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Baysan M, Broere M, Wille ME, Bergsma JE, Mik EG, Juffermans NP, Tsonaka R, van der Bom JG, Arbous SM. Description of mitochondrial oxygen tension and its variability in healthy volunteers. PLoS One 2024; 19:e0300602. [PMID: 38829894 PMCID: PMC11146699 DOI: 10.1371/journal.pone.0300602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 02/27/2024] [Indexed: 06/05/2024] Open
Abstract
OBJECTIVES Describing mitochondrial oxygenation (mitoPO2) and its within- and between-subject variability over time after 5-aminolevulinic acid (ALA) plaster application in healthy volunteers. DESIGN Prospective cohort study. SETTING Measurements were performed in Leiden University Medical Center, the Netherlands. PARTICIPANTS Healthy volunteers enrolled from July to September 2020. INTERVENTIONS Two ALA plasters were placed parasternal left and right, with a 3-hour time interval, to examine the influence of the calendar time on the value of mitoPO2. We measured mitoPO2 at 4, 5, 7, 10, 28, and 31 hours after ALA plaster 1 application, and at 4, 5, 7, 25, and 28 hours after ALA plaster 2 application. PRIMARY AND SECONDARY OUTCOME MEASURES At each time point, five mitoPO2 measurements were performed. Within-subject variability was defined as the standard deviation (SD) of the mean of five measurements per timepoint of a study participant. The between-subject variability was the SD of the mean mitoPO2 value of the study population per timepoint. RESULTS In 16 completed inclusions, median mitoPO2 values and within-subject variability were relatively similar over time at all time points for both plasters. An increase in overall between-subject variability was seen after 25 hours ALA plaster time (19.6 mm Hg vs 23.9 mm Hg after respectively 10 and 25 hours ALA plaster time). CONCLUSIONS The mitoPO2 values and within-subject variability remained relatively stable over time in healthy volunteers. An increase in between-subject variability was seen after 25 hours ALA plaster time warranting replacement of the ALA plaster one day after its application. TRIAL REGISTRATION ClinicalTrials.gov with trial number NCT04626661.
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Affiliation(s)
- Meryem Baysan
- Department of Intensive Care Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Jon J van Rood Center for Clinical Transfusion Research, Sanquin/Leiden University Medical Center, Leiden, the Netherlands
| | - Mark Broere
- Department of Intensive Care Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Jon J van Rood Center for Clinical Transfusion Research, Sanquin/Leiden University Medical Center, Leiden, the Netherlands
| | - Maarten E. Wille
- Department of Intensive Care Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Jule E. Bergsma
- Department of Intensive Care Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Egbert G. Mik
- Department of Anesthesiology, Laboratory of Experimental Anesthesiology, Erasmus MC- University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Nicole P. Juffermans
- Department of Intensive Care Medicine, OLVG Hospital, Amsterdam, the Netherlands
- Department of Laboratory of Translation Intensive Care, Erasmus MC- University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Roula Tsonaka
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Johanna G. van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Jon J van Rood Center for Clinical Transfusion Research, Sanquin/Leiden University Medical Center, Leiden, the Netherlands
| | - Sesmu M. Arbous
- Department of Intensive Care Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
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Hilderink BN, Crane RF, van den Bogaard B, Pillay J, Juffermans NP. Hyperoxemia and hypoxemia impair cellular oxygenation: a study in healthy volunteers. Intensive Care Med Exp 2024; 12:37. [PMID: 38619625 PMCID: PMC11018572 DOI: 10.1186/s40635-024-00619-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/28/2024] [Indexed: 04/16/2024] Open
Abstract
INTRODUCTION Administration of oxygen therapy is common, yet there is a lack of knowledge on its ability to prevent cellular hypoxia as well as on its potential toxicity. Consequently, the optimal oxygenation targets in clinical practice remain unresolved. The novel PpIX technique measures the mitochondrial oxygen tension in the skin (mitoPO2) which allows for non-invasive investigation on the effect of hypoxemia and hyperoxemia on cellular oxygen availability. RESULTS During hypoxemia, SpO2 was 80 (77-83)% and PaO2 45(38-50) mmHg for 15 min. MitoPO2 decreased from 42(35-51) at baseline to 6(4.3-9)mmHg (p < 0.001), despite 16(12-16)% increase in cardiac output which maintained global oxygen delivery (DO2). During hyperoxic breathing, an FiO2 of 40% decreased mitoPO2 to 20 (9-27) mmHg. Cardiac output was unaltered during hyperoxia, but perfused De Backer density was reduced by one-third (p < 0.01). A PaO2 < 100 mmHg and > 200 mmHg were both associated with a reduction in mitoPO2. CONCLUSIONS Hypoxemia decreases mitoPO2 profoundly, despite complete compensation of global oxygen delivery. In addition, hyperoxemia also decreases mitoPO2, accompanied by a reduction in microcirculatory perfusion. These results suggest that mitoPO2 can be used to titrate oxygen support.
