Decreased ventilatory efficiency during incremental exercise in bronchiectasis.
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ABSTRACT:
SUBMITTER: Yuan JJ
PROVIDER: S-EPMC7330375 | biostudies-literature | 2020 May
REPOSITORIES: biostudies-literature
Publications
Decreased ventilatory efficiency during incremental exercise in bronchiectasis.
Yuan Jing-Jing JJ Li Hui-Min HM Huang Yan Y Han Xiao-Rong XR Gao Yong-Hua YH Zhong Nan-Shan NS Martinez-Garcia Miguel Angel MA Guan Wei-Jie WJ
Journal of thoracic disease 20200501 5
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Project description:Background: Air trapping and gas exchange abnormalities are major causes of exercise limitation in chronic obstructive pulmonary disease (COPD). During incremental cardiopulmonary exercise testing, actual nadir values of ventilatory equivalents for carbon dioxide (V E/VCO 2) and oxygen (V E/VO 2) may be difficult to identify in COPD patients because of limited ventilatory compensation capacity. Therefore, we aimed in this exploratory study to detect a possible correlation between the magnitude of ventilation augmentation, as manifested by increments in ventilatory equivalents from nadir to peak exercise values and air trapping, detected with static testing. Methods: In this observational study, we studied data obtained previously from 20 COPD patients who, during routine follow-up, underwent a symptom-limited incremental exercise test and in whom a plethysmography was obtained concurrently. Air trapping at rest was assessed by measurement of the residual volume (RV) to total lung capacity (TLC) ratio (RV/TLC). Gas exchange data collected during the symptom-limited incremental cardiopulmonary exercise test allowed determination of the nadir and peak exercise values of V E/VCO 2 and V E/VO 2, thus enabling calculation of the difference between peak exrcise value and nadir values of V E/VCO 2 and V E/VO 2, designated ΔV E/VCO 2 and ΔV E/VO 2, respectively. Results: We found a statistically significant inverse correlation between both ΔV E/VCO 2 (r = -0. 5058, 95% CI -0.7750 to -0.08149, p = 0.0234) and ΔV E/VO 2 (r = -0.5588, 95% CI -0.8029 to -0.1545, p = 0.0104) and the degree of air trapping (RV/TLC). There was no correlation between ΔV E/VCO 2 and forced expiratory volume in the first second, or body mass index. Conclusions: The ventilatory equivalents increment to compensate for acidosis during incremental exercise testing was inversely correlated with air trapping (RV/TLC).
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Project description:Background:Although numerous studies have reported the effect of inspiratory muscle training for improving exercise performance, the outcome of whether exercise performance is improved by inspiratory muscle training is controversial. Therefore, this study investigated the influence of inspiratory muscle-loaded exercise training (IMLET) on peak oxygen uptake (VO2peak), respiratory responses, and exercise performance under normoxic (N) and hypoxic (H) exercise conditions. We hypothesised that IMLET enhances respiratory muscle strength and improves respiratory response, thereby improving VO2peak and work capacity under H condition. Methods:Sixteen university track runners (13 men and 3 women) were randomly assigned to the IMLET (n?=?8) or exercise training (ET) group (n?=?8). All subjects underwent 4?weeks of 20-min 60% VO2peak cycling exercise training, thrice per week. IMLET loaded 50% of maximal inspiratory pressure during exercise. At pre- and post-training periods, subjects performed exhaustive incremental cycling under normoxic (N; 20.9?±?0%) and hypoxic (H; 15.0?±?0.1%) conditions. Results:Although maximal inspiratory pressure (PImax) significantly increased after training in both groups, the extent of PImax increase was significantly higher in the IMLET group (from 102?±?20 to 145?±?26 cmH2O in IMLET; from 111?±?23 to 127?±?23 cmH2O in ET; P?<?0.05). In both groups, VO2peak and maximal work load (Wmax) similarly increased both under N and H conditions after training (P?<?0.05). Further, the extent of Wmax decrease under H condition was lower in the IMLET group at post-training test than at pre-training (from -?14.7?±?2.2% to -?12.5?±?1.7%; P?<?0.05). Maximal minute ventilation in both N and H conditions increased after training than in the pre-training period. Conclusions:Our IMLET enhanced the respiratory muscle strength, and the decrease in work capacity under hypoxia was reduced regardless of the increase in VO2peak.
