO2ear ≤ 93%) during maximal treadmill exercise. SaO2ear was significantly yet weakly correlated with V˙E/V˙O2 (P < 0.01, r = 0.28) and V˙E/V˙CO2 (P < 0.001, r = 0.33) but not with V˙O2max. CONCLUSION These results indicate that the prevalence of EIAH in highly trained men during maximal treadmill exercise at sea level is greater compared with previously suggested data, with exercise mode perhaps playing a factor in the number of athletes who experience EIAH.
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Affiliation(s)
- Keren Constantini
- 1HH Morris Human Performance Laboratory, Department of Kinesiology, Indiana University, Bloomington, IN; 2Department of Health and Kinesiology, Purdue University, West Lafayette, IN; and 3Department of Kinesiology, Kansas State University, Manhattan, KS
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30
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Guimard A, Collomp K, Zorgati H, Brulaire S, Woorons X, Amiot V, Prieur F. Effect of swim intensity on responses to dynamic apnoea. J Sports Sci 2017; 36:1015-1021. [PMID: 28682161 DOI: 10.1080/02640414.2017.1349328] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of this study was to determine the influence of swim intensity on acute responses to dynamic apnoea. 9 swimmers performed one 50 m front crawl trial in four different conditions: at 400 m velocity (V400) with normal breathing (NB), at V400 in complete apnoea (Ap), at maximal velocity (Vmax) with NB and at Vmax in Ap. Peak heart rate (HRpeak), blood lactate concentration after exercise (Lacpost ex) and Borg rating of perceived exertion (RPE) were measured. Arterial oxygen saturation (SpO2) was monitored with a pulse oximeter at forehead level during and after exercise. In Ap, swimming at V400 induced a significantly lower HRpeak and Lacpost ex than swimming at Vmax whilst RPE and the kinetics of SpO2 were not different at V400 and at Vmax. The minimal value of SpO2 in Ap was reached 10 to 11 s after the end of V400 and Vmax (81.7 ± 10.1% and 84.4 ± 10.6%, respectively). Swimming a 50 m front crawl in Ap resulted in a large decrease in SpO2 which occurred only after the cessation of exercise. The higher duration of apnoea during submaximal exercise could explain why SpO2 and RPE reached the same values as for maximal exercise..
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Affiliation(s)
- A Guimard
- a CIAMS , Univ Paris-Sud, Université Paris Saclay , Orsay Cedex , France.,b CIAMS, Université d'Orléans , Orléans , France
| | - K Collomp
- a CIAMS , Univ Paris-Sud, Université Paris Saclay , Orsay Cedex , France.,b CIAMS, Université d'Orléans , Orléans , France .,c Département des Analyses , AFLD , Chatenay-Malabry , France
| | - H Zorgati
- d Laboratory of Physiology and Functional Explorations, Ibn Eljazzar Faculty of Medicine , University of Sousse , Sousse , Tunisia
| | - S Brulaire
- a CIAMS , Univ Paris-Sud, Université Paris Saclay , Orsay Cedex , France.,b CIAMS, Université d'Orléans , Orléans , France
| | - X Woorons
- e Unité de Recherche Pluridisciplinaire Sport Santé Société (URePSSS) -EA 7369 , Université de Lille , Lille , France
| | - V Amiot
- f Service de Médecine du Sport et d'Exploration Fonctionnelle Respiratoire , CHR Orléans La Source , Orléans Cedex 1 , France
| | - F Prieur
- a CIAMS , Univ Paris-Sud, Université Paris Saclay , Orsay Cedex , France.,b CIAMS, Université d'Orléans , Orléans , France
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Black MI, Potter CR, Corbett J, Clark CCT, Draper SB. Maximal Oxygen Uptake Is Achieved in Hypoxia but Not Normoxia during an Exhaustive Severe Intensity Run. Front Physiol 2017; 8:96. [PMID: 28270770 PMCID: PMC5319197 DOI: 10.3389/fphys.2017.00096] [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] [Received: 09/12/2016] [Accepted: 02/06/2017] [Indexed: 01/01/2023] Open
Abstract
Highly aerobically trained individuals are unable to achieve maximal oxygen uptake (V˙O2max) during exhaustive running lasting ~2 min, instead V˙O2 plateaus below V˙O2max after ~1 min. Hypoxia offers the opportunity to study the (V˙O2) response to an exhaustive run relative to a hypoxia induced reduction in V˙O2max. The aim of this study was to explore whether there is a difference in the percentage of V˙O2max achieved (during a 2 min exhaustive run) in normoxia and hypoxia. Fourteen competitive middle distance runners (normoxic V˙O2max 67.0 ± 5.2 ml.kg−1.min−1) completed exhaustive treadmill ramp tests and constant work rate (CWR) tests in normoxia and hypoxia (FiO2 0.13). The V˙O2 data from the CWR tests were modeled using a single exponential function. End exercise normoxic CWR V˙O2 was less than normoxic V˙O2max (86 ± 6% ramp, P < 0.001). During the hypoxic CWR test, hypoxic V˙O2max was achieved (102 ± 8% ramp, P = 0.490). The phase II time constant was greater in hypoxia (12.7 ± 2.8 s) relative to normoxia (10.4 ± 2.6 s) (P = 0.029). The results demonstrate that highly aerobically trained individuals cannot achieve V˙O2max during exhaustive severe intensity treadmill running in normoxia, but can achieve the lower V˙O2max in hypoxia despite a slightly slower V˙O2 response.
