Sex differences in respiratory exercise physiology

Sex differences in heart rate responses to sub-maximal exercise in young adults

There is paucity of scientific information on sex differences in heart rate (HR) responses during and after a sub-maximal exercise test in young adults. We assessed sex differences in normal HR responses during and after a sub-maximal-effort cycle ergometer exercise test in apparently healthy young adults. One hundred young adults (50 males and 50 females) participated in the study. Subjects performed a sub-maximal exercise at an intensity that produced 60–85% of a pre-determined age-predicted maximum HR. Measurements of subjects’ HR were done at rest, during exercise and post exercise recovery periods. The present data indicated that after adjusting for covariates, greater (P<0.05) HR responses (delta HR 2 min, delta HR 5 min, delta peak HR) were observed in men relative to women. Males also indicated significantly higher (P<0.05) %HRmax and %HRreserve compared to females. Variables of HR response during post-exercise recovery did not differ between males and females. HR responses during exercise were greater in young adult males compared to females while HR responses at post-exercise recovery were similar between the two groups. The present findings may be useful in interpreting more accurately the significance of HR responses during and after exercise in healthy young adults according to sex.

Precise mimicking of exercise hyperpnea to investigate the oxygen cost of breathing

The oxygen cost of exercise hyperpnea (V˙(O2 RM)) has been quantified using a variety of techniques with inconsistent findings. Between-study variation relates to poor control of breathing patterns and lung mechanics. We developed a methodology allowing precise matching of exercising WOB in order to estimate V˙(O2 RM). Thirteen healthy young subjects (7 male) completed an incremental cycle exercise test, familiarization and experimental days where exercise hyperpnea was mimicked. On experimental days, feedback of exercise flow, volume and the respiratory pressures were provided while end-tidal CO2 was kept at exercise levels during each 5-min trial. Minute ventilation levels between 50 and 100% maximum were mimicked 3-5 times. The r(2) between exercise and mimic trails was 0.99 for frequency, tidal volume and minute ventilation; 0.86 for esophageal pressure swings and 0.93 for WOB. The coefficient of variation for (V˙(O2) averaged 4.3, 4.4 and 5.7% for 50, 75 and 100% ventilation trials. When WOB and other respiratory parameters are tightly controlled, the V˙(O2 RM) can be consistently estimated.

Effects of gas exchange on acid-base balance

This paper describes the interactions between ventilation and acid-base balance under a variety of conditions including rest, exercise, altitude, pregnancy, and various muscle, respiratory, cardiac, and renal pathologies. We introduce the physicochemical approach to assessing acid-base status and demonstrate how this approach can be used to quantify the origins of acid-base disorders using examples from the literature. The relationships between chemoreceptor and metaboreceptor control of ventilation and acid-base balance summarized here for adults, youth, and in various pathological conditions. There is a dynamic interplay between disturbances in acid-base balance, that is, exercise, that affect ventilation as well as imposed or pathological disturbances of ventilation that affect acid-base balance. Interactions between ventilation and acid-base balance are highlighted for moderate- to high-intensity exercise, altitude, induced acidosis and alkalosis, pregnancy, obesity, and some pathological conditions. In many situations, complete acid-base data are lacking, indicating a need for further research aimed at elucidating mechanistic bases for relationships between alterations in acid-base state and the ventilatory responses.

Heart rate response during a simulated Olympic boxing match is predominantly above ventilatory threshold 2: a cross sectional study

