1
|
Kasiak P, Kowalski T, Rębiś K, Klusiewicz A, Ładyga M, Sadowska D, Wilk A, Wiecha S, Barylski M, Poliwczak AR, Wierzbiński P, Mamcarz A, Śliż D. Is the Ventilatory Efficiency in Endurance Athletes Different?-Findings from the NOODLE Study. J Clin Med 2024; 13:490. [PMID: 38256624 PMCID: PMC10816682 DOI: 10.3390/jcm13020490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/13/2024] [Accepted: 01/14/2024] [Indexed: 01/24/2024] Open
Abstract
Background: Ventilatory efficiency (VE/VCO2) is a strong predictor of cardiovascular diseases and defines individuals' responses to exercise. Its characteristics among endurance athletes (EA) remain understudied. In a cohort of EA, we aimed to (1) investigate the relationship between different methods of calculation of VE/VCO2 and (2) externally validate prediction equations for VE/VCO2. Methods: In total, 140 EA (55% males; age = 22.7 ± 4.6 yrs; BMI = 22.6 ± 1.7 kg·m-2; peak oxygen uptake = 3.86 ± 0.82 L·min-1) underwent an effort-limited cycling cardiopulmonary exercise test. VE/VCO2 was first calculated to ventilatory threshold (VE/VCO2-slope), as the lowest 30-s average (VE/VCO2-Nadir) and from whole exercises (VE/VCO2-Total). Twelve prediction equations for VE/VCO2-slope were externally validated. Results: VE/VCO2-slope was higher in females than males (27.7 ± 2.6 vs. 26.1 ± 2.0, p < 0.001). Measuring methods for VE/VCO2 differed significantly in males and females. VE/VCO2 increased in EA with age independently from its type or sex (β = 0.066-0.127). Eleven equations underestimated VE/VCO2-slope (from -0.5 to -3.6). One equation overestimated VE/VCO2-slope (+0.2). Predicted and observed measurements differed significantly in nine models. Models explained a low amount of variance in the VE/VCO2-slope (R2 = 0.003-0.031). Conclusions: VE/VCO2-slope, VE/VCO2-Nadir, and VE/VCO2-Total were significantly different in EA. Prediction equations for the VE/VCO2-slope were inaccurate in EA. Physicians should be acknowledged to properly assess cardiorespiratory fitness in EA.
Collapse
Affiliation(s)
- Przemysław Kasiak
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Tomasz Kowalski
- Department of Physiology, Institute of Sport—National Research Institute, 01-982 Warsaw, Poland
| | - Kinga Rębiś
- Department of Physiology, Institute of Sport—National Research Institute, 01-982 Warsaw, Poland
| | - Andrzej Klusiewicz
- Department of Physical Education and Health in Biala Podlaska, Branch in Biala Podlaska, Jozef Pilsudski University of Physical Education, 00-968 Warsaw, Poland
| | - Maria Ładyga
- Department of Physiology, Institute of Sport—National Research Institute, 01-982 Warsaw, Poland
| | - Dorota Sadowska
- Department of Physiology, Institute of Sport—National Research Institute, 01-982 Warsaw, Poland
| | - Adrian Wilk
- Department of Kinesiology, Institute of Sport—National Research Institute, 01-982 Warsaw, Poland
| | - Szczepan Wiecha
- Department of Physical Education and Health in Biala Podlaska, Branch in Biala Podlaska, Jozef Pilsudski University of Physical Education, 00-968 Warsaw, Poland
| | - Marcin Barylski
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lodz, 90-419 Lodz, Poland
| | - Adam Rafał Poliwczak
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lodz, 90-419 Lodz, Poland
| | - Piotr Wierzbiński
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Artur Mamcarz
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Daniel Śliż
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
| |
Collapse
|
2
|
Muller PDT. Ventilatory efficiency (η⩒E) of the exercise: A detailed method report. MethodsX 2023; 11:102412. [PMID: 37860042 PMCID: PMC10582470 DOI: 10.1016/j.mex.2023.102412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/03/2023] [Indexed: 10/21/2023] Open
Abstract
Ventilatory efficiency is a combination of the ventilatory-metabolic response stemming from non-invasive analysis of cardiopulmonary exercise testing. Despite being a recognized marker in exercise physiology, this measure presents considerable limitations, including the imprecise designation of "efficiency", broadly recognized, and recently denominated as "excess ventilation". Herein we present a detailed method, with substantial improvements, and new physiological insights, in order to better define the true ventilatory efficiency of the exercise, according to recommendations for physical/physiological processes.•"Ventilatory efficiency" of the exercise is a remarkable physiological index.•Several limitations are currently debated.•We report a new ventilatory efficiency index that match with recommendations.
