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Husaini M, Emery MS. Cardiopulmonary Exercise Testing Interpretation in Athletes: What the Cardiologist Should Know. Card Electrophysiol Clin 2024; 16:71-80. [PMID: 38280815 DOI: 10.1016/j.ccep.2023.09.008] [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] [Indexed: 01/29/2024]
Abstract
The noninvasive assessment of oxygen consumption, carbon dioxide production, and ventilation during a cardiopulmonary exercise test (CPET) provides insight into the cardiovascular, pulmonary, and metabolic system's ability to respond to exercise. Exercise physiology has been shown to be distinct for competitive athletes and highly active persons (CAHAPs), thus creating more nuanced interpretations of CPET parameters. CPET in CAHAP is an important test that can be used for both diagnosis (provoking symptoms during a truly maximal test) and performance.
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Affiliation(s)
- Mustafa Husaini
- Department of Medicine, Division of Cardiovascular Medicine, Washington University School of Medicine, 4921 Parkview Place, Saint Louis, MO 63110, USA. https://twitter.com/husainim
| | - Michael S Emery
- Sports Cardiology Center, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, 9500 Euclid Avenue, Desk J2-4, Cleveland, OH 44195, USA.
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Kasiak P, Kowalski T, Rębiś K, Klusiewicz A, Ładyga M, Sadowska D, Wilk A, Wiecha S, Barylski M, Poliwczak AR, Wierzbiński P, Mamcarz A, Śliż D. Is the Ventilatory Efficiency in Endurance Athletes Different?-Findings from the NOODLE Study. J Clin Med 2024; 13:490. [PMID: 38256624 PMCID: PMC10816682 DOI: 10.3390/jcm13020490] [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: 12/09/2023] [Revised: 01/13/2024] [Accepted: 01/14/2024] [Indexed: 01/24/2024] Open
Abstract
Background: Ventilatory efficiency (VE/VCO2) is a strong predictor of cardiovascular diseases and defines individuals' responses to exercise. Its characteristics among endurance athletes (EA) remain understudied. In a cohort of EA, we aimed to (1) investigate the relationship between different methods of calculation of VE/VCO2 and (2) externally validate prediction equations for VE/VCO2. Methods: In total, 140 EA (55% males; age = 22.7 ± 4.6 yrs; BMI = 22.6 ± 1.7 kg·m-2; peak oxygen uptake = 3.86 ± 0.82 L·min-1) underwent an effort-limited cycling cardiopulmonary exercise test. VE/VCO2 was first calculated to ventilatory threshold (VE/VCO2-slope), as the lowest 30-s average (VE/VCO2-Nadir) and from whole exercises (VE/VCO2-Total). Twelve prediction equations for VE/VCO2-slope were externally validated. Results: VE/VCO2-slope was higher in females than males (27.7 ± 2.6 vs. 26.1 ± 2.0, p < 0.001). Measuring methods for VE/VCO2 differed significantly in males and females. VE/VCO2 increased in EA with age independently from its type or sex (β = 0.066-0.127). Eleven equations underestimated VE/VCO2-slope (from -0.5 to -3.6). One equation overestimated VE/VCO2-slope (+0.2). Predicted and observed measurements differed significantly in nine models. Models explained a low amount of variance in the VE/VCO2-slope (R2 = 0.003-0.031). Conclusions: VE/VCO2-slope, VE/VCO2-Nadir, and VE/VCO2-Total were significantly different in EA. Prediction equations for the VE/VCO2-slope were inaccurate in EA. Physicians should be acknowledged to properly assess cardiorespiratory fitness in EA.