The present study aimed to describe heart rate (HR) responses during a simulated Olympic boxing match and examine physiological parameters of boxing athletes. Ten highly trained Olympic boxing athletes (six men and four women) performed a maximal graded exercise test on a motorized treadmill to determine maximal oxygen uptake (52.2 mL · kg⁻¹ · min⁻¹ ± 7.2 mL · kg⁻¹ · min⁻¹) and ventilatory thresholds 1 and 2. Ventilatory thresholds 1 and 2 were used to classify the intensity of exercise based on respective HR during a boxing match. In addition, oxygen uptake (V̇O₂) was estimated during the match based on the HR response and the HR-V̇O₂ relationship obtained from a maximal graded exercise test for each participant. On a separate day, participants performed a boxing match lasting three rounds, 2 minutes each, with a 1-minute recovery period between each round, during which HR was measured. In this context, HR and V̇O₂ were above ventilatory threshold 2 during 219.8 seconds ± 67.4 seconds. There was an increase in HR and V̇O₂ as a function of round (round 3 < round 2 < round 1, P < 0.0001). These findings may direct individual training programs for boxing practitioners and other athletes.

Pulmonary gas exchange and acid-base balance during exercise

As the first step in the oxygen-transport chain, the lung has a critical task: optimizing the exchange of respiratory gases to maintain delivery of oxygen and the elimination of carbon dioxide. In healthy subjects, gas exchange, as evaluated by the alveolar-to-arterial PO2 difference (A-aDO2), worsens with incremental exercise, and typically reaches an A-aDO2 of approximately 25 mmHg at peak exercise. While there is great individual variability, A-aDO2 is generally largest at peak exercise in subjects with the highest peak oxygen consumption. Inert gas data has shown that the increase in A-aDO2 is explained by decreased ventilation-perfusion matching, and the development of a diffusion limitation for oxygen. Gas exchange data does not indicate the presence of right-to-left intrapulmonary shunt developing with exercise, despite recent data suggesting that large-diameter arteriovenous shunt vessels may be recruited with exercise. At the same time, multisystem mechanisms regulate systemic acid-base balance in integrative processes that involve gas exchange between tissues and the environment and simultaneous net changes in the concentrations of strong and weak ions within, and transfer between, extracellular and intracellular fluids. The physicochemical approach to acid-base balance is used to understand the contributions from independent acid-base variables to measured acid-base disturbances within contracting skeletal muscle, erythrocytes and noncontracting tissues. In muscle, the magnitude of the disturbance is proportional to the concentrations of dissociated weak acids, the rate at which acid equivalents (strong acid) accumulate and the rate at which strong base cations are added to or removed from muscle.

Physiological correlates of skating performance in women's and men's ice hockey

The purpose of the current investigation was to identify relationships between physiological off-ice tests and on-ice performance in female and male ice hockey players on a comparable competitive level. Eleven women, 24 ± 3.0 years, and 10 male ice hockey players, 23 ± 2.4 years, were tested for background variables: height, body weight (BW), ice hockey history, and lean body mass (LBM) and peak torque (PT) of the thigh muscles, VO2peak and aerobic performance (Onset of Blood Lactate Accumulation [OBLA], respiratory exchange ratio [RER1]) during an incremental bicycle ergometer test. Four different on-ice tests were used to measure ice skating performance. For women, skating time was positively correlated (p < 0.05) to BW and negatively correlated to LBM%, PT/BW, OBLA, RER 1, and VO2peak (ml O2·kg(-1) BW(-1)·min(-1)) in the Speed test. Acceleration test was positively correlated to BW and negatively correlated to OBLA and RER 1. For men, correlation analysis revealed only 1 significant correlation where skating time was positively correlated to VO2peak (L O2·min(-1)) in the Acceleration test. The male group had significantly higher physiological test values in all variables (absolute and relative to BW) but not in relation to LBM. Selected off-ice tests predict skating performance for women but not for men. The group of women was significantly smaller and had a lower physiological performance than the group of men and were slower in the on-ice performance tests. However, gender differences in off-ice variables were reduced or disappeared when values were related to LBM, indicating a similar capacity of producing strength and aerobic power in female and male hockey players. Skating performance in female hockey players may be improved by increasing thigh muscle strength, oxygen uptake, and relative muscle mass.