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Project description:It has never been possible to immediately evaluate heart rate variability (HRV) during exercise. We aimed to visualize the real-time changes in the power spectrum of HRV during exercise and to investigate its relationship to the ventilatory threshold (VT). Thirty healthy subjects (29.1±5.7 years of age) and 35 consecutive patients (59.0±13.2 years of age) with myocardial infarctions underwent cardiopulmonary exercise tests with an RAMP protocol ergometer. The HRV was continuously assessed with power spectral analyses using the maximum entropy method and projected on a screen without delay. During exercise, a significant decrease in the high frequency (HF) was followed by a drastic shift in the power spectrum of the HRV with a periodic augmentation in the low frequency/HF (L/H) and steady low HF. When the HRV threshold (HRVT) was defined as conversion from a predominant high frequency (HF) to a predominant low frequency/HF (L/H), the VO2 at the HRVT (HRVT-VO2) was substantially correlated with the VO2 at the lactate threshold and VT) in the healthy subjects (r=0.853 and 0.921, respectively). The mean difference between each threshold (0.65 mL/kg per minute for lactate threshold and HRVT, 0.53 mL/kg per minute for VT and HRVT) was nonsignificant (P>0.05). Furthermore, the HRVT-VO2 was also correlated with the VT-VO2 in these myocardial infarction patients (r=0.867), and the mean difference was -0.72 mL/kg per minute and was nonsignificant (P>0.05). A HRV analysis with our method enabled real-time visualization of the changes in the power spectrum during exercise. This can provide additional information for detecting the VT.
| S-EPMC5778955 | biostudies-literature
Project description:Maximal O2 uptake is impaired in end-stage renal disease (ESRD), reducing quality of life and longevity. While determinants of maximal exercise intolerance are well defined, little is known of limitation during submaximal constant load exercise. By comparing individuals with ESRD and healthy controls, the aim of this exploratory study was to characterize mechanisms of exercise intolerance in participants with ESRD by assessing cardiopulmonary physiology at rest and during exercise. Resting spirometry and echocardiography were performed in 20 dialysis-dependent participants with ESRD (age: 59 ± 12 yr, 14 men and 6 women) and 20 healthy age- and sex-matched controls. Exercise tolerance was assessed with ventilatory gas exchange and central hemodynamics during a maximal cardiopulmonary exercise test and 30 min of submaximal constant load exercise. Left ventricular mass (292 ± 102 vs. 185 ± 83 g, P = 0.01) and filling pressure (E/e': 6.48 ± 3.57 vs. 12.09 ± 6.50 m/s, P = 0.02) were higher in participants with ESRD; forced vital capacity (3.44 ± 1 vs. 4.29 ± 0.95 L/min, P = 0.03) and peak O2 uptake (13.3 ± 2.7 vs. 24.6 ± 7.3 mL·kg-1·min-1, P < 0.001) were lower. During constant load exercise, the relative increase in the arterial-venous O2 difference (13 ± 18% vs. 74 ± 18%) and heart rate (32 ± 18 vs. 75 ± 29%) were less in participants with ESRD despite exercise being performed at a higher percentage of maximum minute ventilation (48 ± 3% vs. 39 ± 3%) and heart rate (82 ± 2 vs. 64 ± 2%). Ventilatory and chronotropic incompetence contribute to exercise intolerance in individuals with ESRD. Both are potential targets for medical and lifestyle interventions.