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Affiliation(s)
- Matthew I Black
- School of Sport, Exercise and Health Sciences, Loughborough University Loughborough, UK
| | | | - Jo Corbett
- Department of Sport and Exercise Science, University of Portsmouth Portsmouth, UK
| | - Cain C T Clark
- HE Sport, University Centre, Hartpury College Gloucestershire, UK
| | - Stephen B Draper
- HE Sport, University Centre, Hartpury College Gloucestershire, UK
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Colas-Ribas C, Signolet I, Henni S, Feuillloy M, Gagnadoux F, Abraham P. High prevalence of known and unknown pulmonary diseases in patients with claudication during exercise oximetry: A retrospective analysis. Medicine (Baltimore) 2016; 95:e4888. [PMID: 27749546 PMCID: PMC5059048 DOI: 10.1097/md.0000000000004888] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 07/04/2016] [Accepted: 08/24/2016] [Indexed: 11/30/2022] Open
Abstract
The prevalence of pulmonary disease in patients with peripheral artery disease (PAD) has not been extensively studied. Recent evidence has shown that ∼20% of the patients have an atypical chest transcutaneous oxygen pressure (TcpO2) pattern during exercise, which suggests walking-induced hypoxemia. The main objectives of this study were to: (1) describe in a retrospective way the characteristics of the patients suffering from claudication, who attended a treadmill testing in our laboratory, (2) assess the prevalence of known or unknown pulmonary disease. The second aim of this study was to evaluate the impact of the therapeutic interventions on the walking capacities, after treatment, of the eventually detected pulmonary disorders.We retrospectively analyzed 1482 exercise TcpO2 test results. Patients that had no history of pulmonary disease, but either reported severe dyspnea or showed atypical profiles on their chest exercise-TcpO2, were advised to refer to the department of pneumology for additional investigations.In addition to the 166 patients with a history of pulmonary disease, 158 patients were suspected of unknown pulmonary disease from the result of their TcpO2 test. Many patients (n = 99/158, 62.7%) did not attend a pulmonologist visit. A pulmonary disease was established in 55 (93.2%) of the other 59 patients. Obstructive sleep apnea syndrome (OSAS) was the one and only diagnosis retained in 42/59 patients (71.2%). Among the 47 patients who had a second evaluation of their walking capacity on treadmill, 38 had treatment of the pulmonary disease found, vascular surgery treatment or a severe restricted diet, 9 had no treatment. Only the "treated" group showed a significant improvement in the maximal walking distance on treadmill between the 2 evaluations, 313 ± 251 m to 433 ± 317 m (P = 0.03).This retrospective pilot study underlines the high prevalence of both known and unknown pulmonary disease in patients whose primary complaint was lower limb claudication. Systematic screening and treatment of pulmonary disease in patients with claudication might be justified, to improve walking ability of such patients and possibly reduce or delay the requirement for revascularization. Prospective studies are required to confirm these preliminary results.