Sildenafil and bosentan improve arterial oxygenation during acute hypoxic exercise: a controlled laboratory trial

OBJECTIVES

Sildenafil and, recently, bosentan have been reported to increase arterial saturation and exercise capacity at altitude. The mechanisms behind this are still poorly defined but may be related to attenuation of hypoxic pulmonary vasoconstriction (HPV) and improved gas exchange. This study was designed to examine and compare the effect of sildenafil and bosentan on pulmonary gas exchange during acute hypoxic exercise in a controlled laboratory setting.

METHODS

Sixteen athletic university students (8 males, 8 females) were examined during exercise in a hypoxic chamber (11% oxygen) before and after the administration of either sildenafil (n=10) or bosentan (n=6). Respiratory and metabolic measurements were taken at rest and during increasing exercise intensity (up to 90% of their individual maximal oxygen uptake [VO(2)max]) in concert with arterial blood gas sampling.

RESULTS

Both drugs resulted in small, but significant increases in arterial PO(2) (2-3 Torr) and O(2) saturation (3-4%) at rest and during hypoxic exercise, in both men and women. No significant changes in arterial PCO(2) or ventilation were seen at rest or during exercise in hypoxia; however, heart rate (both at rest and during exercise) was increased with both sildenafil and bosentan in both men and women.

CONCLUSIONS

These data demonstrate that sildenafil and bosentan equally improve arterial oxygenation in acute hypoxia in both men and women, which could account for improved physical performance at altitude.

Sex differences in exertional dyspnea in patients with mild COPD: physiological mechanisms

The purpose of this study was to evaluate the physiological basis for sex-differences in exercise-induced dyspnea in patients with mild COPD. We compared operating lung volumes, breathing pattern and dyspnea during incremental cycling in 32 men (FEV(1)=86±10% predicted) and women (FEV(1)=86±12% predicted) with mild COPD and 32 age-matched controls. There were no sex differences in dyspnea in the control group at any work-rate or ventilation (V(E)). Women with COPD had significantly greater dyspnea than men at 60 and 80 W. At 80 W, dyspnea ratings were 5.7±2.3 and 3.3±2.5 Borg units (P<0.05) and the V(E) to maximal ventilatory capacity ratio was 72% and 55% in women and men, respectively (P<0.05). Comparable increases in dynamic hyperinflation were seen in both male and female COPD groups at symptom limitation but women reached tidal volume constraints at a lower work rate and V(E) than men. Superimposing mild COPD on the normal aging effects had greater sensory consequences in women because of their naturally reduced ventilatory reserve.

Physiological consequences of a high work of breathing during heavy exercise in humans

The healthy respiratory system has a remarkable capacity for meeting the metabolic demands placed upon it during strenuous exercise. For example, in order to regulate alveolar partial pressure of oxygen and carbon dioxide during heavy workloads, a 20-fold increase in alveolar ventilation can occur. The high metabolic costs and subsequent increased work of breathing associated with this ventilatory increase can result in a number of limitations to the healthy respiratory system. Two examples of respiratory system limitations that are associated with a high work of breathing are expiratory flow limitation and exercise-induced diaphragmatic fatigue. Expiratory flow limitation can lead to an inability to increase alveolar ventilation (V (A)) in the face of increasing metabolic demands, resulting in gas exchange impairment and diminished endurance exercise performance. Furthermore, the high ventilatory requirements of endurance athletes and the inherent anatomical differences in females could make these groups more susceptible to expiratory flow limitation. Fatigue of the diaphragm has also been documented after strenuous exercise and may be related to a mechanism which increases sympathetic vasoconstrictor outflow and reduces limb blood flow during prolonged exercise. This competition between the muscles of respiration and locomotion for a limited cardiac output may have dramatic consequences for exercise performance. This brief review summarizes the literature as it pertains to the work of breathing, expiratory flow limitation, and exercise-induced diaphragmatic fatigue in healthy humans.

