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Boussuges A, Chaumet G, Boussuges M, Menard A, Delliaux S, Brégeon F. Ultrasound assessment of the respiratory system using diaphragm motion-volume indices. Front Med (Lausanne) 2023; 10:1190891. [PMID: 37275363 PMCID: PMC10235454 DOI: 10.3389/fmed.2023.1190891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/03/2023] [Indexed: 06/07/2023] Open
Abstract
Background Although previous studies have determined limit values of normality for diaphragm excursion and thickening, it would be beneficial to determine the normal diaphragm motion-to-inspired volume ratio that integrates the activity of the diaphragm and the quality of the respiratory system. Methods To determine the normal values of selected ultrasound diaphragm motion-volume indices, subjects with normal pulmonary function testing were recruited. Ultrasound examination recorded diaphragm excursion on both sides during quiet breathing and deep inspiration. Diaphragm thickness was also measured. The inspired volumes of the corresponding cycles were systematically recorded using a spirometer. The indices were calculated using the ratio excursion, or percentage of thickening, divided by the corresponding breathing volume. From this corhort, normal values and limit values for normality were determined. These measurements were compared to those performed on the healthy side in patients with hemidiaphragm paralysis because an increase in hemidiaphragm activity has been previously demonstated in such circumstances. Results A total of 122 subjects (51 women, 71 men) with normal pulmonary function were included in the study. Statistical analysis revealed that the ratio of excursion, or percentage of thickening, to inspired volume ratio significantly differed between males and females. When the above-mentioned indices using excursion were normalized by body weight, no gender differences were found. The indices differed between normal respiratory function subjects and patients with hemidiaphragm paralysis (27 women, 41 men). On the paralyzed side, the average ratio of the excursion divided by the inspired volume was zero. On the healthy side, the indices using the excursion and the percentage of thickening during quiet breathing or deep inspiration were significantly increased comparedto patients with normal lung function. According to the logistic regression analysis, the most relevant indice appeared to be the ratio of the excursion measured during quiet breathing to the inspired volume. Conclusion The normal values of the diaphragm motion-volume indices could be useful to estimate the performance of the respiratory system. Proposed indices appear suitable in a context of hyperactivity.
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Affiliation(s)
- Alain Boussuges
- Center for Cardiovascular and Nutrition Research, C2VN (Aix Marseille University, INSERM 1263, INRAE 1260), Faculté de Médecine, Marseille, France
- APHM, Hôpital Nord, Explorations Fonctionnelles Respiratoires, Marseille, France
| | | | - Martin Boussuges
- Aix Marseille University, APHM, Département de Pneumologie, Hôpital Nord, Marseille, France
| | - Amelie Menard
- APHM, Hôpital Nord, Unité Post COVID, Service de Médecine Interne, Marseille, France
| | - Stephane Delliaux
- Center for Cardiovascular and Nutrition Research, C2VN (Aix Marseille University, INSERM 1263, INRAE 1260), Faculté de Médecine, Marseille, France
- APHM, Hôpital Nord, Explorations Fonctionnelles Respiratoires, Marseille, France
| | - Fabienne Brégeon
- APHM, Hôpital Nord, Explorations Fonctionnelles Respiratoires, Marseille, France
- Aix Marseille University, APHM, Microbes Evolution Phylogeny and Infections Department, IHU-Méditerranée Infection, Marseille, France
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Delliaux S, Ichinose M, Watanabe K, Fujii N, Nishiyasu T. Muscle metaboreflex activation during hypercapnia modifies nonlinear heart rhythm dynamics, increasing the complexity of the sinus node autonomic regulation in humans. Pflugers Arch 2023; 475:527-539. [PMID: 36645512 DOI: 10.1007/s00424-022-02780-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/01/2022] [Accepted: 12/04/2022] [Indexed: 01/17/2023]
Abstract
Muscle metaboreflex activation during hypercapnia leads to enhanced pressive effects that are poorly understood while autonomic responses including baroreflex function are not documented. Thus, we assessed heart rate variability (HRV) that is partly due to autonomic influences on sinus node with linear tools (spectral analysis of instantaneous heart period), baroreflex set point and sensitivity with the heart period-arterial pressure transfer function and sequences methods, and system coupling through the complexity of RR interval dynamics with nonlinear tools (Poincaré plots and approximate entropy (ApEn)). We studied ten healthy young men at rest and then during muscle metaboreflex activation (MMA, postexercise muscle ischemia) and hypercapnia (HCA, PetCO2 = + 10 mmHg from baseline) separately and combined (MMA + HCA). The strongest pressive responses were observed during MMA + HCA, while baroreflex sensitivity was similarly lowered in the three experimental conditions. HRV was significantly different in MMA + HCA compared to MMA and HCA separately, with the lowest total power spectrum (p < 0.05), including very low frequency (p < 0.05), low frequency (p < 0.05), and high frequency (tendency) power spectra decreases, and the lowest Poincaré plot short-term variability index (SD1): SD1 = 36.2 ms (MMA + HCA) vs. SD1 = 43.1 ms (MMA, p < 0.05) and SD1 = 46.1 ms (HCA, p < 0.05). Moreover, RR interval dynamic complexity was significantly increased only in the MMA + HCA condition (ApEn increased from 1.04 ± 0.04, 1.07 ± 0.02, and 1.05 ± 0.03 to 1.10 ± 0.03, 1.13 ± 0.04, and 1.17 ± 0.03 in MMA, HCA, and MMA + HCA conditions, respectively; p < 0.01). These results suggest that in healthy young men, muscle metaboreflex activation during hypercapnia leads to interactions that reduce parasympathetic influence on the sinus node activity but complexify its dynamics.
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Affiliation(s)
- Stephane Delliaux
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France.
- Assistance Publique - Hôpitaux de Marseille, APHM, Hôpital Nord, Pôle Cardiovasculaire et Thoracique, Laboratoire de Physiologie Respiratoire - Explorations à l'Exercice, Marseille, France.