Collapse
Affiliation(s)
- Paulo de Tarso Muller
- Federal University of Mato Grosso do Sul (UFMS)/Maria Aparecida Pedrossian Hospital (HUMAP), Laboratory of Respiratory Pathophysiology (LAFIR), Campo Grande MS, Mato Grosso do Sul, Brazil
| |
Collapse
|
3
|
Mattavelli I, Vignati C, Farina S, Apostolo A, Cattadori G, De Martino F, Pezzuto B, Zaffalon D, Agostoni P. Beyond VO2: the complex cardiopulmonary exercise test. Eur J Prev Cardiol 2023; 30:ii34-ii39. [PMID: 37819225 DOI: 10.1093/eurjpc/zwad154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/21/2023] [Accepted: 05/06/2023] [Indexed: 10/13/2023]
Abstract
Cardiopulmonary exercise test (CPET) is a valuable diagnostic tool with a specific application in heart failure (HF) thanks to the strong prognostic value of its parameters. The most important value provided by CPET is the peak oxygen uptake (peak VO2), the maximum rate of oxygen consumption attainable during physical exertion. According to the Fick principle, VO2 equals cardiac output (Qc) times the arteriovenous content difference [C(a-v)O2], where Ca is the arterial oxygen and Cv is the mixed venous oxygen content, respectively; therefore, VO2 can be reduced both by impaired O2 delivery (reduced Qc) or extraction (reduced arteriovenous O2 content). However, standard CPET is not capable of discriminating between these different impairments, leading to the need for 'complex' CPET technologies. Among non-invasive methods for Qc measurement during CPET, inert gas rebreathing and thoracic impedance cardiography are the most used techniques, both validated in healthy subjects and patients with HF, at rest and during exercise. On the other hand, the non-invasive assessment of peripheral muscle perfusion is possible with the application of near-infrared spectroscopy, capable of measuring tissue oxygenation. Measuring Qc allows, by having haemoglobin values available, to discriminate how much any VO2 deficit depends on the muscle, anaemia or heart.
Collapse
Affiliation(s)
- Irene Mattavelli
- Centro Cardiologico Monzino, IRCCS, Via Parea, 4, Milan 20138, Italy
| | - Carlo Vignati
- Centro Cardiologico Monzino, IRCCS, Via Parea, 4, Milan 20138, Italy
- Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Stefania Farina
- Centro Cardiologico Monzino, IRCCS, Via Parea, 4, Milan 20138, Italy
- Cytogenetics and Medical Genetics, University of Milano-Bicocca, Milan, Italy
| | - Anna Apostolo
- Centro Cardiologico Monzino, IRCCS, Via Parea, 4, Milan 20138, Italy
| | - Gaia Cattadori
- Multimedica IRCCS, Unità Operativa Cardiologia Riabilitativa, Multimedica IRCCS, Milan, Italy
| | - Fabiana De Martino
- Casa di Cura Tortorella, Dipartimento Medico, Unità funzionale di Cardiologia, Casa di Cura Tortorella, Salerno, Italy
| | - Beatrice Pezzuto
- Centro Cardiologico Monzino, IRCCS, Via Parea, 4, Milan 20138, Italy
| | - Denise Zaffalon
- Cardiovascular Department, 'Azienda Sanitaria Universitaria Giuliano-Isontina', Trieste, Italy
| | - Piergiuseppe Agostoni
- Centro Cardiologico Monzino, IRCCS, Via Parea, 4, Milan 20138, Italy
- Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| |
Collapse
|