Lung density is not altered following intense normobaric hypoxic interval training in competitive female cyclists

Noninvasive imaging techniques have been used to assess pulmonary edema following exercise but results remain equivocal. Most studies examining this phenomenon have used male subjects while the female response has received little attention. Some suggest that women, by virtue of their smaller lungs, airways, and diffusion surface areas may be more susceptible to pulmonary limitations during exercise. Accordingly, the purpose of this study was to determine if intense normobaric hypoxic exercise could induce pulmonary edema in women. Baseline lung density was obtained in eight highly trained female cyclists (mean +/- SD: age = 26 +/- 7 yr; height = 172.2 +/- 6.7 cm; mass = 64.1 +/- 6.7 kg; Vo(2max) = 52.2 +/- 2.2 ml.kg(-1).min(-1)) using computed tomography (CT). CT scans were obtained at the level of the aortic arch, the tracheal carina, and the superior end plate of the tenth thoracic vertebra. While breathing 15% O(2), subjects then performed five 2.5-km cycling intervals [mean power = 212 +/- 31 W; heart rate (HR) = 94.5 +/- 2.2%HRmax] separated by 5 min of recovery. Throughout the intervals, subjects desaturated to 82 +/- 4%, which was 13 +/- 2% below resting hypoxic levels. Scans were repeated 44 +/- 8 min following exercise. Mean lung density did not change from pre (0.138 +/- 0.014 g/ml)- to postexercise (0.137 +/- 0.011 g/ml). These findings suggest that pulmonary edema does not occur in highly trained females following intense normobaric hypoxic exercise.

Difference in breathing strategies during exercise between trained elderly men and women

This study compared the ventilatory responses and exercise tidal flow-volume (Vt) loops during exercise in order to analyze the influence of gender on breathing strategy in a fit aging population. Sixteen trained elderly men (63.0+/-2.9 years) and eight peer women (62.3 +/- 5.5 years) performed an incremental test on a cycle ergometer. At 90% maximal oxygen consumption (VO2max), the women presented a significantly higher expiratory flow limitation (EFL) than the men (38 +/- 10 vs 17 +/- 8% of Vt, respectively) (P<0.01) and a lower value of expiratory reserve volume relative to forced vital capacity (FVC) compared with the men (16.8 +/- 5.3% vs 23.0 +/- 5.2%, respectively) (P<0.05). Inspiratory reserve volume relative to FVC was significantly higher in women than men at 50% (P<0.05), 70% (P<0.01) and 90%VO2max (25.2 +/- 5.4% vs 12.2 +/- 4.2%, respectively, at 90%VO2max) (P<0.01). Mechanical ventilatory constraints occurred in trained elderly men and women. However, different breathing strategies were observed relative to gender. A significantly higher EFL was measured in women, whereas men rather presented a dynamic hyperinflation. This specific breathing strategy measured in trained elderly women would induce lower ventilatory efficiency than in peer men.

Physiological characteristics of badminton match play

The present study aimed at examining the physiological characteristics and metabolic demands of badminton single match play. Twelve internationally ranked badminton players (eight women and four men) performed an incremental treadmill test [VO(2peak = )50.3 +/- 4.1 ml min(-1) kg(-1) (women) and 61.8 +/- 5.9 ml min(-1) kg(-1) (men), respectively]. On a separate day, they played a simulated badminton match of two 15 min with simultaneous gas exchange (breath-by-breath) and heart rate measurements. Additionally, blood lactate concentrations were determined before, after 15 min and at the end of the match. Furthermore, the duration of rallies and rests in between, the score as well as the number of shots per rally were recorded. A total of 630 rallies was analysed. Mean rally and rest duration were 5.5 +/- 4.4 s and 11.4 +/- 6.0 s, respectively, with an average 5.1 +/- 3.9 shots played per rally. Mean oxygen uptake (VO(2)), heart rate (HR), and blood lactate concentrations during badminton matches were 39.6 +/- 5.7 ml min(-1) kg(-1) (73.3% VO(2peak)), 169 +/- 9 min(-1) (89.0% HR(peak)) and 1.9 +/- 0.7 mmol l(-1), respectively. For a single subject 95% confidence intervals for VO(2) and HR during match play were on average 45.7-100.9% VO(2peak) and 78.3-99.8% HR(peak). High average intensity of badminton match play and considerable variability of several physiological variables demonstrate the importance of anaerobic alactacid and aerobic energy production in competitive badminton. A well-developed aerobic endurance capacity seems necessary for fast recovery between rallies or intensive training workouts.