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Affiliation(s)
- Bashar N Hilderink
- Department of Intensive Care, OLVG Hospital, Amsterdam, The Netherlands.
| | - Reinier F Crane
- Department of Intensive Care, OLVG Hospital, Amsterdam, The Netherlands
| | | | - Janesh Pillay
- Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Nicole P Juffermans
- Department of Intensive Care, OLVG Hospital, Amsterdam, The Netherlands
- Laboratory of Translational Intensive Care, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Ogura A, Izawa KP, Tawa H, Wada M, Kanai M, Kubo I, Makihara A, Yoshikawa R, Matsuda Y. End-tidal oxygen partial pressure is a strong prognostic predictive factor in patients with cardiac disease. Clin Physiol Funct Imaging 2023; 43:404-412. [PMID: 37293922 DOI: 10.1111/cpf.12838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 04/20/2023] [Accepted: 06/07/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Cardiopulmonary exercise testing (CPET) variables represent central and peripheral factors and combined factors in the pathology of patients with cardiac disease. The difference in end-tidal oxygen partial pressure from resting to anaerobic threshold (ΔPETO2 ) may represent predominantly peripheral factors. This study aimed to verify the prognostic significance of ΔPETO2 for major adverse cardiac and cerebrovascular events (MACCE) in cardiac patients, including comparison with the minute ventilation-carbon dioxide production relationship (VE/VCO2 slope), and peak oxygen uptake (VO2 ). METHODS In total, 185 patients with cardiac disease who underwent CPET were consecutively enroled in this retrospective study. The primary endpoint was 3-year MACCE. The ability of ΔPETO2 , VE/VCO2 slope, and peak VO2 to predict MACCE was examined. RESULTS Optimal cut-off values for predicting MACCE were 2.0 mmHg for ΔPETO2 (area under the curve [AUC]: 0.829), 29.8 for VE/VCO2 slope (AUC: 0.734), and 19.0 mL/min/kg for peak VO2 (AUC: 0.755). The AUC of ΔPETO2 was higher than those of VE/VCO2 slope and peak VO2 . The MACCE-free survival rate was significantly lower in the ΔPETO2 ≤ 2.0 group versus the ΔPETO2 > 2.0 group (44.4% vs. 91.2%, p < 0.001). ΔPETO2 ≤ 2.0 was an independent predictor of MACCE after adjustment for age and VE/VCO2 slope (hazard ratio [HR], 7.28; p < 0.001) and after adjustment for age and peak VO2 (HR, 6.52; p < 0.001). CONCLUSION ΔPETO2 was a strong predictor of MACCE independent of and superior to VE/VCO2 slope and peak VO2 in patients with cardiac disease.
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Affiliation(s)
- Asami Ogura
- Department of Rehabilitation, Sanda City Hospital, Sanda, Japan
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan
- Cardiovascular Stroke Renal Project (CRP), Hyogo, Japan
| | - Kazuhiro P Izawa
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan
- Cardiovascular Stroke Renal Project (CRP), Hyogo, Japan
| | - Hideto Tawa
- Department of Cardiology, Sanda City Hospital, Sanda, Japan
| | - Masaaki Wada
- Department of Rehabilitation, Sanda City Hospital, Sanda, Japan
| | - Masashi Kanai
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan
- Cardiovascular Stroke Renal Project (CRP), Hyogo, Japan
| | - Ikko Kubo
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan
- Cardiovascular Stroke Renal Project (CRP), Hyogo, Japan
| | - Ayano Makihara
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan
- Cardiovascular Stroke Renal Project (CRP), Hyogo, Japan
| | | | - Yuichi Matsuda
- Department of Cardiology, Sanda City Hospital, Sanda, Japan
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Pühringer M, Ring-Dimitriou S, Iglseder B, Frey V, Trinka E, Paulweber B. Sequencing patterns of ventilatory indices in less trained adults. Front Sports Act Living 2023; 4:1066131. [PMID: 36755562 PMCID: PMC9900118 DOI: 10.3389/fspor.2022.1066131] [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: 10/10/2022] [Accepted: 12/14/2022] [Indexed: 01/24/2023] Open
Abstract
Submaximal ventilatory indices, i.e., point of optimal ventilatory efficiency (POE) and anaerobic threshold (AT), are valuable indicators to assess the metabolic and ventilatory response during cardiopulmonary exercise testing (CPET). The order in which the ventilatory indices occur (ventilatory indices sequencing pattern, VISP), may yield additional information for the interpretation of CPET results and for exercise intensity prescription. Therefore, we determined whether different VISP groups concerning POE and AT exist. Additionally, we analysed fat metabolism via the exercise intensity eliciting the highest fat oxidation rate (Fatmax) as a possible explanation for differences between VISP groups. 761 less trained adults (41-68 years) completed an incremental exercise test on a cycle ergometer until volitional exhaustion. The ventilatory indices were determined using automatic and visual detection methods, and Fatmax was determined using indirect calorimetry. Our study identified two VISP groups with a lower work rate at POE compared to AT in VISPPOE < AT but not in group VISPPOE = AT. Therefore, training prescription based on POE rather than AT would result in different exercise intensity recommendations in 66% of the study participants and consequently in unintended physiological adaptions. VISPPOE < AT participants were not different to VISPPOE = AT participants concerning VO2peak and Fatmax. However, participants exhibiting a difference in work rate (VISPPOE < AT) were characterized by a higher aerobic capacity at submaximal work rate compared to VISPPOE = AT. Thus, analysing VISP may help to gain new insights into the complex ventilatory and metabolic response to exercise. But a methodological framework still must be established.