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Affiliation(s)
- Przemysław Kasiak
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Tomasz Kowalski
- Department of Physiology, Institute of Sport—National Research Institute, 01-982 Warsaw, Poland
| | - Kinga Rębiś
- Department of Physiology, Institute of Sport—National Research Institute, 01-982 Warsaw, Poland
| | - Andrzej Klusiewicz
- Department of Physical Education and Health in Biala Podlaska, Branch in Biala Podlaska, Jozef Pilsudski University of Physical Education, 00-968 Warsaw, Poland
| | - Maria Ładyga
- Department of Physiology, Institute of Sport—National Research Institute, 01-982 Warsaw, Poland
| | - Dorota Sadowska
- Department of Physiology, Institute of Sport—National Research Institute, 01-982 Warsaw, Poland
| | - Adrian Wilk
- Department of Kinesiology, Institute of Sport—National Research Institute, 01-982 Warsaw, Poland
| | - Szczepan Wiecha
- Department of Physical Education and Health in Biala Podlaska, Branch in Biala Podlaska, Jozef Pilsudski University of Physical Education, 00-968 Warsaw, Poland
| | - Marcin Barylski
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lodz, 90-419 Lodz, Poland
| | - Adam Rafał Poliwczak
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lodz, 90-419 Lodz, Poland
| | - Piotr Wierzbiński
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Artur Mamcarz
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Daniel Śliż
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
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Komici K, Bencivenga L, Rengo G, Bianco A, Guerra G. Ventilatory efficiency in post-COVID-19 athletes. Physiol Rep 2023; 11:e15795. [PMID: 37734918 PMCID: PMC10513909 DOI: 10.14814/phy2.15795] [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: 03/13/2023] [Revised: 07/11/2023] [Accepted: 08/07/2023] [Indexed: 09/23/2023] Open
Abstract
Limitation in exercise capacity has not been described in athletes affected by SARS-CoV-2 infection. However, patients who have recovered from COVID-19 without cardiopulmonary impairment show exaggerated ventilatory response during exercise. Therefore, we aimed to evaluate the ventilatory efficiency (VEf) in competitive athletes recovered from COVID-19 and to characterize the ventilation versus carbon dioxide relationship (VE/VCO2 ) slope in this population. Thirty-seven competitive athletes with COVID-19 were recruited for this study. All participants underwent spirometry, echocardiography, and cardiopulmonary exercise testing (CPET). z-FVC values and end-title pressure of CO2 (PET CO2 ) were lower in the third tertile compared with the first tertile: -0.753 ± 0.473 vs. 0.037 ± 0.911, p = 0.05; 42.2 ± 2.7 vs. 37.1 ± 2.5 mmHg, p < 0.01. VE/VCO2 slope was significantly correlated to maximal VCO2 /VE and maximal VO2 /VE: coefficient = -0.5 R2 = 0.58, p < 0.0001 and coefficient = -0.3 R2 = 0.16, p = 0.008. Competitive athletes affected by SARS-CoV-2 infection, without cardio-respiratory disease sequel, may present ventilatory inefficiency (ViE), without exercise capacity limitation. FVC is higher in athletes with better ventilatory performance during exercise, and increased VE/VCO2 slope is inversely correlated to max VCO2 /VE and max VO2 /VE.
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Affiliation(s)
- Klara Komici
- Department of Medicine and Health SciencesUniversity of MoliseCampobassoItaly
- Exercise and Sports Medicine UnitAntonio Cardarelli HospitalCampobassoItaly
| | - Leonardo Bencivenga
- Department of Translational Medical SciencesUniversity of Naples “Federico II”NaplesItaly
| | - Giuseppe Rengo
- Department of Translational Medical SciencesUniversity of Naples “Federico II”NaplesItaly
- Istituti Clinici Scientifici Maugeri IRCCS‐Scientific Institute of Telese TermeTelese TermeItaly
| | - Andrea Bianco
- Department of Translational Medical SciencesUniversity of Campania “L. Vanvitelli”NaplesItaly
| | - Germano Guerra
- Department of Medicine and Health SciencesUniversity of MoliseCampobassoItaly
- Exercise and Sports Medicine UnitAntonio Cardarelli HospitalCampobassoItaly
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Espinosa-Ramírez M, Riquelme S, Araya F, Rodríguez G, Figueroa-Martínez F, Gabrielli L, Viscor G, Reid WD, Contreras-Briceño F. Effectiveness of Respiratory Muscles Training by Voluntary Isocapnic Hyperpnea Versus Inspiratory Threshold Loading on Intercostales and Vastus Lateralis Muscles Deoxygenation Induced by Exercise in Physically Active Adults. BIOLOGY 2023; 12:biology12020219. [PMID: 36829497 PMCID: PMC9953077 DOI: 10.3390/biology12020219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
Respiratory muscle training (RMT) improves physical performance, although it is still debated whether this effect depends on the type of training. The purpose of this study was to compare the effects of two different types of RMT, i.e., voluntary isocapnic hyperpnea (VIH) and inspiratory threshold loading (ITL), on the deoxygenation of intercostal (ΔSmO2-m. intercostales) and vastus lateralis (ΔSmO2-m. vastus lateralis) muscles during exercise. Twenty-four participants performed eight weeks of RMT by: (i) VIH (3 days·week-1 for 12 min at 60% maximal voluntary ventilation) or (ii) ITL (5 sets·week-1 of 30 breaths·minute-1 at 60% maximal inspiratory pressure). Cardiopulmonary exercise testing (CPET) included ΔSmO2 (the change from baseline to end of test) of intercostal and vastus lateralis muscles. After RMT, both groups showed decreased ΔSmO2-m. intercostales (VIH = 12.8 ± 14.6%, p = 0.04 (effect size, ES = 0.59), and ITL = 8.4 ± 9.8%, p = 0.04 (ES = 0.48)), without a coincident change of ∆SmO2-m. vastus lateralis. ITL training induced higher V˙O2-peak absolute values than VIH (mean Δ post-pre, ITL = 229 ± 254 mL·min-1 [95% CI 67-391] vs. VIH, 39 ± 153 mL·min-1 [95% CI -58-136.0], p = 0.01). In conclusion, both RMT improved the balance between supply and oxygen consumption levels of m. intercostales during CPET, with ITL also inducing an increase of aerobic capacity.