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Affiliation(s)
- Christophe Colas-Ribas
- Department of Sports Medicine and Vascular Investigations, University Hospital of Angers, Univ. Angers, Université Bretagne Loire, France
| | - Isabelle Signolet
- Department of Sports Medicine and Vascular Investigations, University Hospital of Angers, Univ. Angers, Université Bretagne Loire, France
| | - Samir Henni
- Department of Sports Medicine and Vascular Investigations, University Hospital of Angers, Univ. Angers, Université Bretagne Loire, France
| | - Mathieu Feuillloy
- Ecole supérieure d’électronique de l’Ouest, Institute of Science & Technology, France
- LAUM–UMR CNR6613, France
| | - Frédéric Gagnadoux
- Department of Pneumology, University Hospital of Angers, Univ. Angers, Université Bretagne Loire, INSERM 1063, France
| | - Pierre Abraham
- Department of Sports Medicine and Vascular Investigations, University Hospital of Angers, Univ. Angers, Université Bretagne Loire, France
- Mitovasc, UMR INSERM 1083/CNRS 6214, Univ. Angers, Université Bretagne Loire, Angers, France
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Chenivesse C, Boulanger S, Langlois C, Wemeau-Stervinou L, Perez T, Wallaert B. Oxygen desaturation during a 6-minute walk test as a predictor of maximal exercise-induced gas exchange abnormalities in sarcoidosis. J Thorac Dis 2016; 8:1995-2003. [PMID: 27621852 DOI: 10.21037/jtd.2016.06.39] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Common tests for evaluating gas exchange impairment have different strengths and weaknesses. Alveolar-to-arterial oxygen pressure difference (AaDO2) at peak exercise is a sensitive indicator but it cannot be measured repeatedly. Diffusing capacity of the lung for carbon monoxide (DLco) is measured at rest and may be too insensitive to predict the effects of exercise on gas exchange impairment. Oxygen desaturation during a 6-minute walk test (∆SpO2-6MWT) can be measured repeatedly, but its value in sarcoidosis is unknown. Here, we evaluated the ability of ∆SpO2-6MWT and DLco to predict gas exchange impairment during exercise in sarcoidosis. METHODS This retrospective study of 130 subjects with sarcoidosis investigated the relationship between DLco, ∆SpO2-6MWT, and peak AaDO2 using correlation tests, inter-test reliability analyses, and predictive values. For the analyses of inter-test reliability and predictive values, DLco, peak AaDO2, and ∆SpO2-6MWT were considered as binary variables (normal/abnormal) according to previously defined thresholds. RESULTS Correlation coefficients between DLco, ∆SpO2-6MWT, and peak AaDO2 were intermediate (0.53-0.67, P<0.0003) and Kappa coefficients were low (0.21-0.42, P=0.0003-0.02). DLco predicted (I) increased peak AaDO2 with a positive predictive value (PPV) of 66% and a negative predictive value (NPV) of 78% and (II) increased ∆SpO2-6MWT with a PPV at 36% and an NPV at 88%. Normal DLco was a good predictor of the absence of severe desaturation during the 6MWT (94% NPV) and at peak exercise during cardiopulmonary exercise test (CPET) (100% NPV). ∆SpO2-6MWT predicted peak AaDO2 increase with a PPV of 74% and an NPV of 60%. CONCLUSIONS In a large population of sarcoidosis patients, neither ∆SpO2-6MWT nor DLco was a good predictor of increased peak AaDO2. In contrast, normal DLco was a good predictor of the absence of severe desaturation during the 6MWT and at peak exercise during CPET.
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Affiliation(s)
- Cecile Chenivesse
- Department of Respiratory Medicine, Rare Disease Center, Univ. Lille, F-59000 Lille, France
| | - Sarah Boulanger
- Department of Respiratory Medicine, Rare Disease Center, Univ. Lille, F-59000 Lille, France
| | - Carole Langlois
- Department of Biostatistics, Univ. Lille, F-59000 Lille, France
| | | | - Thierry Perez
- Department of Respiratory Medicine, Rare Disease Center, Univ. Lille, F-59000 Lille, France; Lung Function Department, Univ. Lille, F-59000 Lille, France
| | - Benoit Wallaert
- Department of Respiratory Medicine, Rare Disease Center, Univ. Lille, F-59000 Lille, France
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Exercise-Induced Hypoxaemia Developed at Sea-Level Influences Responses to Exercise at Moderate Altitude. PLoS One 2016; 11:e0161819. [PMID: 27583364 PMCID: PMC5008680 DOI: 10.1371/journal.pone.0161819] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 08/12/2016] [Indexed: 11/20/2022] Open
Abstract
Purpose The aim of this study was to investigate the impact of exercise-induced hypoxaemia (EIH) developed at sea-level on exercise responses at moderate acute altitude. Methods Twenty three subjects divided in three groups of individuals: highly trained with EIH (n = 7); highly trained without EIH (n = 8) and untrained participants (n = 8) performed two maximal incremental tests at sea-level and at 2,150 m. Haemoglobin O2 saturation (SpO2), heart rate, oxygen uptake (VO2) and several ventilatory parameters were measured continuously during the tests. Results EIH athletes had a drop in SpO2 from 99 ± 0.8% to 91 ± 1.2% from rest to maximal exercise at sea-level, while the other groups did not exhibit a similar decrease. EIH athletes had a greater decrease in VO2max at altitude compared to non-EIH and untrained groups (-22 ± 7.9%, -16 ± 5.3% and -13 ± 9.4%, respectively). At altitude, non-EIH athletes had a similar drop in SpO2 as EIH athletes (13 ± 0.8%) but greater than untrained participants (6 ± 1.0%). EIH athletes showed greater decrease in maximal heart rate than non-EIH athletes at altitude (8 ± 3.3 bpm and 5 ± 2.9 bpm, respectively). Conclusion EIH athletes demonstrated specific cardiorespiratory response to exercise at moderate altitude compared to non-EIH athletes with a higher decrease in VO2max certainly due to the lower ventilator and HRmax responses. Thus EIH phenomenon developed at sea-level negatively impact performance and cardiorespiratory responses at acute moderate altitude despite no potentiated O2 desaturation.