- Laboratory of Physiology - Circulation, Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
- Japan Society for the Promotion of Science, Tokyo, Japan.
| | - Masashi Ichinose
- Laboratory of Physiology - Circulation, Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
- School of Business and Administration, Meiji University, Tokyo, Japan
| | - Kazuhito Watanabe
- Laboratory of Physiology - Circulation, Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Naoto Fujii
- Laboratory of Physiology - Circulation, Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Takeshi Nishiyasu
- Laboratory of Physiology - Circulation, Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
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Boussuges A, Habert P, Chaumet G, Rouibah R, Delorme L, Menard A, Million M, Bartoli A, Guedj E, Gouitaa M, Zieleskiewicz L, Finance J, Coiffard B, Delliaux S, Brégeon F. Diaphragm dysfunction after severe COVID-19: An ultrasound study. Front Med (Lausanne) 2022; 9:949281. [PMID: 36091672 PMCID: PMC9448976 DOI: 10.3389/fmed.2022.949281] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundSARS-CoV-2 infection can impair diaphragm function at the acute phase but the frequency of diaphragm dysfunction after recovery from COVID-19 remains unknown.Materials and methodsThis study was carried out on patients reporting persistent respiratory symptoms 3–4 months after severe COVID-19 pneumonia. The included patients were selected from a medical consultation designed to screen for recovery after acute infection. Respiratory function was assessed by a pulmonary function test, and diaphragm function was studied by ultrasonography.ResultsIn total, 132 patients (85M, 47W) were recruited from the medical consultation. During the acute phase of the infection, the severity of the clinical status led to ICU admission for 58 patients (44%). Diaphragm dysfunction (DD) was detected by ultrasonography in 13 patients, two of whom suffered from hemidiaphragm paralysis. Patients with DD had more frequently muscle pain complaints and had a higher frequency of prior cardiothoracic or upper abdominal surgery than patients with normal diaphragm function. Pulmonary function testing revealed a significant decrease in lung volumes and DLCO and the dyspnea scores (mMRC and Borg10 scores) were significantly increased in patients with DD. Improvement in respiratory function was recorded in seven out of nine patients assessed 6 months after the first ultrasound examination.ConclusionAssessment of diaphragm function by ultrasonography after severe COVID-19 pneumonia revealed signs of dysfunction in 10% of our population. In some cases, ultrasound examination probably discovered an un-recognized pre-existing DD. COVID-19 nonetheless contributed to impairment of diaphragm function. Prolonged respiratory physiotherapy led to improvement in respiratory function in most patients.Clinical trial registration[www.cnil.fr], identifier [#PADS20-207].
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Affiliation(s)
- Alain Boussuges
- Faculté de Médecine, Center for Cardiovascular and Nutrition Research, C2VN, INSERM 1263, INRAE 1260, Aix-Marseille University, Marseille, France
- Explorations Fonctionnelles Respiratoires, Hôpital Nord, APHM, Marseille, France
- *Correspondence: Alain Boussuges, ,
| | - Paul Habert
- Département d’Imagerie, Hôpital Nord, APHM, LIIE, Aix-Marseille University, Marseille, France
| | | | - Rawah Rouibah
- Explorations Fonctionnelles Respiratoires, Hôpital Nord, APHM, Marseille, France
| | - Lea Delorme
- IRD, IHU-Méditerranée Infection, Marseille, France
| | - Amelie Menard
- Unité Post COVID, Service de Médecine Interne, Hôpital Nord, APHM, Marseille, France
| | - Matthieu Million
- Microbes Evolution Phylogeny and Infections (MEPHI), IHU-Méditerranée Infection, APHM, Aix-Marseille University, Marseille, France
| | - Axel Bartoli
- Département de Radiologie, CNRS, CRMBM, Hôpital Timone, APHM, Aix-Marseille University, Marseille, France
| | - Eric Guedj
- Department of Nuclear Medicine, CNRS, Centrale Marseille, Institut Fresnel, Hôpital Timone, CERIMED, APHM, Aix-Marseille University, Marseille, France
| | - Marion Gouitaa
- Clinique des Bronches, Allergie et Sommeil, Hôpital Nord, APHM, Marseille, France
| | - Laurent Zieleskiewicz
- Faculté de Médecine, Center for Cardiovascular and Nutrition Research, C2VN, INSERM 1263, INRAE 1260, Aix-Marseille University, Marseille, France
- Service d’Anesthésie et Réanimation, Hôpital Nord, Marseille, France
| | - Julie Finance
- Explorations Fonctionnelles Respiratoires, Hôpital Nord, APHM, Marseille, France
| | - Benjamin Coiffard
- Département des Maladies Respiratoire et Transplantation Pulmonaire, Hôpital Nord, APHM, Aix-Marseille University, Marseille, France
| | - Stephane Delliaux
- Faculté de Médecine, Center for Cardiovascular and Nutrition Research, C2VN, INSERM 1263, INRAE 1260, Aix-Marseille University, Marseille, France
- Explorations Fonctionnelles Respiratoires, Hôpital Nord, APHM, Marseille, France
| | - Fabienne Brégeon
- Explorations Fonctionnelles Respiratoires, Hôpital Nord, APHM, Marseille, France
- Microbes Evolution Phylogeny and Infections (MEPHI), IHU-Méditerranée Infection, APHM, Aix-Marseille University, Marseille, France
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Sow A, Delliaux S, Guinde J, Finance J, Rey F, Boussuges A, Palot A, Reynaud-Gaubert M, Bregeon F. Le test d’hyperoxie (100 % oxygène) a-t-il un intérêt en première intention dans la recherche d’un shunt ? Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cabon E, Rey F, Tissier-Ducamp D, Del Volgo MJ, Delliaux S, Bues-Charbit M, Charpin D, Brégeon F. [Occurrence of delayed symptoms after a challenge test with methacholine]. Rev Mal Respir 2018; 35:249-255. [PMID: 29602485 DOI: 10.1016/j.rmr.2017.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 09/01/2017] [Indexed: 10/17/2022]
Abstract
There are few prospective studies available on the development of delayed symptoms following challenge tests with methacholine (MCT) at the currently recommended doses. The objective of this study was to describe the nature and frequency of respiratory symptoms suggestive of bronchospasm developing within 24hours after a MCT. The study was offered to adult patients who underwent MCT seen consecutively between June and October 2015. Following the test, a questionnaire adapted from the GINA asthma control questionnaire bearing on diurnal and nocturnal symptoms (cough, dyspnoea, wheeze and tightness), was delivered to the patient and the replies collected by telephone 24hours later. Of the 101 patients included (initial FEV1 2.82±0.79L), 46 (46 %) were MCT+ and 55 (54 %) MCT-. Among the MCT-, 4 (7 %) presented with immediate symptoms (S+) and 4 (7 %) with delayed symptoms. Among the MCT+ patients, 36 (78 %) presented with immediate symptoms (P<0.001 compared with the MCT- patients), and 39 (85 %) with delayed symptoms (P<0.001 compared with the MCT- patients). Delayed symptoms developed with a mean of 5h30 after the provocation test. Immediate and delayed symptoms were more frequent in subjects having significant non-specific bronchial hyper-reactivity. Informing patients of the risk of developing delayed symptoms seems useful and allows optimization of their management after a MCT.
