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Biomedical subjects

I Vogiatzis

Publications and source records attributed to I Vogiatzis.

11 recordsLinked to original sources

Oxygen kinetics and debt during recovery from expiratory flow-limited exercise in healthy humans.

In healthy subjects expiratory flow limitation (EFL) during exercise can lower O(2) delivery to the working muscles. We hypothesized that if this affects exercise performance it should influence O(2) kinetics at the end of exercise when the O(2) debt is repaid. We performed an incremental exercise test on six healthy males with a Starling resistor in the expiratory line limiting expiratory flow to approximately 1 l s(-1) to determine maximal EFL exercise workload (W (max)). In two more square-wave exercise runs subjects exercised with and without EFL at W (max) for 6 min, while measuring arterial O(2) saturation (% SaO(2)), end-tidal pressure of CO(2) (P (ET)CO(2)) and breath-by-breath O(2) consumption VO2 taking into account changes in O(2) stored in the lungs. Over the last minute of EFL exercise, mean P (ET)CO(2) (54.7 +/- 9.9 mmHg) was significantly higher (P < 0.05) compared to control (41.4 +/- 3.9 mmHg). At the end of EFL exercise %SaO(2) fell significantly by 4 +/- 3%. When exercise stopped, EFL was removed, and we continued to measure VO2. During recovery, there was an immediate step increase in [Formula: see text] so that repayment of EFL O(2) debt started at a higher VO2 than control. Recovery VO2 kinetics after EFL exercise was best characterized by a double-exponential function with fundamental and slow time constants of 27 +/- 11 and 1,020 +/- 305 s, compared to control values of 41 +/- 10 and 1,358 +/- 320 s, respectively. EFL O(2) debt was 52 +/- 22% greater than control (2.19 +/- 0.58 vs. 1.49 +/- 0.38 l). We conclude that EFL exercise increases the O(2) debt and leads to hypoxemia in part due to hypercapnia.

Carbon Dioxide↗

Effects of rehabilitation on chest wall volume regulation during exercise in COPD patients.

In order to investigate underlying mechanisms, the present authors studied the effect of pulmonary rehabilitation on the regulation of total chest wall and compartmental (ribcage, abdominal) volumes during exercise in patients with chronic obstructive pulmonary disease. In total, 20 patients (forced expiratory volume in one second, mean +/- SEM 39 +/- 3% predicted) undertook high-intensity exercise 3 days x week(-1) for 12 weeks. Before and after rehabilitation, the changes in chest wall (cw) volumes at the end of expiration (EEV) and inspiration (EIV) were computed by optoelectronic plethysmography during incremental exercise to the limit of tolerance (W(peak)). Rehabilitation significantly improved W(peak) (57+/-7 versus 47+/-5 W). In the post-rehabilitation period and at identical work rates, significant reductions were observed in minute ventilation (35.1+/-2.7 versus 38.4+/-2.7 L x min(-1)), breathing frequency (26+/-1 versus 29+/-1 breaths x min(-1)) and EEV(cw) and EIV(cw) (by 182+/-79 and 136+/-37 mL, respectively). Inspiratory reserve volume was significantly increased (by 148+/-70 mL). Volume reductions were attributed to significant changes in abdominal EEV and EIV (by 163+/-59 and 125+/-27 mL, respectively). The improvement in W(peak) was similar in patients who progressively hyperinflated during exercise and those who did not (24 and 26%, respectively). In conclusion, pulmonary rehabilitation lowers chest wall volumes during exercise by decreasing the abdominal volumes. The improvement in exercise capacity following rehabilitation is independent of the pattern of exercise-induced dynamic hyperinflation.

Aged↗

Patterns of dynamic hyperinflation during exercise and recovery in patients with severe chronic obstructive pulmonary disease.

BACKGROUND: Not all patients with severe chronic obstructive pulmonary disease (COPD) progressively hyperinflate during symptom limited exercise. The pattern of change in chest wall volumes (Vcw) was investigated in patients with severe COPD who progressively hyperinflate during exercise and those who do not. METHODS: Twenty patients with forced expiratory volume in 1 second (FEV(1)) 35 (2)% predicted were studied during a ramp incremental cycling test to the limit of tolerance (Wpeak). Changes in Vcw at the end of expiration (EEVcw), end of inspiration (EIVcw), and at total lung capacity (TLCVcw) were computed by optoelectronic plethysmography (OEP) during exercise and recovery. RESULTS: Two significantly different patterns of change in EEVcw were observed during exercise. Twelve patients had a progressive significant increase in EEVcw during exercise (early hyperinflators, EH) amounting to 750 (90) ml at Wpeak. In contrast, in all eight remaining patients EEVcw remained unchanged up to 66% Wpeak but increased significantly by 210 (80) ml at Wpeak (late hyperinflators, LH). Although at the limit of tolerance the increase in EEVcw was significantly greater in EH, both groups reached similar Wpeak and breathed with a tidal EIVcw that closely approached TLCVcw (EIVcw/TLCVcw 93 (1)% and 93 (3)%, respectively). EEVcw was increased by 254 (130) ml above baseline 3 minutes after exercise only in EH. CONCLUSIONS: Patients with severe COPD exhibit two patterns during exercise: early and late hyperinflation. In those who hyperinflate early, it may take several minutes before the hyperinflation is fully reversed after termination of exercise.

Exercise↗

Dynamic hyperinflation and tolerance to interval exercise in patients with advanced COPD.