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Ohya T, Yamanaka R, Ohnuma H, Hagiwara M, Suzuki Y. Hyperoxia Extends Time to Exhaustion During High-Intensity Intermittent Exercise: a Randomized, Crossover Study in Male Cyclists. SPORTS MEDICINE-OPEN 2016; 2:34. [PMID: 27747789 PMCID: PMC4996887 DOI: 10.1186/s40798-016-0059-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 08/15/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Some endurance athletes exhibit exercise-induced arterial hypoxemia during high-intensity exercise. Inhalation of hyperoxic gas during exercise has been shown to counteract this exercise-associated reduction in hemoglobin oxygen saturation (SaO2), but the effects of hyperoxic gas inhalation on performance and SaO2 during high-intensity intermittent exercise remain unclear. This study investigated the effects of hyperoxic gas inhalation on performance and SaO2 during high-intensity intermittent cycling exercise. METHODS Eight male cyclists performed identical intermittent exercise tests (five sets of 3-min high-intensity cycling alternated with 3-min active recovery periods) under two different inspired air conditions, hyperoxia (HO; FIO2 = 0.36) and normoxia (NO; FIO2 = 0.21). The fifth set of each test was terminated at exhaustion, and the exercise time to exhaustion was recorded. Variables associated with arterial oxygen saturation (SpO2) were measured using an ear pulse oximeter. RESULTS Time to exhaustion under HO conditions was significantly longer than under NO conditions (34.9 ± 4.6 vs. 30.0 ± 2.5 min, P = 0.004, ES = 1.32). SpO2 was maintained under HO conditions but decreased under NO conditions. CONCLUSIONS Hyperoxic gas inhalation during the entire high-intensity intermittent exercise enhanced exercise performance in male cyclists.
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Affiliation(s)
- Toshiyuki Ohya
- Department of Sports Science, Japan Institute of Sports Sciences, Tokyo, 115-0056, Japan.
| | - Ryo Yamanaka
- Department of Sports Science, Japan Institute of Sports Sciences, Tokyo, 115-0056, Japan
| | - Hayato Ohnuma
- Department of Sports Science, Japan Institute of Sports Sciences, Tokyo, 115-0056, Japan
| | - Masahiro Hagiwara
- Department of Sports Science, Japan Institute of Sports Sciences, Tokyo, 115-0056, Japan
| | - Yasuhiro Suzuki
- Department of Sports Science, Japan Institute of Sports Sciences, Tokyo, 115-0056, Japan
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Gaston AF, Roca E, Doucende G, Hapkova I, Subirats E, Durand F. Réponses physiologiques à l’exercice en altitude modérée : intérêt de la mesure de la SpO2. Sci Sports 2016. [DOI: 10.1016/j.scispo.2015.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Van Thienen R, Hespel P. Enhanced muscular oxygen extraction in athletes exaggerates hypoxemia during exercise in hypoxia. J Appl Physiol (1985) 2015; 120:351-61. [PMID: 26607244 DOI: 10.1152/japplphysiol.00210.2015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 11/22/2015] [Indexed: 01/11/2023] Open
Abstract
High rate of muscular oxygen utilization facilitates the development of hypoxemia during exercise at altitude. Because endurance training stimulates oxygen extraction capacity, we investigated whether endurance athletes are at higher risk to developing hypoxemia and thereby acute mountain sickness symptoms during exercise at simulated high altitude. Elite athletes (ATL; n = 8) and fit controls (CON; n = 7) cycled for 20 min at 100 W (EX100W), as well as performed an incremental maximal oxygen consumption test (EXMAX) in normobaric hypoxia (0.107 inspired O2 fraction) or normoxia (0.209 inspired O2 fraction). Cardiorespiratory responses, arterial Po2 (PaO2), and oxygenation status in m. vastus lateralis [tissue oxygenation index (TOIM)] and frontal cortex (TOIC) by near-infrared spectroscopy, were measured. Muscle O2 uptake rate was estimated from change in oxyhemoglobin concentration during a 10-min arterial occlusion in m. gastrocnemius. Maximal oxygen consumption in normoxia was 70 ± 2 ml·min(-1·)kg(-1) in ATL vs. 43 ± 2 ml·min(-1·)kg(-1) in CON, and in hypoxia decreased more in ATL (-41%) than in CON (-25%, P < 0.05). Both in normoxia at PaO2 of ∼95 Torr, and in hypoxia at PaO2 of ∼35 Torr, muscle O2 uptake was twofold higher in ATL than in CON (0.12 vs. 0.06 ml·min(-1)·100 g(-1); P < 0.05). During EX100W in hypoxia, PaO2 dropped to lower (P < 0.05) values in ATL (27.6 ± 0.7 Torr) than in CON (33.5 ± 1.0 Torr). During EXMAX, but not during EX100W, TOIM was ∼15% lower in ATL than in CON (P < 0.05). TOIC was similar between the groups at any time. This study shows that maintenance of high muscular oxygen extraction rate at very low circulating PaO2 stimulates the development of hypoxemia during submaximal exercise in hypoxia in endurance-trained individuals. This effect may predispose to premature development of acute mountain sickness symptoms during exercise at altitude.
