Blood shifts between body compartments during submaximal exercise with induced expiratory flow limitation in healthy humans.

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Version: Author's accepted manuscript
License: All rights reserved
Serval ID
serval:BIB_AADAFFF83CBC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Blood shifts between body compartments during submaximal exercise with induced expiratory flow limitation in healthy humans.
Journal
The Journal of physiology
Author(s)
Stucky F., Uva B., Kayser B., Aliverti A.
ISSN
1469-7793 (Electronic)
ISSN-L
0022-3751
Publication state
Published
Issued date
01/2023
Peer-reviewed
Oui
Volume
601
Number
1
Pages
227-244
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
External expiratory flow limitation (EFLe) can be applied in healthy subjects to mimic the effects of chronic obstructive pulmonary disease during exercise. At maximal exercise intensity, EFLe leads to exercise intolerance owing to respiratory pump dysfunction limiting venous return. We quantified blood shifts between body compartments to determine whether such effects can be observed during submaximal exercise, when the load on the respiratory system is milder. Ten healthy men (25.2 ± 3.2 years of age, 177.3 ± 5.4 cm in height and weighing 67.4 ± 5.8 kg) exercised at 100 W (∼40% of maximal oxygen uptake) while breathing spontaneously (CTRL) or with EFLe. We measured respiratory dynamics with optoelectronic plethysmography, oesophageal (P <sub>es</sub> ) and gastric (P <sub>ga</sub> ) pressures with balloon catheters, and blood shifting between body compartments with double body plethysmography. During exercise, EFLe resulted in the following changes: (i) greater intrabreath blood shifts between the trunk and the extremities [518 ± 221 (EFLe) vs. 224 ± 60 ml (CTRL); P < 0.001] associated with lower P <sub>es</sub> during inspiration (r = 0.53, P < 0.001) and higher P <sub>ga</sub> during expiration (r = 0.29, P < 0.024); and (ii) a progressive pooling of blood in the trunk over time (∼700 ml after 3 min of exercise; P < 0.05), explained by a predominant effect of lower inspiratory P <sub>es</sub> (r = 0.54, P < 0.001) over that of increased P <sub>ga</sub> . It follows that during submaximal exercise, EFLe amplifies the respiratory pump mechanism, with a prevailing contribution from lower inspiratory P <sub>es</sub> over increased expiratory P <sub>ga</sub> , drawing blood into the trunk. Whether these results can be replicated in chronic obstructive pulmonary disease patients remains to be determined. KEY POINTS: External expiratory flow limitation (EFLe) can be applied in healthy subjects to mimic the effects of chronic obstructive pulmonary disease and safely study the mechanisms of exercise intolerance associated with the disease. At maximal exercise intensity with EFLe, exercise intolerance results from high expiratory pressures altering the respiratory pump mechanism and limiting venous return. We used double body plethysmography to quantify blood shifting between the trunk and the extremities and to examine whether the same effects occur with EFLe at submaximal exercise intensity, where the increase in expiratory pressures is milder. Our data show that during submaximal exercise, EFLe amplifies the respiratory pump mechanism, each breath producing greater blood displacements between the trunk and the extremities, with a prevailing effect from lower inspiratory intrathoracic pressure progressively drawing blood into the trunk. These results help us to understand the haemodynamic effects of respiratory pressures during submaximal exercise with expiratory flow restriction.
Keywords
Male, Humans, Respiration, Veins, Pulmonary Disease, Chronic Obstructive, exercise, expiratory flow limitation, respiratory pump, venous return
Pubmed
Web of science
Open Access
Yes
Create date
16/11/2022 15:02
Last modification date
11/01/2023 7:52
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