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Affiliation(s)
- E Cabon
- Service des explorations fonctionnelles respiratoires, centre hospitalo-universitaire Nord, pôle thoracique et cardiovasculaire, AP-HM, chemin des Bourrely, 13015 Marseille, France
| | - F Rey
- Service des explorations fonctionnelles respiratoires, centre hospitalo-universitaire Nord, pôle thoracique et cardiovasculaire, AP-HM, chemin des Bourrely, 13015 Marseille, France
| | - D Tissier-Ducamp
- Service des explorations fonctionnelles respiratoires, centre hospitalo-universitaire Nord, pôle thoracique et cardiovasculaire, AP-HM, chemin des Bourrely, 13015 Marseille, France
| | - M J Del Volgo
- Service des explorations fonctionnelles respiratoires, centre hospitalo-universitaire Nord, pôle thoracique et cardiovasculaire, AP-HM, chemin des Bourrely, 13015 Marseille, France
| | - S Delliaux
- Service des explorations fonctionnelles respiratoires, centre hospitalo-universitaire Nord, pôle thoracique et cardiovasculaire, AP-HM, chemin des Bourrely, 13015 Marseille, France; UMR MD 2 dysoxie et suractivité AMU, faculté de médecine secteur Nord, 51, boulevard Pierre-Dramard, 13344 Marseille cedex 15, France
| | - M Bues-Charbit
- Pharmacie hospitalière, centre hospitalo-universitaire Nord, AP-HM, 13015 Marseille, France
| | - D Charpin
- Service clinique des bronches de l'allergie et du sommeil, centre hospitalo-universitaire Nord, pôle thoracique et cardiovasculaire, AP-HM, 13015 Marseille, France
| | - F Brégeon
- Service des explorations fonctionnelles respiratoires, centre hospitalo-universitaire Nord, pôle thoracique et cardiovasculaire, AP-HM, chemin des Bourrely, 13015 Marseille, France; Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE) UMR 63 CNRS 7278 IRD 3R198 Inserm U1095, IHU méditerranée infection, AMU, 13005 Marseille, France.
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Rajaoarifetra J, Delliaux S, Rey F, Del Volgo M, Brégeon F. Analyse multidimensionnelle du test de marche de 6 min et phénotypage physiologique. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tissier-Ducamp D, Rey F, Delliaux S, Cabon E, Thomas P, Reynaud Gaubert M, Gomez C, Brégeon F. Évaluation de la force musculaire respiratoire chez les patients en attente de transplantation pulmonaire. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cabon E, Rey F, Tissier-Ducamp D, Del Volgo M, Delliaux S, Charpin D, Brégeon B, Brégeon F. Évaluation de la survenue de symptômes respiratoires évocateurs de bronchospasme à distance d’un test de provocation bronchique par la méthacholine (TPM). Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Delliaux S, Ichinose M, Watanabe K, Fujii N, Nishiyasu T. Cardiovascular responses to forearm muscle metaboreflex activation during hypercapnia in humans. Am J Physiol Regul Integr Comp Physiol 2015; 309:R43-50. [PMID: 25904685 DOI: 10.1152/ajpregu.00402.2014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 04/16/2015] [Indexed: 12/27/2022]
Abstract
We characterized the cardiovascular responses to forearm muscle metaboreflex activation during hypercapnia. Ten healthy males participated under three experimental conditions: 1) hypercapnia (HCA, PetCO2 : +10 mmHg, by inhalation of a CO2-enriched gas mixture); 2) muscle metaboreflex activation (MMA, by 5 min of local circulatory occlusion after 1 min of 50% maximum voluntary contraction isometric handgrip under normocapnia); and 3) HCA+MMA. We measured mean arterial pressure (MAP), heart rate (HR), and cardiac output (CO); calculated stroke volume (SV), and total peripheral resistance (TPR); and evaluated myocardial oxygen consumption (MV̇o2) and cardiac work (CW) noninvasively. MAP increased in the three experimental conditions but HCA+MMA led to the highest MAP, CO, and HR. Moreover, HCA+MMA increased SV and was associated with the highest MV̇o2 and CW. HCA and MMA exhibited inhibitory interactions with MAP, HR, TPR, MV̇o2, and CW, increases of which were smaller during HCA+MMA than the sum of the increases during HCA and MMA alone (MAP: +28 ± 2 vs. +34 ± 2 mmHg, P < 0.001; HR: +15 ± 2 vs. +22 ± 3 bpm, P < 0.01; TPR: +1.1 ± 1.4 vs. +3.0 ± 1.5 mmHg·l·min(-1), P < 0.05; MV̇o2: +50.25 ± 4.74 vs. +59.48 ± 5.37 mmHg·min(-1)·10(-2), P < 0.01; CW: +59.10 ± 7.52 vs. +63.67 ± 7.71 ml mmHg·min(-1)·10(-4), P < 0.05). Oppositely, HCA and MMA interactions were linearly additive for CO (+2.3 ± 0.4 l/min) and SV (+13 ± 4 ml). We showed that muscle metaboreflex and hypercapnia interact in healthy humans, reducing vasoconstriction but enhancing SV.