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Affiliation(s)
- Ruud Van Thienen
- Exercise Physiology Research Group, Department of Kinesiology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Peter Hespel
- Exercise Physiology Research Group, Department of Kinesiology, Katholieke Universiteit Leuven, Leuven, Belgium
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van de Sande DAJP, Hoogeveen A, Hoogsteen J, Kemps HMC. The diagnostic accuracy of exercise electrocardiography in asymptomatic recreational and competitive athletes. Scand J Med Sci Sports 2015; 26:214-20. [DOI: 10.1111/sms.12420] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2014] [Indexed: 12/22/2022]
Affiliation(s)
| | - A. Hoogeveen
- Department of Sports Medicine; Maxima Medical Center; Veldhoven The Netherlands
| | - J. Hoogsteen
- Department of Cardiology; Maxima Medical Center; Veldhoven The Netherlands
| | - H. M. C. Kemps
- Department of Cardiology; Maxima Medical Center; Veldhoven The Netherlands
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Veronez L, Pereira MC, da Silva SMD, Barcaui LA, De Capitani EM, Moreira MM, Paschoal IA. Volumetric capnography for the evaluation of chronic airways diseases. Int J Chron Obstruct Pulmon Dis 2014; 9:983-9. [PMID: 25284998 PMCID: PMC4181545 DOI: 10.2147/copd.s62886] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Obstructive lung diseases of different etiologies present with progressive peripheral airway involvement. The peripheral airways, known as the silent lung zone, are not adequately evaluated with conventional function tests. The principle of gas washout has been used to detect pulmonary ventilation inhomogeneity and to estimate the location of the underlying disease process. Volumetric capnography (VC) analyzes the pattern of CO2 elimination as a function of expired volume. Objective To measure normalized phase 3 slopes with VC in patients with non-cystic fibrosis bronchiectasis (NCB) and in bronchitic patients with chronic obstructive pulmonary disease (COPD) in order to compare the slopes obtained for the groups. Methods NCB and severe COPD were enrolled sequentially from an outpatient clinic (Hospital of the State University of Campinas). A control group was established for the NCB group, paired by sex and age. All subjects performed spirometry, VC, and the 6-Minute Walk Test (6MWT). Two comparisons were made: NCB group versus its control group, and NCB group versus COPD group. The project was approved by the ethical committee of the institution. Statistical tests used were Wilcoxon or Student’s t-test; P<0.05 was considered to be a statistically significant difference. Results Concerning the NCB group (N=20) versus the control group (N=20), significant differences were found in body mass index and in several functional variables (spirometric, VC, 6MWT) with worse results observed in the NCB group. In the comparison between the COPD group (N=20) versus the NCB group, although patients with COPD had worse spirometric and 6MWT values, the capnographic variables mean phase 2 slope (Slp2), mean phase 3 slope normalized by the mean expiratory volume, or mean phase 3 slope normalized by the end-tidal CO2 concentration were similar. Conclusion These findings may indicate that the gas elimination curves are not sensitive enough to monitor the severity of structural abnormalities. The role of normalized phase 3 slope may be worth exploring as a more sensitive index of small airway disease, even though it may not be equally sensitive in discriminating the severity of the alterations.