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Affiliation(s)
- Maximiliano Espinosa-Ramírez
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Santiago Riquelme
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Felipe Araya
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Guido Rodríguez
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Fernanda Figueroa-Martínez
- Laboratory of Voice, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Luigi Gabrielli
- Advanced Center for Chronic Diseases (ACCDiS), Division of Cardiovascular Diseases, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta #367, Santiago 8380000, Chile
| | - Ginés Viscor
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain
| | - W. Darlene Reid
- Department of Physical Therapy and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON M5G 2C4, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON M5G 2A2, Canada
| | - Felipe Contreras-Briceño
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
- Advanced Center for Chronic Diseases (ACCDiS), Division of Cardiovascular Diseases, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta #367, Santiago 8380000, Chile
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain
- Millennium Institute for Intelligent Healthcare Engineering, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
- Correspondence: ; Tel.: +56-9-82288153
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Martin ȘA, Martin-Hadmaș RM. Differences in Adolescent's Cardiometabolic Health: A Comparison Regarding Guided Team and Endurance Sports. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:17070. [PMID: 36554948 PMCID: PMC9779139 DOI: 10.3390/ijerph192417070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
Physical exercise can induce changes in gas exchange and ventilation kinetics. Of these, some will lead to various adaptations which can influence performance and health. We conducted a single-center observational study on 40 participants. Of them, 20 participants came from volleyball (Sample 1) and the other 20 participants came from triathlon (Sample 2). All participants underwent anthropometric and basal metabolic rate measurements, along with a laboratory aerobic capacity test (VO2peak). In Sample 1, the VO2peak was 2.38 L/min and 37.5 mL/min/kg, unlike in Sample 2, which had 2.31 L/min (p = 0.402, Mann-Whitney U = 204) and 43 mL/min/kg oxygen uptake (p = 0.0001). VE/VO2 was significantly different (p = 0.0002, Mann-Whitney U = 80), reaching 31.3 and 36.1 L/min in Sample 1 and Sample 2. Similar results were obtained regarding VE/VCO2 (p = 0.0074, Mann-Whitney U = 126), i.e., 31.3 and 33.9 L/min in Sample 1 and Sample 2. The contribution of physical activity was observed in both groups by taking into account the peak oxygen uptake. In comparison, the team sports sample showed an increased metabolic cost at the VO2peak.