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Affiliation(s)
- Stephane Delliaux
- Aix-Marseille University, MD, DS-ACI, UMR 2, Marseille, France; APHM, Hôpital Nord, Pôle cardiovasculaire et thoracique, Laboratoire de Physiologie Respiratoire-Explorations à l'Exercice, Marseille, France; Assistance Publique, Hôpitaux de Marseille, Hôpital Nord, Pôle cardiovasculaire et thoracique, Laboratoire de Physiologie Respiratoire-Explorations à l'Exercice, Marseille, France; Laboratory of Physiology-Circulation, Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan; and Japan Society for the Promotion of Science, Tokyo, Japan
| | - Masashi Ichinose
- School of Business and Administration, Meiji University, Tokyo, Japan; Laboratory of Physiology-Circulation, Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan; and
| | - Kazuhito Watanabe
- Laboratory of Physiology-Circulation, Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan; and
| | - Naoto Fujii
- Laboratory of Physiology-Circulation, Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan; and Japan Society for the Promotion of Science, Tokyo, Japan
| | - Takeshi Nishiyasu
- Laboratory of Physiology-Circulation, Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan; and
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Gravier G, Delliaux S, Delpierre S, Guieu R, Jammes Y. Inter-individual differences in breathing pattern at high levels of incremental cycling exercise in healthy subjects. Respir Physiol Neurobiol 2013; 189:59-66. [DOI: 10.1016/j.resp.2013.06.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 06/26/2013] [Accepted: 06/28/2013] [Indexed: 10/26/2022]
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Gravier G, Delliaux S, Ba A, Delpierre S, Guieu R, Jammes Y. Early Ventilation-Heart Rate Breakpoint during Incremental Cycling Exercise. Int J Sports Med 2013; 35:191-8. [DOI: 10.1055/s-0033-1345145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- G. Gravier
- UMR MD2 Faculty of Medicine, Aix Marseille University, Marseille, France
| | - S. Delliaux
- UMR MD2 Faculty of Medicine, Aix Marseille University, Marseille, France
| | - A. Ba
- Faculté de Médecine, Physiologie humaine, Université Cheikh Anta Diop, Dakar, Senegal
| | - S. Delpierre
- UMR MD2 Faculty of Medicine, Aix Marseille University, Marseille, France
| | - R. Guieu
- UMR MD2 Faculty of Medicine, Aix Marseille University, Marseille, France
| | - Y. Jammes
- UMR MD2 Faculty of Medicine, Aix Marseille University, Marseille, France
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Gravier G, Steinberg JG, Lejeune PJ, Delliaux S, Guieu R, Jammes Y. Exercise-induced oxidative stress influences the motor control during maximal incremental cycling exercise in healthy humans. Respir Physiol Neurobiol 2013; 186:265-72. [DOI: 10.1016/j.resp.2013.02.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 02/20/2013] [Accepted: 02/26/2013] [Indexed: 10/27/2022]
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Fujii N, Honda Y, Delliaux S, Tsuji B, Watanabe K, Sugihara A, Kondo N, Nishiyasu T. Effect of voluntary hypocapnic hyperventilation on cutaneous circulation in resting heated humans. Am J Physiol Regul Integr Comp Physiol 2012; 303:R975-83. [DOI: 10.1152/ajpregu.00169.2012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hypocapnia attenuates the sweat response normally seen in hyperthermic resting subjects, but its effect on the blood flow response in their nonglabrous skin under the same hyperthermic conditions remains unclear. In the present study, we investigated whether hypocapnia induced by voluntary hyperventilation affects the blood flow response to heat stress in the nonglabrous skin of resting humans. Nine healthy male subjects were passively heated using legs-only hot water immersion and a water-perfused suit, which caused esophageal temperature (Tes) to increase by as much as 1.0°C. During normothermia and at +0.6°C Tes and +1.0°C Tes, the subjects performed two voluntary 7-min hyperventilation (minute ventilation = 40 l/min) trials (hypocapnic and eucapnic) in random order. End-tidal CO2 pressure was reduced by 23–25 torr during hypocapnic hyperventilation, but it was maintained at the spontaneous breathing level during eucapnic hyperventilation. Cutaneous blood flow was evaluated as the cutaneous red blood cell flux in the forearm (CBFforearm) or forehead (CBFforehead) and was normalized to the normothermic spontaneous breathing value. Hypocapnic hyperventilation at +0.6°C Tes was associated with significantly reduced CBFforearm, compared with eucapnic hyperventilation, after 5–7 min of hyperventilation (395 to 429 vs. 487 to 525% baseline, P < 0.05). No significant difference in CBFforehead was seen during hypocapnic hyperventilation compared with eucapnic hyperventilation at +0.6°C Tes or +1.0°C Tes. These results suggest that in resting humans, hypocapnia achieved through voluntary hyperventilation attenuates the increase in cutaneous blood flow elicited by moderate heat stress in the nonglabrous skin of the forearm, but not the forehead.