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Affiliation(s)
- Liliani Veronez
- Department of Physical Therapy, University of Votuporanga (Educational Foundation of Votuporanga), Votuporanga, Brazil
| | - Monica Corso Pereira
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Silvia Maria Doria da Silva
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Luisa Affi Barcaui
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Eduardo Mello De Capitani
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Marcos Mello Moreira
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Ilma Aparecida Paschoal
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
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Petersson J, Glenny RW. Gas exchange and ventilation-perfusion relationships in the lung. Eur Respir J 2014; 44:1023-41. [PMID: 25063240 DOI: 10.1183/09031936.00037014] [Citation(s) in RCA: 189] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This review provides an overview of the relationship between ventilation/perfusion ratios and gas exchange in the lung, emphasising basic concepts and relating them to clinical scenarios. For each gas exchanging unit, the alveolar and effluent blood partial pressures of oxygen and carbon dioxide (PO2 and PCO2) are determined by the ratio of alveolar ventilation to blood flow (V'A/Q') for each unit. Shunt and low V'A/Q' regions are two examples of V'A/Q' mismatch and are the most frequent causes of hypoxaemia. Diffusion limitation, hypoventilation and low inspired PO2 cause hypoxaemia, even in the absence of V'A/Q' mismatch. In contrast to other causes, hypoxaemia due to shunt responds poorly to supplemental oxygen. Gas exchanging units with little or no blood flow (high V'A/Q' regions) result in alveolar dead space and increased wasted ventilation, i.e. less efficient carbon dioxide removal. Because of the respiratory drive to maintain a normal arterial PCO2, the most frequent result of wasted ventilation is increased minute ventilation and work of breathing, not hypercapnia. Calculations of alveolar-arterial oxygen tension difference, venous admixture and wasted ventilation provide quantitative estimates of the effect of V'A/Q' mismatch on gas exchange. The types of V'A/Q' mismatch causing impaired gas exchange vary characteristically with different lung diseases.
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Affiliation(s)
- Johan Petersson
- Section of Anaesthesiology and Intensive Care Medicine, Dept of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden Dept of Anaesthesiology, Surgical Services and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Robb W Glenny
- Dept of Medicine, Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA, USA Dept of Physiology and Biophysics, University of Washington, Seattle, WA, USA
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Seixas DM, Seixas DMT, Pereira MC, Moreira MM, Paschoal IA. Oxygen desaturation in healthy subjects undergoing the incremental shuttle walk test. J Bras Pneumol 2014; 39:440-6. [PMID: 24068265 PMCID: PMC4075871 DOI: 10.1590/s1806-37132013000400007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 07/09/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To determine the probability of oxygen desaturation in healthy individuals undergoing the incremental shuttle walk test (ISWT). METHODS We enrolled 83 healthy subjects: 55 males (including 1 smoker) and 28 females. We determined pre-ISWT FEV1, FEV6, HR and SpO2, as well as post-ISWT HR and SpO2. RESULTS Mean values overall were as follows: age, 35.05 ± 12.53 years; body mass index, 24.30 ± 3.47 kg/m2; resting HR, 75.12 ± 12.48 bpm; resting SpO2, 97.96 ± 1.02%; FEV1, 3.75 ± 0.81 L; FEV6, 4.45 ± 0.87 L; FEV1/FEV6 ratio, 0.83 ± 0.08 (no restriction or obstruction); incremental shuttle walk distance, 958.30 ± 146.32 m; post-ISWT HR, 162.41 ± 18.24 bpm; and post-ISWT SpO2, 96.27 ± 2.21%. In 11 subjects, post-ISWT SpO2 was higher than was pre-ISWT SpO2. In 17 subjects, there was a 4% decrease in SpO2 after the ISWT. There were no statistically significant differences between the groups with and without post-ISWT oxygen desaturation in terms of age, gender, FEV1, FEV6, FEV1/FEV6, pre-ISWT SpO2, incremental shuttle walk distance, HR, or percentage of maximal HR. In the individuals with post-ISWT oxygen desaturation, the body mass index was higher (p = 0.01) and post-ISWT SpO2 was lower (p = 0.0001). CONCLUSIONS Healthy individuals can present oxygen desaturation after the ISWT. Using the ISWT to predict subtle respiratory abnormalities can be misleading. In healthy subjects, oxygen desaturation is common after the ISWT, as it is during any intense physical activity.
