Determinants of exercise performance in normal men with externally imposed expiratory flow limitation.

Details

Serval ID
serval:BIB_2AA9B8DF8358
Type
Article: article from journal or magazin.
Collection
Publications
Title
Determinants of exercise performance in normal men with externally imposed expiratory flow limitation.
Journal
Journal of Applied Physiology
Author(s)
Iandelli I., Aliverti A., Kayser B., Dellacà R., Cala S.J., Duranti R., Kelly S., Scano G., Sliwinski P., Yan S., Macklem P.T., Pedotti A.
ISSN
8750-7587 (Print)
ISSN-L
0161-7567
Publication state
Published
Issued date
2002
Volume
92
Number
5
Pages
1943-1952
Language
english
Abstract
To understand how externally applied expiratory flow limitation (EFL) leads to impaired exercise performance and dyspnea, we studied six healthy males during control incremental exercise to exhaustion (C) and with EFL at approximately 1. We measured volume at the mouth (Vm), esophageal, gastric and transdiaphragmatic (Pdi) pressures, maximal exercise power (W(max)) and the difference (Delta) in Borg scale ratings of breathlessness between C and EFL exercise. Optoelectronic plethysmography measured chest wall and lung volume (VL). From Campbell diagrams, we measured alveolar (PA) and expiratory muscle (Pmus) pressures, and from Pdi and abdominal motion, an index of diaphragmatic power (W(di)). Four subjects hyperinflated and two did not. EFL limited performance equally to 65% W(max) with Borg = 9-10 in both. At EFL W(max), inspiratory time (TI) was 0.66s +/- 0.08, expiratory time (TE) 2.12 +/- 0.26 s, Pmus approximately 40 cmH2O and DeltaVL-DeltaVm = 488.7 +/- 74.1 ml. From PA and VL, we calculated compressed gas volume (VC) = 163.0 +/- 4.6 ml. The difference, DeltaVL-DeltaVm-VC (estimated blood volume shift) was 326 ml +/- 66 or 7.2 ml/cmH2O PA. The high Pmus and long TE mimicked a Valsalva maneuver from which the short TI did not allow recovery. Multiple stepwise linear regression revealed that the difference between C and EFL Pmus accounted for 70.3% of the variance in DeltaBorg. DeltaW(di) added 12.5%. We conclude that high expiratory pressures cause severe dyspnea and the possibility of adverse circulatory events, both of which would impair exercise performance.
Keywords
Adult, Blood Volume/physiology, Diaphragm/physiology, Exercise Test, Exercise Tolerance/physiology, Forced Expiratory Flow Rates/physiology, Humans, Inspiratory Capacity/physiology, Male, Physical Exertion/physiology, Plethysmography, Pressure, Pulmonary Ventilation/physiology, Reference Values, Total Lung Capacity/physiology
Pubmed
Web of science
Create date
19/09/2013 9:50
Last modification date
20/08/2019 13:10
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