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Affiliation(s)
- Ștefan Adrian Martin
- Department of Physiology, Center for Advanced Medical and Pharmaceutical Research “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Gheorghe Marinescu 38, 540139 Mureș, Romania
| | - Roxana Maria Martin-Hadmaș
- Department of Community Nutrition and Food Safety, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, Gheorghe Marinescu 38, 540139 Mureș, Romania
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Husaini M, Emery MS. Cardiopulmonary Exercise Testing Interpretation in Athletes. Cardiol Clin 2022; 41:71-80. [DOI: 10.1016/j.ccl.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Braga F, Espinosa G, Monteiro A, Marinho B, Drummond E. Physiological Effects of Exercising at Different Intensities Wearing Surgical or Double-layer Cotton Facemasks Compared to Not Wearing a Mask. Eur J Sport Sci 2022; 23:925-935. [PMID: 35418276 DOI: 10.1080/17461391.2022.2065928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Since the beginning of the SARS-CoV-2 pandemic, the community use of facemasks has been widely recommended. However, their use during exercise has raised safety concerns. Thus, we compared the physiological differences between exercising wearing a surgical (SM) or a double-layer-cotton (DLC) facemask and not wearing a mask (NM). Sixteen volunteers underwent 4 bouts of cycling-based exercise, which consisted of two different intensities: light-to-moderate and moderate-to-high. Facemasks were used as follows: bout-1 and 4: NM; bout-2: SM or DLC and bout-3: DLC or SM. Ventilatory, metabolic, pulmonary gas exchange (PGE) and perceptual variables were collected. At both exercise intensities compared to NM, both facemasks induced similar ventilatory adaptations, increasing inspiratory time and tidal volume and decreasing breathing frequency. Effect sizes (ES) were larger for DLC than for SM. At moderate-to-high, both facemasks reduced the minute ventilation, whereas at light-to-moderate, it was only seen with DLC. End tidal and mixed CO2 pressures, as well as the difference between them, increased with both facemasks. Again, ES was larger for DLC than SM. No relevant oxygen saturation drop was observed with both facemaks and exercise intensities. A small ES increament in VO2 and VCO2 were seen with both facemasks. Effort perception increased at moderate-to-high for both exercise intensities, buth larger EF were with DLC than SM . DLC increased facial temperature during both exercise intensities. In conclusion, ventilatory adjustments imposed during facemask exercise influenced PGE and metabolic and perceptual changes. Larger ES were mostly seen for DLC than SM.Novelty Bullets Facemasks affect the breathing pattern by changing the frequency and amplitude of pulmonary ventilation.The augmented ventilatory work increases VO2, VCO2, and RPE and promotes nonconcerning drops in SpO2 and CO2 retention.Increased inspiratory and expiratory pressure can account for the reduction in pulmonary physiological dead space.
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Affiliation(s)
- Fabrício Braga
- Human Performance Laboratory; Rio de Janeiro; Brazil.,Casa de Saúde São José; Rio de Janeiro; Brazil
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Harbour E, Stöggl T, Schwameder H, Finkenzeller T. Breath Tools: A Synthesis of Evidence-Based Breathing Strategies to Enhance Human Running. Front Physiol 2022; 13:813243. [PMID: 35370762 PMCID: PMC8967998 DOI: 10.3389/fphys.2022.813243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/28/2022] [Indexed: 01/23/2023] Open
Abstract
Running is among the most popular sporting hobbies and often chosen specifically for intrinsic psychological benefits. However, up to 40% of runners may experience exercise-induced dyspnoea as a result of cascading physiological phenomena, possibly causing negative psychological states or barriers to participation. Breathing techniques such as slow, deep breathing have proven benefits at rest, but it is unclear if they can be used during exercise to address respiratory limitations or improve performance. While direct experimental evidence is limited, diverse findings from exercise physiology and sports science combined with anecdotal knowledge from Yoga, meditation, and breathwork suggest that many aspects of breathing could be improved via purposeful strategies. Hence, we sought to synthesize these disparate sources to create a new theoretical framework called “Breath Tools” proposing breathing strategies for use during running to improve tolerance, performance, and lower barriers to long-term enjoyment.
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Affiliation(s)
- Eric Harbour
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria
- *Correspondence: Eric Harbour,
| | - Thomas Stöggl
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria
- Red Bull Athlete Performance Center, Salzburg, Austria
| | - Hermann Schwameder
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria
| | - Thomas Finkenzeller
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria
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Cardiopulmonary Exercise Test Parameters in Athletic Population: A Review. J Clin Med 2021; 10:jcm10215073. [PMID: 34768593 PMCID: PMC8584629 DOI: 10.3390/jcm10215073] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/17/2021] [Accepted: 10/26/2021] [Indexed: 11/23/2022] Open
Abstract
Although still underutilized, cardiopulmonary exercise testing (CPET) allows the most accurate and reproducible measurement of cardiorespiratory fitness and performance in athletes. It provides functional physiologic indices which are key variables in the assessment of athletes in different disciplines. CPET is valuable in clinical and physiological investigation of individuals with loss of performance or minor symptoms that might indicate subclinical cardiovascular, pulmonary or musculoskeletal disorders. Highly trained athletes have improved CPET values, so having just normal values may hide a medical disorder. In the present review, applications of CPET in athletes with special attention on physiological parameters such as VO2max, ventilatory thresholds, oxygen pulse, and ventilatory equivalent for oxygen and exercise economy in the assessment of athletic performance are discussed. The role of CPET in the evaluation of possible latent diseases and overtraining syndrome, as well as CPET-based exercise prescription, are outlined.