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Avaliação do comprometimento respiratório em pacientes com lúpus eritematoso sistêmico com o teste de caminhada de seis minutos. REVISTA BRASILEIRA DE REUMATOLOGIA 2014. [DOI: 10.1016/j.rbr.2014.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Waltz X, Romana M, Lalanne-Mistrih ML, Machado RF, Lamarre Y, Tarer V, Hardy-Dessources MD, Tressières B, Divialle-Doumdo L, Petras M, Maillard F, Etienne-Julan M, Connes P. Hematologic and hemorheological determinants of resting and exercise-induced hemoglobin oxygen desaturation in children with sickle cell disease. Haematologica 2013; 98:1039-44. [PMID: 23539539 DOI: 10.3324/haematol.2013.083576] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The aim of the study was to determine the factors associated with resting and exercise-induced hemoglobin oxygen desaturation. The well-established six-minute walk test was conducted in 107 sickle cell children (50 with sickle hemoglobin C disease and 57 with sickle cell anemia) at steady state. Hemoglobin oxygen saturation was measured before and immediately after the six-minute walk test. Blood samples were obtained on the same day to measure hematologic and hemorheological parameters. Exercise-induced hemoglobin oxygen desaturation was defined as a drop in hemoglobin oxygen saturation of 3% or more at the end of the six-minute walk test compared to resting levels. No children with sickle hemoglobin C disease, but approximately 50% of children with sickle cell anemia showed mild or moderate oxygen desaturation at rest, which was independently associated with the percentage of reticulocytes. Exercise-induced hemoglobin oxygen desaturation was observed in 18% of children with sickle hemoglobin C disease and 34% of children with sickle cell anemia, and was independently associated with the six-minute walk test, acute chest syndrome rate and the strength of red blood cell aggregates in children with sickle cell anemia. No association was found in children with sickle hemoglobin C disease between exercise-induced hemoglobin oxygen desaturation and the measured parameters. Hemoglobin oxygen desaturation at rest was common in children with sickle cell anemia but not in children with sickle hemoglobin C disease, and was mainly associated with greater hemolysis. Physiological strain during exercise and red blood cell aggregation properties may predict the occurrence of exercise-induced hemoglobin oxygen desaturation in children with sickle cell anemia.
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Affiliation(s)
- Xavier Waltz
- UMR Inserm 665, Pointe-à-Pitre, Guadeloupe, Université des Antilles et de la Guyane, Pointe-à-Pitre, France
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Wang L, Liu W, Wang Y, Wang JC, Tu Q, Liu R, Wang J. Construction of oxygen and chemical concentration gradients in a single microfluidic device for studying tumor cell-drug interactions in a dynamic hypoxia microenvironment. LAB ON A CHIP 2013; 13:695-705. [PMID: 23254684 DOI: 10.1039/c2lc40661f] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Recent microfluidic advancements in oxygen gradients have greatly promoted controllable oxygen-sensitive cellular investigations at microscale resolution. However, multi-gradient integration in a single microfluidic device for tissue-mimicking cell investigation is not yet well established. In this study, we describe a method that can generate oxygen and chemical concentration gradients in a single microfluidic device via the formation of an oxygen gradient in a chamber and a chemical concentration gradient between adjacent chambers. The oxygen gradient dynamics were systematically investigated, and were quantitatively controlled using simple exchange between the aerial oxygen and the oxygen-free conditions in the gas-permeable polydimethylsiloxane channel. Meanwhile, the chemical gradient dynamics was generated using a special channel-branched device. For potential medical applications of the established oxygen and chemical concentration gradients, a tumor cell therapy assessment was performed using two antitumor drugs (tirapazamine and bleomycin) and two tumor cell lines (human lung adenocarcinoma A549 cells and human cervical carcinoma HeLa cells). The results of the proof-of-concept experiment indicate the dose-dependent antitumor effect of the drugs and hypoxia-induced cytotoxicity of tirapazamine. We demonstrate that the integration of oxygen and chemical concentration gradients in a single device can be applied to investigating oxygen- and chemical-sensitive cell events, which can also be valuable in the development of multi-gradient generating procedures and specific drug screening.
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Affiliation(s)
- Lei Wang
- College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi 712100, China
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Zhou J, Liu Y. Effects of genistein and estrogen on the genioglossus in rats exposed to chronic intermittent hypoxia may be HIF-1α dependent. Oral Dis 2013; 19:702-11. [DOI: 10.1111/odi.12060] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Revised: 11/16/2012] [Accepted: 12/09/2012] [Indexed: 01/06/2023]
Affiliation(s)
- J Zhou
- Department of Orthodontics; Stomatology School of Tongji University; Shanghai; China
| | - Y Liu
- Department of Orthodontics; Stomatology School of Tongji University; Shanghai; China
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Franklin SH, Van Erck-Westergren E, Bayly WM. Respiratory responses to exercise in the horse. Equine Vet J 2012; 44:726-32. [DOI: 10.1111/j.2042-3306.2012.00666.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S. H. Franklin
- School of Animal and Veterinary Sciences; University of Adelaide; South Australia; Australia
| | | | - W. M. Bayly
- Office of the Provost; Washington State University; Washington; USA
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Soaresa MR, Pereira CADC. Six-minute walk test: reference values for healthy adults in Brazil. J Bras Pneumol 2012; 37:576-83. [PMID: 22042388 DOI: 10.1590/s1806-37132011000500003] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Accepted: 06/06/2011] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To develop regression equations for six-minute walk distance (6MWD) in healthy adults (20-80 years of age) in Brazil. METHODS We included 132 volunteers (66 males) without respiratory disease, cardiac disease, or comorbidities that affect ambulation. The volunteers completed three six-minute walk tests. Prior to and at the end of each test, we obtained SpO2 and maximal HR, as well as the Borg scale scores for sensation of dyspnea and lower limb fatigue. The data included in the final analysis were derived from the test with the greatest 6MWD. RESULTS The mean 6MWD values were 566 ± 87 m and 538 ± 95 m in males and females, respectively (p = 0.08). The 6MWD was greater in taller individuals and decreased in parallel with increases in age or body index mass (BMI). The best adjusted model was the quadratic model. We derived the following equation (valid for both genders): 6MWD = 511 + stature² (cm) × 0.0066 - age² × 0.030 - BMI² × 0.068. This equation explained 55% of the variance in 6MWD. CONCLUSIONS Reference values explaining a high proportion of the variance were derived by a quadratic regression model in healthy adults (of a wide range of ages) in Brazil.