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Affiliation(s)
- Naoto Fujii
- Institute of Health and Sports Science, University of Tsukuba, Tsukuba, Japan
| | - Yasushi Honda
- Institute of Health and Sports Science, University of Tsukuba, Tsukuba, Japan
| | - Stephane Delliaux
- Institute of Health and Sports Science, University of Tsukuba, Tsukuba, Japan
- UMR L'Université de la Méditerranée Secteur Nord Physiologie et Physiopathologie en conditions d'oxygénation extrêmes, Institut fédératif de recherche Jean Roche, Faculté de Médecine, Université de la Méditerranée, Marseille, France; and
| | - Bun Tsuji
- Institute of Health and Sports Science, University of Tsukuba, Tsukuba, Japan
| | - Kazuhito Watanabe
- Institute of Health and Sports Science, University of Tsukuba, Tsukuba, Japan
| | - Akira Sugihara
- Institute of Health and Sports Science, University of Tsukuba, Tsukuba, Japan
| | - Narihiko Kondo
- Faculty of Human Development, Kobe University, Kobe, Japan
| | - Takeshi Nishiyasu
- Institute of Health and Sports Science, University of Tsukuba, Tsukuba, Japan
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Jammes Y, Steinberg JG, By Y, Brerro-Saby C, Condo J, Olivier M, Guieu R, Delliaux S. Fatiguing stimulation of one skeletal muscle triggers heat shock protein activation in several rat organs: the role of muscle innervation. ACTA ACUST UNITED AC 2012; 215:4041-8. [PMID: 22899526 DOI: 10.1242/jeb.074427] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We hypothesised that activation of muscle afferents by fatigue triggers a widespread activation of heat shock proteins (HSPs) in resting muscles and different organs. In anaesthetised rats, HSP25 and HSP70 levels were determined in both tibialis anterior (TA) and extensor digitorum longus (EDL) muscles and in the diaphragm, kidney and brain by ELISA, which mostly identifies phosphorylated HSP, and western blotting. One TA muscle was electrically stimulated and tissues were sampled 10 or 60 min after the stimulation had ended. The nerve supply to the stimulated TA or its counterpart in the contralateral limb was left intact or suppressed. In control rats, no muscle stimulation was performed and tissues were sampled at the same time points (10 or 60 min). After TA stimulation, ELISA showed an increased HSP25 content in the contralateral TA, EDL and diaphragm at 10 min but not at 60 min, and HSP70 increased in all sampled tissues at 60 min. Western blotting did not show any changes in HSP25 and HSP70 at 10 min, while at 60 min HSP25 increased in all sampled tissues except the brain and HSP70 was elevated in all tissues. Denervation of the contralateral non-stimulated limb suppressed HSP changes in TA and after denervation of the stimulated TA the widespread activation of HSPs in other organs was absent. Our data suggest that fatigue-induced activation of skeletal muscle afferents triggers an early increase in phosphorylated HSP25 in muscles and a delayed elevation of non-phosphorylated HSP25 and HSP70 in skeletal and respiratory muscles, kidney and brain.
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Affiliation(s)
- Yves Jammes
- UMR MD2, Faculty of Medicine, Aix-Marseille University, Marseille, France.
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Jammes Y, Steinberg JG, Delliaux S. Chronic fatigue syndrome: acute infection and history of physical activity affect resting levels and response to exercise of plasma oxidant/antioxidant status and heat shock proteins. J Intern Med 2012; 272:74-84. [PMID: 22112145 DOI: 10.1111/j.1365-2796.2011.02488.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES A history of high-level physical activity and/or acute infection might constitute stress factors affecting the plasma oxidant-antioxidant status and levels of heat shock proteins (HSPs) in patients with chronic fatigue syndrome (CFS). DESIGN This case-control study compared data from 43 CFS patients to results from a matched control group of 23 healthy sedentary subjects. SETTING AND SUBJECTS Five patients had no relevant previous history (group I). Eighteen had practised high-level sport (group II), and severe acute infection had been diagnosed in nine patients (group III). A combination of sport practice and infection was noted in 11 patients (group IV). INTERVENTIONS After examination at rest, all subjects performed a maximal cycling exercise test. Plasma levels of two markers of oxidative stress [thiobarbituric acid reactive substances (TBARS) and reduced ascorbic acid (RAA)] and both HSP27 and HSP70 were measured. RESULTS At rest, compared with the control group, the TBARS level was higher in groups II, III and IV patients, and the RAA level was lower in groups III and IV. In addition, HSP70 levels were significantly lower in all CFS groups, compared with controls, but negative correlations were found between resting HSP27 and HSP70 levels and the history of physical activity. After exercise, the peak level of TBARS significantly increased in groups II, III and IV, and the variations in HSP27 and HSP70 were attenuated or suppressed, with the greatest effects in groups III and IV. CONCLUSION The presence of stress factors in the history of CFS patients is associated with severe oxidative stress and the suppression of protective HSP27 and HSP70 responses to exercise.
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Affiliation(s)
- Y Jammes
- UMR MD2 P2COE, Faculty of Medicine, Aix-Marseille University and Clinical Respiratory Physiology and Exercise Testing Laboratory, Thorax Pole, National Assistance - Hospitals in Marseille, Marseille, France.