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Collins SÉ, Phillips DB, Brotto AR, Rampuri ZH, Stickland MK. Ventilatory efficiency in athletes, asthma and obesity. Eur Respir Rev 2021; 30:30/161/200206. [PMID: 34289980 DOI: 10.1183/16000617.0206-2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/16/2020] [Indexed: 11/05/2022] Open
Abstract
During submaximal exercise, minute ventilation (V' E) increases in proportion to metabolic rate (i.e. carbon dioxide production (V' CO2 )) to maintain arterial blood gas homeostasis. The ratio V' E/V' CO2 , commonly termed ventilatory efficiency, is a useful tool to evaluate exercise responses in healthy individuals and patients with chronic disease. Emerging research has shown abnormal ventilatory responses to exercise (either elevated or blunted V' E/V' CO2 ) in some chronic respiratory and cardiovascular conditions. This review will briefly provide an overview of the physiology of ventilatory efficiency, before describing the ventilatory responses to exercise in healthy trained endurance athletes, patients with asthma, and patients with obesity. During submaximal exercise, the V' E/V' CO2 response is generally normal in endurance-trained individuals, patients with asthma and patients with obesity. However, in endurance-trained individuals, asthmatics who demonstrate exercise induced-bronchoconstriction, and morbidly obese individuals, the V' E/V' CO2 can be blunted at maximal exercise, likely because of mechanical ventilatory constraint.
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Affiliation(s)
- Sophie É Collins
- Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Devin B Phillips
- Respiratory Investigation Unit, Department of Medicine, Queen's University, Kingston, Canada
| | - Andrew R Brotto
- Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Zahrah H Rampuri
- Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Michael K Stickland
- Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,G.F. MacDonald Centre for Lung Health, Covenant Health, Edmonton, Canada
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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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12
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Dorelli G, Braggio M, Gabbiani D, Busti F, Caminati M, Senna G, Girelli D, Laveneziana P, Ferrari M, Sartori G, Dalle Carbonare L, Crisafulli E. Importance of Cardiopulmonary Exercise Testing amongst Subjects Recovering from COVID-19. Diagnostics (Basel) 2021; 11:diagnostics11030507. [PMID: 33809260 PMCID: PMC7998697 DOI: 10.3390/diagnostics11030507] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/20/2021] [Accepted: 03/11/2021] [Indexed: 11/20/2022] Open
Abstract
The cardiopulmonary exercise test (CPET) provides an objective assessment of ventilatory limitation, related to the exercise minute ventilation (VE) coupled to carbon dioxide output (VCO2) (VE/VCO2); high values of VE/VCO2 slope define an exercise ventilatory inefficiency (EVin). In subjects recovered from hospitalised COVID-19, we explored the methodology of CPET in order to evaluate the presence of cardiopulmonary alterations. Our prospective study (RESPICOVID) has been proposed to evaluate pulmonary damage’s clinical impact in post-COVID subjects. In a subgroup of subjects (RESPICOVID2) without baseline confounders, we performed the CPET. According to the VE/VCO2 slope, subjects were divided into having EVin and exercise ventilatory efficiency (EVef). Data concerning general variables, hospitalisation, lung function, and gas-analysis were also collected. The RESPICOVID2 enrolled 28 subjects, of whom 8 (29%) had EVin. As compared to subjects with EVef, subjects with EVin showed a reduction in heart rate (HR) recovery. VE/VCO2 slope was inversely correlated with HR recovery; this correlation was confirmed in a subgroup of older, non-smoking male subjects, regardless of the presence of arterial hypertension. More than one-fourth of subjects recovered from hospitalised COVID-19 have EVin. The relationship between EVin and HR recovery may represent a novel hallmark of post-COVID cardiopulmonary alterations.
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Affiliation(s)
- Gianluigi Dorelli
- School of Medicine in Sports and Exercise, University of Verona, 37134 Verona, Italy; (G.D.); (M.B.); (M.F.); (L.D.C.)
| | - Michele Braggio
- School of Medicine in Sports and Exercise, University of Verona, 37134 Verona, Italy; (G.D.); (M.B.); (M.F.); (L.D.C.)
| | - Daniele Gabbiani
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; (D.G.); (F.B.); (D.G.); (G.S.)
| | - Fabiana Busti
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; (D.G.); (F.B.); (D.G.); (G.S.)
| | - Marco Caminati
- Department of Medicine, Allergy and Clinical Immunology Section, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; (M.C.); (G.S.)
| | - Gianenrico Senna
- Department of Medicine, Allergy and Clinical Immunology Section, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; (M.C.); (G.S.)
| | - Domenico Girelli
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; (D.G.); (F.B.); (D.G.); (G.S.)
| | - Pierantonio Laveneziana
- INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, AP-HP, Sorbonne Université, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service des Explorations Fonctionnelles de la Respiration, de l’Exercice et de la Dyspnée du Département Médico-Universitaire «APPROCHES», 75013 Paris, France;
| | - Marcello Ferrari
- School of Medicine in Sports and Exercise, University of Verona, 37134 Verona, Italy; (G.D.); (M.B.); (M.F.); (L.D.C.)
| | - Giulia Sartori
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; (D.G.); (F.B.); (D.G.); (G.S.)
- Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy
| | - Luca Dalle Carbonare
- School of Medicine in Sports and Exercise, University of Verona, 37134 Verona, Italy; (G.D.); (M.B.); (M.F.); (L.D.C.)
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; (D.G.); (F.B.); (D.G.); (G.S.)
| | - Ernesto Crisafulli
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; (D.G.); (F.B.); (D.G.); (G.S.)
- Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy
- Correspondence:
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Albesa-Albiol L, Serra-Payá N, Garnacho-Castaño MA, Guirao Cano L, Pleguezuelos Cobo E, Maté-Muñoz JL, Garnacho-Castaño MV. Ventilatory efficiency during constant-load test at lactate threshold intensity: Endurance versus resistance exercises. PLoS One 2019; 14:e0216824. [PMID: 31112561 PMCID: PMC6528988 DOI: 10.1371/journal.pone.0216824] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/29/2019] [Indexed: 12/22/2022] Open
Abstract
There is a lack of evidence about the ventilatory efficiency in resistance exercises despite the key role played in endurance exercises. This study aimed to compare the cardiorespiratory, metabolic responses and ventilatory efficiency between half-squat (HS) and cycle ergometer exercises during a constant-load test at the lactate threshold (LT) intensity. Eighteen healthy male participants were randomly assigned in a crossover design to carry out HS or cycle ergometer tests. For the three HS tests, a one repetition maximum (1RM) test was performed first to determine the load (kg) corresponding to the 1RM percentages. In the second test, the incremental HS exercise was carried out to establish the load (kg) at the LT intensity. Finally, a constant-load HS test was performed at the LT intensity. The first cycle ergometer test was incremental loading to determine the intensity in watts corresponding to the LT, followed by a constant-load test at the LT intensity. A recovery time of 48 hours between each test was established. During both constant-load test, cardiorespiratory and metabolic responses were monitored. A significant exercise mode x time interaction effect was only detected in oxygen uptake (VO2), heart rate, and blood lactate (p < 0.001). No differences were found between the two types of exercise in ventilatory efficiency (p >0.05). Ventilation (VE) and carbon dioxide were highly correlated (p <0.001) in the cycle ergometer (r = 0.892) and HS (r = 0.915) exercises. In the VO2 efficiency slope (OUES), similarly significant and high correlations (p <0.001) were found between VO2 and log10 VE in the cycle ergometer (r = 0.875) and in the HS (r = 0.853) exercise. Although the cardioventilatory responses were greater in the cycle ergometer test as compared to HS exercise, ventilatory efficiency was very similar between the two exercise modalities in a predominantly aerobic metabolism.
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Affiliation(s)
- Lluis Albesa-Albiol
- GRI-AFIRS, School of Health Sciences, TecnoCampus-Pompeu Fabra University, Mataró, Barcelona, Spain
| | - Noemí Serra-Payá
- GRI-AFIRS, School of Health Sciences, TecnoCampus-Pompeu Fabra University, Mataró, Barcelona, Spain
| | | | - Lluis Guirao Cano
- GRI-AFIRS, School of Health Sciences, TecnoCampus-Pompeu Fabra University, Mataró, Barcelona, Spain
- Department of Rehabilitation, Hospital Asepeyo, Sant Cugat, Barcelona, Spain
| | - Eulogio Pleguezuelos Cobo
- GRI-AFIRS, School of Health Sciences, TecnoCampus-Pompeu Fabra University, Mataró, Barcelona, Spain
- Department of Physical and Rehabilitation Medicine, Hospital de Mataró, Mataró, Barcelona, Spain
| | - José Luis Maté-Muñoz
- Department of Physical Activity and Sports Science, Alfonso X El Sabio University, Villanueva de la Cañada, Madrid, Spain
| | - Manuel V. Garnacho-Castaño
- GRI-AFIRS, School of Health Sciences, TecnoCampus-Pompeu Fabra University, Mataró, Barcelona, Spain
- * E-mail:
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