| S-EPMC7509284 | biostudies-literature
Project description:Objectives: To assess whether nasal breathing improves exercise ventilatory efficiency in patients with heart failure (HF) or chronic coronary syndromes (CCS). Background: Exercise inefficient ventilation predicts disease progression and mortality in patients with cardiovascular diseases. In healthy people, improved ventilatory efficiency with nasal compared to oral breathing was found. Methods: Four study groups were recruited: Patients with HF, patients with CCS, old (age≥45 years) and young (age 20-40 years) healthy control subjects. After a 3-min warm-up, measurements of 5 min with once nasal and once oral breathing were performed in randomized order at 50% peak power on cycle ergometer. Ventilation and gas exchange parameters measured with spiroergometry were analysed by Wilcoxon paired-sample tests and linear mixed models adjusted for sex, height, weight and test order. Results: Groups comprised 15 HF, CCS, and young control and 12 old control. Ventilation/carbon dioxide production ( V˙ E/ V˙ CO2), ventilation ( V˙ E), breathing frequency (fR), and end-tidal oxygen partial pressure (PETO2) were significantly lower and tidal volume and end-tidal carbon dioxide partial pressure (PETCO2) significantly higher during nasal compared to oral breathing in all groups, with large effect sizes for most parameters. For patients with HF, median V˙ E/ V˙ CO2 was 35% lower, fR 26% lower, and PETCO2 10% higher with nasal compared to oral breathing, respectively. Exercise oscillatory ventilation (EOV) was present in 6 patients and markedly reduced with nasal breathing. Conclusion: Nasal breathing during submaximal exercise significantly improved ventilatory efficiency and abnormal breathing patterns (rapid shallow breathing and EOV) in 80% of our patients with HF and CCS.
| S-EPMC11334221 | biostudies-literature
Project description:Purpose: Ketosis, achieved through ingestion of ketone esters, may influence endurance exercise capacity by altering substrate metabolism. However, the effects of ketone consumption on acid-base status and subsequent metabolic and respiratory compensations are poorly described. Methods: Twelve athletically trained individuals completed an incremental bicycle ergometer exercise test to exhaustion following the consumption of either a ketone ester [(R)-3-hydroxybutyrate-(R)-1,3-butanediol] or a taste-matched control drink (bitter flavoured water) in a blinded, cross-over study. Respiratory gases and arterialised blood gas samples were taken at rest and at regular intervals during exercise. Results: Ketone ester consumption increased blood D-β-hydroxybutyrate concentration from 0.2 to 3.7 mM/L (p < 0.01), causing significant falls versus control in blood pH to 7.37 and bicarbonate to 18.5 mM/L before exercise. To compensate for ketoacidosis, minute ventilation was modestly increased (p < 0.05) with non-linearity in the ventilatory response to exercise (ventilatory threshold) occurring at a 22 W lower workload (p < 0.05). Blood pH and bicarbonate concentrations were the same at maximal exercise intensities. There was no difference in exercise performance having consumed the ketone ester or control drink. Conclusion: Athletes compensated for the greater acid load caused by ketone ester ingestion by elevating minute ventilation and earlier hyperventilation during incremental exercise.
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Project description: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.
| S-EPMC10513909 | biostudies-literature
Project description: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.
| S-EPMC6528988 | biostudies-literature
Project description:OBJECTIVE:The objective of this study was to determine whether net cycling efficiency (NET) is altered by 24-hour fasting or overfeeding and whether it correlates with dietary-related energy expenditure (EE) and future weight change. METHODS:In a crossover design, healthy subjects fasted or were overfed for 24 hours while in a whole-room calorimeter using five diets with doubled energy needs: standard, high-carbohydrate (75%), high-fat (60%), high-protein (30%), and low-protein (3%) diets. Graded cycling exercise at low power outputs (10-25-50 W) was performed the day before and after each dietary intervention. RESULTS:NET did not change following any dietary intervention (all P > 0.05 vs. 0). Individual changes in NET did not correlate with EE responses to dietary interventions. However, the change in NET after low-protein overfeeding was inversely correlated with baseline body fat (r = -0.60, P = 0.01); that is, NET increased in lean but decreased in overweight subjects (Δ = 0.010 ± 0.010 vs. -0.013 ± 0.009, P = 0.0003). Increased NET following the low-protein diet was associated with weight gain after 6 months (r = 0.60, P = 0.05). CONCLUSIONS:Despite no substantial effect of acute overfeeding or fasting on NET, the change in NET following low-protein overfeeding depends on adiposity and may influence weight change, suggesting that increased efficiency in a setting of protein scarcity is an adaptive response that may ultimately lead to weight gain.
| S-EPMC5783742 | biostudies-literature