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Ichinose M, Delliaux S, Watanabe K, Fujii N, Nishiyasu T. Evaluation of muscle metaboreflex function through graded reduction in forearm blood flow during rhythmic handgrip exercise in humans. Am J Physiol Heart Circ Physiol 2011; 301:H609-16. [PMID: 21602474 DOI: 10.1152/ajpheart.00076.2011] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hypoperfusion of active skeletal muscle elicits a reflex pressor response termed the muscle metaboreflex. Our aim was to determine the muscle metaboreflex threshold and gain in humans by creating an open-loop relationship between active muscle blood flow and hemodynamic responses during a rhythmic handgrip exercise. Eleven healthy subjects performed the exercise at 5 or 15% of maximal voluntary contraction (MVC) in random order. During the exercise, forearm blood flow (FBF), which was continuously measured using Doppler ultrasound, was reduced in five steps by manipulating the inner pressure of an occlusion cuff on the upper arm. The FBF at each level was maintained for 3 min. The initial reductions in FBF elicited no hemodynamic changes, but once FBF fell below a threshold, mean arterial blood pressure (MAP) and heart rate (HR) increased and total vascular conductance (TVC) decreased in a linear manner. The threshold FBF during the 15% MVC trial was significantly higher than during the 5% MVC trial. The gain was then estimated as the slope of the relationship between the hemodynamic responses and FBFs below the threshold. The gains for the MAP and TVC responses did not differ between workloads, but the gain for the HR response was greater in the 15% MVC trial. Our findings thus indicate that increasing the workload shifts the threshold for the muscle metaboreflex to higher blood flows without changing the gain of the reflex for the MAP and TVC responses, whereas it enhances the gain for the HR response.
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Affiliation(s)
- Masashi Ichinose
- Human Integrative Physiology Laboratory, School of Business Administration, Meiji Univ., Tokyo, Japan.
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Delliaux S, Ichinose M, Watanabe K, Fujii N, Nishiyasu T. Hypercapnic Chemoreflex And Muscle Metaboreflex Interactions: Effects on Heart. Med Sci Sports Exerc 2010. [DOI: 10.1249/01.mss.0000389323.31280.4d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Jammes Y, Delliaux S, Coulange M, Jammes C, Kipson N, Brerro-Saby C, Bregeon F. EMG Changes in Thigh and Calf Muscles in Fin Swimming Exercise. Int J Sports Med 2010; 31:548-54. [DOI: 10.1055/s-0030-1251993] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Brerro-Saby C, Delliaux S, Steinberg JG, Boussuges A, Gole Y, Jammes Y. Combination of two oxidant stressors suppresses the oxidative stress and enhances the heat shock protein 27 response in healthy humans. Metabolism 2010; 59:879-86. [PMID: 20005545 DOI: 10.1016/j.metabol.2009.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Revised: 10/01/2009] [Accepted: 10/13/2009] [Indexed: 11/19/2022]
Abstract
We tested the hypothesis that the combination of 2 oxidant stressors (hyperoxia and fatiguing exercise) might reduce or suppress the oxidative stress. We concomitantly measured the plasma concentration of heat shock proteins (Hsp) that protect the cells against the deleterious effects of reactive oxygen species. Healthy humans breathed pure oxygen under normobaric condition for 50-minute periods during which they stayed at rest or executed maximal static handgrip sustained until exhaustion. They also repeated handgrip bouts in normoxic condition. We performed venous blood measurements of 2 markers of the oxidative stress (thiobarbituric acid reactive substances and reduced ascorbic acid) and Hsp27. Under normoxic condition, the handgrip elicited an oxidative stress and a modest increase in plasma Hsp27 level (+7.1 +/- 5.4 ng/mL). Under hyperoxic condition, (1) at rest, compared with the same time schedule in normoxic condition, we measured an oxidative stress (increased thiobarbituric acid reactive substances and decreased reduced ascorbic acid levels) and the plasma Hsp27 level increased (maximal variation, +12.5 +/- 6.0 ng/mL); and (2) after the handgrip, the oxidative stress rapidly disappeared. The combination of both hyperoxia and handgrip bout doubled the Hsp27 response (maximal variation, +24.8 +/- 9.2 ng/mL). Thus, the combination of 2 hits eliciting an oxidative stress seems to induce an adaptive Hsp27 response that might counterbalance an excessive production of reactive oxygen species.
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Affiliation(s)
- Christelle Brerro-Saby
- UMR MD2 P2COE, Faculté de Médecine, Université de la Méditerranée, 13916 cedex 20 Marseille, France
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Ichinose M, Watanabe K, Delliaux S, Fujii N, Nishiyasu T. Muscle Metaboreflex Functions During Dynamic Exercise in Humans. Med Sci Sports Exerc 2010. [DOI: 10.1249/01.mss.0000384308.56888.d9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Jammes Y, Steinberg JG, Delliaux S, Brégeon F. Chronic fatigue syndrome combines increased exercise-induced oxidative stress and reduced cytokine and Hsp responses. J Intern Med 2009; 266:196-206. [PMID: 19457057 DOI: 10.1111/j.1365-2796.2009.02079.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES As heat shock proteins (Hsp) protect the cells against the deleterious effects of oxidative stress, we hypothesized that Hsp expression might be reduced in patients suffering from chronic fatigue syndrome (CFS) who present an accentuated exercise-induced oxidative stress. DESIGN This case-control study compared nine CFS patients to a gender-, age- and weight-matched control group of nine healthy sedentary subjects. INTERVENTIONS All subjects performed an incremental cycling exercise continued until exhaustion. We measured ventilation and respiratory gas exchange and evoked compound muscle potential (M-wave) recorded from vastus lateralis. Repetitive venous blood sampling allowed measurements of two markers of oxidative stress [thiobarbituric acid reactive substances (TBARS) and reduced ascorbic acid (RAA)], two cytokines (IL-6 and TNF-alpha) and two Hsp (Hsp27 and Hsp70) at rest, during maximal exercise and the 60-min recovery period. RESULTS Compared with controls, resting CFS patients had low baseline levels of RAA and Hsp70. Their response to maximal exercise associated (i) M-wave alterations indicating reduced muscle membrane excitability, (ii) early and accentuated TBARS increase accompanying reduced changes in RAA level, (iii) absence of significant increase in IL-6 and TNF-alpha, and (iv) delayed and marked reduction of Hsp27 and Hsp70 variations. The post-exercise increase in TBARS was accentuated in individuals having the lowest variations of Hsp27 and Hsp70. CONCLUSIONS The response of CFS patients to incremental exercise associates a lengthened and accentuated oxidative stress, which might result from delayed and insufficient Hsp production.