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Affiliation(s)
- Martin Pühringer
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria
| | | | - Bernhard Iglseder
- Department of Geriatric Medicine, Christian-Doppler-Clinic, Paracelsus Medical University, Salzburg, Austria
| | - Vanessa Frey
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University and Centre for Cognitive Neuroscience, Affiliated Member of the European Reference Network EpiCARE, Salzburg, Austria
| | - Eugen Trinka
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University and Centre for Cognitive Neuroscience, Affiliated Member of the European Reference Network EpiCARE, Salzburg, Austria
- Neuroscience Institute, Christian Doppler University Hospital, Paracelsus Medical University and Centre for Cognitive Neuroscience, Salzburg, Austria
| | - Bernhard Paulweber
- Department of Internal Medicine I, Paracelsus Medical University, Salzburg, Austria
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Salas-Montoro JA, Mateo March M, Sánchez-Muñoz C, Zabala M. Determination of second lactate threshold using near-infrared spectroscopy in elite cyclists. Int J Sports Med 2022; 43:721-728. [PMID: 35021246 DOI: 10.1055/a-1738-0252] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The use of near-infrared spectroscopy could be an interesting alternative to other invasive or expensive methods to estimate the second lactate threshold. Our objective was to compare the intensities of the muscle oxygen saturation breakpoint obtained with the Humon Hex and the second lactate threshold in elite cyclists. Ninety cyclists performed a maximal graded exercise test. Blood capillary lactate was obtained at the end of steps and muscle oxygenation was continuously monitored. There were no differences (p>0.05) between muscle oxygen oxygenation breakpoint and second lactate threshold neither in power nor in heart rate, nor when these values were relativized as a percentage of maximal aerobic power or maximum heart rate. There were also no differences when men and women were studied separately. Both methods showed a highly correlation in power (r=0.914), percentage of maximal aerobic power (r=0.752), heart rate (r=0.955), and percentage of maximum heart rate (r=0.903). Bland-Altman resulted in a mean difference of 0.05±0.27 W·kg-1, 0.91±4.93%, 0.63±3.25 bpm, and 0.32±1.69% for power, percentage of maximal aerobic power, heart rate and percentage of maximum heart rate respectively. These findings suggest that Humon may be a non-invasive and low-cost alternative to estimate the second lactate threshold intensity in elite cyclists.
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Affiliation(s)
- José-Antonio Salas-Montoro
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Manuel Mateo March
- Health Psichology, Sport Research Centre, Miguel Hernandez University of Elche, Alicante, Spain.,BMX, Spanish Cycling Federation, Alicante, Spain
| | - Cristóbal Sánchez-Muñoz
- Department of Physical Activity and Sport, Faculty of Physical Activity and Sport Sciences (University of Granada), Granada, Spain
| | - Mikel Zabala
- Department of Physical Activity and Sport, Faculty of Physical Activity and Sport Sciences (University of Granada), Granada, Spain.,Department of Physical Education and Sport, Faculty of Physical Activity and Sport Sciences, Granada, Spain
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Exploration of Internal and External Factors of Swimmers' Performance Based on Biofluid Mechanics and Computer Simulation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126471. [PMID: 34203848 PMCID: PMC8296294 DOI: 10.3390/ijerph18126471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/10/2021] [Accepted: 06/13/2021] [Indexed: 01/11/2023]
Abstract
The purpose of this study is to explore the influence of different swimming strokes on the performance of swimmers and the resistance of each part from the perspective of hydrodynamics. In this paper, the influence of internal and external factors on the swimming speed is analyzed comprehensively and meticulously from the macro and micro perspectives. In the macroscopic part, the swimming speed representation model is established, and the validity of the model is further verified by the analysis of experimental data and hydrodynamic equations. In the microscopic part, we carefully analyzed details such as the opening angle of the palm, the timing of the arm and leg and the angular velocity of each link of the human body. Combined with computer simulation, stereo modeling and numerical analysis are carried out, and the best scheme FOR how to cooperate with each part of the body in swimming is given.
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