Modeling physiological and anthropometric variables known to vary with body size and other confounding variables

This review explores the most appropriate methods of identifying population differences in physiological and anthropometric variables known to differ with body size and other confounding variables. We shall provide an overview of such problems from a historical point of view. We shall then give some guidelines as to the choice of body-size covariates as well as other confounding variables, and show how these might be incorporated into the model, depending on the physiological dependent variable and the nature of the population being studied. We shall also recommend appropriate goodness-of-fit statistics that will enable researchers to confirm the most appropriate choice of model, including, for example, how to compare proportional allometric models with the equivalent linear or additive polynomial models. We shall also discuss alternative body-size scaling variables (height, fat-free mass, body surface area, and projected area of skeletal bone), and whether empirical vs. theoretical scaling methodologies should be reported. We shall offer some cautionary advice (limitations) when interpreting the parameters obtained when fitting proportional power function or allometric models, due to the fact that human physiques are not geometrically similar to each other. In conclusion, a variety of different models will be identified to describe physiological and anthropometric variables known to vary with body size and other confounding variables. These include simple ratio standards (e.g., per body mass ratios), linear and additive polynomial models, and proportional allometric or power function models. Proportional allometric models are shown to be superior to either simple ratio standards or linear and additive polynomial models for a variety of different reasons. These include: 1) providing biologically interpretable models that yield sensible estimates within and beyond the range of data; and 2) providing a superior fit based on the Akaike information criterion (AIC), Bayes information criterion (BIC), or maximum log-likelihood criteria (resulting in a smaller error variance). As such, these models will also: 3) naturally lead to a more powerful analysis-of-covariance test of significance, which will 4) subsequently lead to more correct conclusions when investigating population (epidemiological) or experimental differences in physiological and anthropometric variables known to vary with body size.

Relating pulmonary oxygen uptake to muscle oxygen consumption at exercise onset: in vivo and in silico studies

Assessment of the rate of muscle oxygen consumption, UO(2m), in vivo during exercise involving a large muscle mass is critical for investigating mechanisms regulating energy metabolism at exercise onset. While UO(2m) is technically difficult to obtain under these circumstances, pulmonary oxygen uptake, VO(2p), can be readily measured and used as a proxy to UO(2m). However, the quantitative relationship between VO(2p) and UO(2m) during the nonsteady phase of exercise in humans, needs to be established. A computational model of oxygen transport and utilization--based on dynamic mass balances in blood and tissue cells--was applied to quantify the dynamic relationship between model-simulated UO(2m) and measured VO(2p) during moderate (M), heavy (H), and very heavy (V) intensity exercise. In seven human subjects, VO(2p) and muscle oxygen saturation, StO(2m), were measured with indirect calorimetry and near infrared spectroscopy (NIRS), respectively. The dynamic responses of VO(2p) and StO(2m) at each intensity were in agreement with previously published data. The response time of muscle oxygen consumption, tauUO(2m) estimated by direct comparison between model results and measurements of StO(2m) was significantly faster (P < 0.001) than that of pulmonary oxygen uptake, tauVO(2p) (M: 13 +/- 4 vs. 65 +/- 7 s; H: 13 +/- 4 vs. 100 +/- 24 s; V: 15 +/- 5 vs. 82 +/- 31 s). Thus, by taking into account the dynamics of oxygen stores in blood and tissue and determining muscle oxygen consumption from muscle oxygenation measurements, this study demonstrates a significant temporal dissociation between UO(2m) and VO(2p) at exercise onset.