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Affiliation(s)
- Y Jammes
- UMR MD2 (P2COE), Faculté de Médecine, Université de la Méditerranée, North Hospital, Assistance Publique - Hôpitaux de Marseille, France.
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Jammes Y, Coulange M, Delliaux S, Jammes C, Gole Y, Boussuges A, Brerro-Saby C, Ba A, Marqueste T, Adjriou N. Fin Swimming Improves Respiratory Gas Exchange. Int J Sports Med 2009; 30:173-81. [DOI: 10.1055/s-0028-1105939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ba A, Delliaux S, Bregeon F, Levy S, Jammes Y. Post-exercise heart rate recovery in healthy, obeses, and COPD subjects: relationships with blood lactic acid and PaO2 levels. Clin Res Cardiol 2008; 98:52-8. [DOI: 10.1007/s00392-008-0723-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2008] [Accepted: 09/09/2008] [Indexed: 11/29/2022]
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Guillot C, Steinberg JG, Delliaux S, Kipson N, Jammes Y, Badier M. Physiological, histological and biochemical properties of rat skeletal muscles in response to hindlimb suspension. J Electromyogr Kinesiol 2008; 18:276-83. [PMID: 17158069 DOI: 10.1016/j.jelekin.2006.10.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2006] [Revised: 10/23/2006] [Accepted: 10/23/2006] [Indexed: 11/28/2022] Open
Abstract
In previous study, we found that the reduced exercise-induced production of reactive oxygen species (ROS) reported in slow-oxidative muscle of hypoxemic rats and also in chronic hypoxemic patients did not simply result from deconditioning. In control rats and after a 3-week period of hindlimb suspension (HS), the slow-oxidative (Soleus, SOL) and fast-glycolytic skeletal muscles (Extensor digitorum longus, EDL) were sampled. We determined the response to direct muscle stimulation (twitch stimulation (TS), Maximal force (Fmax)), twitch amplitude and maximal relaxation rate, tetanic frequency, endurance to fatigue after muscle stimulation (MS), the different fibre types based on their myofibrillar adenosinetriphosphatase (ATPase) activity, and the intra-muscular redox status (Thiobarbituric Acid Reactive Sustances: TBARS, reduced glutathione: GSH, reduced ascorbic acid: RAA). After the 3-w HS period: (1) the contractile properties were modified in SOL only (reduced Fmax and twitch amplitude, increased tetanic frequency); (2) the fibre typology was modified in both muscles (in SOL: increased proportion of IIa and IIc fibres, in EDL: increased proportion of IId/x fibres but decreased proportion of IIb fibres); and (3) only in SOL, the TBARS level increased and the GSH and RAA concentrations decreased at rest and after fatiguing MS. Thus, HS accentuates the exercise-induced ROS production in slow-oxidative muscle in a direction opposite to that measured in chronic hypoxemic rats. This strongly suggests that hypoxemia reduces the ROS production independently from any muscle disuse.
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Affiliation(s)
- Chantal Guillot
- Laboratoire de Physiopathologie Respiratoire EA 2201, Institut Jean Roche, Faculté de Médecine Nord, Bd. Pierre Dramard, 13916 Marseille, France
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Coulange M, Riera F, Melin B, Delliaux S, Kipson N, Gimenez C, Robinet C, Jammes Y. Consequences of prolonged total thermoneutral immersion on muscle performance and EMG activity. Pflugers Arch 2007; 455:903-11. [PMID: 17909853 DOI: 10.1007/s00424-007-0335-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Revised: 08/02/2007] [Accepted: 08/16/2007] [Indexed: 10/22/2022]
Abstract
We hypothesized that the changes in muscle temperature and interstitial pressure during thermoneutral immersion may affect the reflex adaptation of the motor drive during static contraction, assessed by the decrease in median frequency (MF) of electromyogram (EMG) power spectrum. Ten subjects were totally immersed for 6 h at 35 degrees C and repeated maximal voluntary contraction (MVC) and submaximal (60% MVC) leg extensions sustained until exhaustion. In vastus lateralis (VL) and soleus (SOL) muscles, the compound muscle potential evoked by muscle stimulation with single shocks (M-wave) was recorded at rest, and MF of surface EMG was calculated during 60% MVCs. We measured lactic acid and potassium venous blood concentrations and calculated plasma volume changes. Data were compared to those obtained in the same individuals exercising at 35 degrees C under dry conditions where the MF decrease during 60% MVCs was modest (-4 to-5%). During immersion, the rectal temperature remained stable, but the thigh and calf surface temperatures significantly increased. Lactic acid and potassium concentrations did not vary, but plasma volume decreased from the 180th min of immersion. The M-wave did not vary in VL but was prolonged in SOL from the 30th min of immersion. From the 220th min of immersion, the maximal MF decrease was majored in both muscles (-18 to -22%). Thus, compared to the dry condition, total body thermoneutral immersion enhances fatigue-induced EMG changes in leg muscles, perhaps through the activation of warm-sensitive muscle endings and/or the changes in interstitial pressure because of vasodilatation.