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Affiliation(s)
- Maria Raquel Soaresa
- Pulmonary Function Laboratory of the Respiratory Diseases Department, São Paulo Hospital for State Civil Servants, São Paulo, Brazil.
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Puga GM, Kokubun E, Simões HG, Nakamura FY, Campbell CSG. Aerobic fitness evaluation during walking tests identifies the maximal lactate steady state. ScientificWorldJournal 2012; 2012:769431. [PMID: 22666152 PMCID: PMC3361292 DOI: 10.1100/2012/769431] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 11/29/2011] [Indexed: 11/17/2022] Open
Abstract
Objective. The aim of this study was to verify the possibility of lactate minimum (LM) determination during a walking test and the validity of such LM protocol on predicting the maximal lactate steady-state (MLSS) intensity. Design. Eleven healthy subjects (24.2 ± 4.5 yr; 74.3 ± 7.7 kg; 176.9 ± 4.1 cm) performed LM tests on a treadmill, consisting of walking at 5.5 km · h−1 and with 20–22% of inclination until voluntary exhaustion to induce metabolic acidosis. After 7 minutes of recovery the participants performed an incremental test starting at 7% incline with increments of 2% at each 3 minutes until exhaustion. A polynomial modeling approach (LMp) and a visual inspection (LMv) were used to identify the LM as the exercise intensity associated to the lowest [bLac] during the test. Participants also underwent to 2–4 constant intensity tests of 30 minutes to determine the MLSS intensity. Results. There were no differences among LMv (12.6 ± 1.7%), LMp (13.1 ± 1.5%), and MLSS (13.6 ± 2.1%) and the Bland and Altman plots evidenced acceptable agreement between them. Conclusion. It was possible to identify the LM during walking tests with intensity imposed by treadmill inclination, and it seemed to be valid on identifying the exercise intensity associated to the MLSS.
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Prieur F, Benoît H. Rôle de l’apport d’O2 dans la limitation de la consommation maximale d’oxygène. Sci Sports 2011. [DOI: 10.1016/j.scispo.2010.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
UNLABELLED Whereas the prevalence of exercise-induced hypoxemia (EIH) in endurance athletes is commonly reported as approximately 50%, most previous studies have not corrected PaO2 for exercise-induced hyperthermia. Furthermore, although a detrimental effect on aerobic performance has been assumed, no study has measured arterial oxygen content (CaO2) in this context. PURPOSE To determine the effect of temperature-correcting PaO2 values for rectal, arterial blood, esophageal, and exercising muscle temperatures during exercise on CaO2 and the prevalence of EIH. METHODS Twenty-three trained males (age 26 +/- 5 yr; VO2peak 65.2 +/- 1.6 mL x kg-1 x min-1) performed incremental treadmill exercise to exhaustion with PaO2 corrected for simultaneous temperature measurements at all four sites. EIH was defined as DeltaPaO2 >or= 10 mm Hg. RESULTS : With no temperature correction, DeltaPaO2 was -20.8 +/- 5.0 mm Hg and prevalence was 96% (n = 23), but when corrected for rectal temperature, DeltaPaO2 was -14.7 +/- 7.8 mm Hg and prevalence was 73% (n = 20); for arterial blood temperature, DeltaPaO2 was -7.7 +/- 6.5 mm Hg and prevalence was 35% (n = 20); and for esophageal temperature, DeltaPaO2 was -8.1 +/- 7.7 mm Hg and prevalence was 48% (n = 23), although when corrected for active muscle temperature, DeltaPaO2 was +8.2 +/- 7.8 mm Hg and prevalence was 0% (n = 10). There were no significant changes in CaO2 except for uncorrected values, and there was no correlation between DeltaPaO2 and VO2peak. CONCLUSIONS Although the prevalence of EIH depends on the temperature correction applied to PaO2 values, in no case is there a significant change in CaO2 or any relationship with maximal aerobic power.
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Affiliation(s)
- Garry C Scroop
- Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, Australia
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