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Affiliation(s)
- Mathieu Coulange
- Laboratoire de Physiopathologie Respiratoire (EA 2201), Institut Jean Roche, Faculté de Médecine, Université de la Méditerranée, Bd. Pierre Dramard, 13920, Cedex 20 Marseille, France
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Delliaux S, Steinberg JG, Bechis G, Paganelli F, Oliver C, Lesavre N, Jammes Y. Statins alter oxidant-antioxidant status and lower exercise-induced oxidative stress. Int J Clin Pharmacol Ther 2007; 45:244-52. [PMID: 17474543 DOI: 10.5414/cpp45244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Data on effects of statins on resting oxidant-antioxidant status are contradictory and no study has been published on the effects of statins on exercise-induced oxidative stress. We carried out a 6-month longitudinal study in 10 dyslipidemic patients receiving 10 mg/day atorvastatin and 13 healthy sedentary subjects. Thiobarbituric acid reactive substances (TBARS) and reduced ascorbic acid (RAA) were measured in plasma at rest and every 5 minutes after submaximal isometric thumb adduction and handgrip sustained until exhaustion. At inclusion, resting TBARS and RAA levels in controls and patients did not differ and exercise increased TBARS and decreased RAA. Atorvastatin reduced resting TBARS and RAA levels in a time-dependent but lipid-independent manner. The main effect was a post-exercise increase in TBARS, without affecting the post-exercise RAA levels. The reduction in oxidative stress occurred earlier in oxidative muscles involved in thumb adduction. In conclusion, atorvastatin lowers resting oxidant-antioxidant activity: exercise-induced oxidative stress occurs mainly in muscles having a high oxidative capacity.
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Affiliation(s)
- S Delliaux
- Aix-Marseille Université, IFR Jean Roche, Marseille, and Assistance Publique-Hôpitaux de Marseille, Service des Explorations Fonctionnelles Respiratoires, Hôpital Nord, Marseille, France
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Delliaux S, Steinberg JG, Lesavre N, Paganelli F, Oliver C, Jammes Y. Effect of long-term atorvastatin treatment on the electrophysiological and mechanical functions of muscle. Int J Clin Pharmacol Ther 2006; 44:251-61. [PMID: 16800097 DOI: 10.5414/cpp44251] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To study alterations in muscle function combining physiological, electrophysiological and metabolic measurements in patients receiving a statin at various dosages during long-term therapy. MATERIAL A 3-month (D0, D30 and D90) longitudinal physiological and electrophysiological muscle study was performed in 26 patients receiving 10, 40 or 80 mg/day atorvastatin. METHOD All subjects performed maximal (MVC) and submaximal (60% MVC) isometric thumb adduction, handgrip and knee extension exercises during the recording of surface electromyograms (EMG) of the adductor pollicis (AP), flexor digitorum (FD) and vastus lateralis (VL). The compound muscle potential (M-wave) evoked by direct muscle stimulation was measured at rest and after 60% MVCs and the EMG power spectrum was analyzed during sustained effort. Blood was sampled from an antecubital vein for measurements of pH, lactate and potassium levels after thumb adduction and handgrip exercises. The measurements were repeated on Day 0 (D0), D30 and D90. RESULTS Atorvastatin did not affect the MVC and endurance time to fatigue. Post-exercise M-wave alterations in the AP began at D30 with the 80 mg/day treatment and there was a reduced or suppressed leftward shift in the EMG power spectrum in the AP and VL with all 3 dosages. In the AP, the EMG changes appeared earlier (D30) with 80 mg/day whereas they only occurred at D90 on the lower dosages. Atorvastatin had no effect on the maximal postexercise variations in pHv and lactate but it significantly reduced the maximal increase in plasma potassium concentration after thumb adduction and handgrip exercise, the effects being only present at D90 on 10 mg/day but occurring as early as D30 with higher dosages. CONCLUSION A 3-month atorvastatin treatment did not affect the maximal performance of skeletal muscle during voluntary efforts but EMG analysis revealed a reduced muscle excitability and an attenuated adaptation to fatigue. These effects prevailed in muscles containing the largest proportion of slow-oxidative fibers and were associated with a reduced outward flow of potassium.
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Affiliation(s)
- S Delliaux
- Aix-Marseille 2 University, EA 2201, Institute Jean Roche, Faculty of Medicine, Marseille, France
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Jammes Y, Steinberg JG, Mambrini O, Brégeon F, Delliaux S. Chronic fatigue syndrome: assessment of increased oxidative stress and altered muscle excitability in response to incremental exercise. J Intern Med 2005; 257:299-310. [PMID: 15715687 DOI: 10.1111/j.1365-2796.2005.01452.x] [Citation(s) in RCA: 116] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Because the muscle response to incremental exercise is not well documented in patients suffering from chronic fatigue syndrome (CFS), we combined electrophysiological (compound-evoked muscle action potential, M wave), and biochemical (lactic acid production, oxidative stress) measurements to assess any muscle dysfunction in response to a routine cycling exercise. DESIGN This case-control study compared 15 CFS patients to a gender-, age- and weight-matched control group (n=11) of healthy subjects. INTERVENTIONS All subjects performed an incremental cycling exercise continued until exhaustion. MAIN OUTCOME MEASURES We measured the oxygen uptake (VO2), heart rate (HR), systemic blood pressure, percutaneous O2 saturation (SpO2), M-wave recording from vastus lateralis, and venous blood sampling allowing measurements of pH (pHv), PO2 (PvO2), lactic acid (LA), and three markers of the oxidative stress (thiobarbituric acid-reactive substances, TBARS, reduced glutathione, GSH, and ascorbic acid, RAA). RESULTS Compared with control, in CFS patients (i) the slope of VO2 versus work load relationship did not differ from control subjects and there was a tendency for an accentuated PvO2 fall at the same exercise intensity, indicating an increased oxygen uptake by the exercising muscles; (ii) the HR and blood pressure responses to exercise did not vary; (iii) the anaerobic pathways were not accentuated; (iv) the exercise-induced oxidative stress was enhanced with early changes in TBARS and RAA and enhanced maximal RAA consumption; and (v) the M-wave duration markedly increased during the recovery period. CONCLUSIONS The response of CFS patients to incremental exercise associates a lengthened and accentuated oxidative stress together with marked alterations of the muscle membrane excitability. These two objective signs of muscle dysfunction are sufficient to explain muscle pain and postexertional malaise reported by our patients.
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Affiliation(s)
- Y Jammes
- Laboratoire de Physiopathologie Respiratoire (UPRES EA 2201), Faculté de Médecine, Institut Fédératif de Recherche Jean Roche, Marseille, France.
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