Dynamic hyperinflation (DH) contributes importantly to the limitation of constant-load exercise (CLE) in patients with chronic obstructive pulmonary disease (COPD). However, its role in the limitation of interval exercise (IE) remains to be explored. The change (Delta) in inspiratory capacity (IC) was measured to reflect changes in DH in 27 COPD patients (forced expiratory volume in one second mean+/-SEM % predicted: 40+/-3) at the end of a symptom-limited CLE test at 80% of peak work capacity (WRmax) and an IE test at 100% WRmax (30 s of work, alternated with 30 s of unloaded pedalling). At the limit of tolerance in both IE and CLE, patients exhibited similar DH (DeltaIC: 0.39+/-0.05 L and 0.45+/-0.05 L, respectively). However, exercise endurance time (t end) for IE (32.7+/-3.0 min) was significantly greater than for CLE (10.3+/-1.6 min). The IE t end correlated with resting IC, expressed as % pred normal. At 30 and 90% of total IE t end, DeltaIC (0.43+/-0.06 and 0.39+/-0.05 L, respectively) and minute ventilation (31.1+/-1.6 and 32.7+/-2.2 L.min(-1), respectively) were not significantly different. Resting hyperinflation helps to explain the limitation of interval exercise. Implementation of interval exercise for rehabilitation should provide important clinical benefits because it prolongs exercise endurance time and allows sustaining higher stable ventilation.

Aged↗

The physiological demands of sail pumping in Olympic level windsurfers.

This study investigated the physiological effects of sail pumping (PB)--a manoeuvre often adopted to provide additional propulsion to the board--in Olympic Class Windsurfing, following relaxation of the "no-pumping" rules by the International Federation. Fifteen Olympic-level windsurfers (10 men) from nine different countries volunteered for the study, which was performed during two international Olympic regattas. The measurements were carried out during actual sailing when both PB and not-pumping (NPB) using a portable metabolimeter. Windsurfing, when PB, elicited a dramatic increase in cardiorespiratory responses compared to NPB. Mean (SD) values for oxygen uptake and heart rate during NPB for the men and women were: 19.2 (4.4) and 15.7 (3.3) ml x kg(-1) x min(-1), and 110 (10) and 122 (12) beats x min(-1), respectively, whereas the values in PB were: 48.4 (5.7) and 40.2 (4.2) ml x kg(-1) x min(-1), and 165 (12) and 172 (13) beats x min(-1), respectively. All the PB parameters, with the exception of heart rate (HR), were significantly higher in the men than in the women but no differences were observed between the sexes in NPB with the exception of HR, which was higher in the women. Our results suggest sail pumping is as physically demanding as most aerobic sporting activities. In the context of the need to deal with a highly demanding athletic branch of sailing as part of an Olympic regatta, recommendations are made on how best to make physical and dietary preparations.

Adult↗

Interval training as an alternative modality to continuous exercise in patients with COPD.

Understanding of what constitutes a training load adequate to induce training effects in patients with chronic obstructive pulmonary disease (COPD) is still evolving. The present study investigated whether interval training (IT) is effective in terms of inducing measurable improvements in physiological response and compared its effects on exercise tolerance (ET) and quality of life to those of continuous training (CT). Thirty-six COPD patients, with a forced expiratory volume in one second of 45+/-4% of the predicted value (mean+/-SEM), were randomly assigned to CT (exercise at 50% of baseline peak work-rate) or IT (work for 30 s at 100% of peak work-rate alternating with 30-s rest intervals) groups that cycled 40 min x day(-1) and 2 days x week(-1) for 12 weeks. After training, both groups showed significantly improved ET (IT, 57+/-6 to 71+/-8 W; CT, 57+/-5 to 70+/-6 W) and total quality-of-life score of the Chronic Respiratory Disease Questionnaire (IT, 77+/-3 to 88+/-2; CT, 78+/-3 to 93+/-2). At identical levels of exercise, minute ventilation was significantly reduced (IT, 35.8+/-2.5 to 31.7+/-2.5 L x min(-1); CT, 36.4+/-2.7 to 32.5+/-2.7 L x min(-1)). The magnitude of improvement in these variables was not significantly different among groups. The present data expand on the principles of exercise prescription for chronic obstructive pulmonary disease patients by demonstrating that interval training elicits substantial training effects, which are similar in magnitude to those produced by continuous training at half the exercise intensity but double the exercise time.

Aged↗

Exhaled nitric oxide in seasonal allergic rhinitis: influence of pollen season and therapy.

Exhaled nitric oxide (eNO) has been proposed as a potential indirect marker of lower airway inflammation in asthma. To investigate the existence of lower airways inflammation in allergic rhinitis eNO measurements were performed in 32 patients with symptomatic and asymptomatic seasonal allergic rhinitis early in and out of pollen seasons and in 80 healthy volunteers. To further define how exhaled NO is modified by therapy, NO levels were detected following 1-month treatment with either inhaled steroids or non-steroids therapy with nedocromil. Exhaled NO (mean +/- SE) was significantly elevated in patients with seasonal allergic rhinitis with and without symptoms (24.2 + 2.5 and 13.9 + 2.9 ppb, respectively) as compared to healthy volunteers (4.5 + 0.3 ppb) both in and out of pollen season (21.2 + 2.1 and 9.0 + 1.4 p.p.b., respectively) with a higher increase during the allergen exposure in season. Higher levels of exhaled NO were detected in patients with symptoms, either from the upper or lower airways, and with bronchial hyperreactivity. The increased exhaled NO in symptomatic patients was reduced only by inhaled steroids and not by nedocromil. These findings possibly suggest the existence of lower airway inflammation in both symptomatic and asymptomatic patients with seasonal allergic rhinitis in and out of pollen season. Thus, exhaled NO may be used as a non-invasive index for early detection of lower airway inflammation and for monitoring the optional treatment in patients with seasonal allergic rhinitis.

Adult↗

Physiological response to moderate exercise workloads in a pulmonary rehabilitation program in patients with varying degrees of airflow obstruction.

STUDY OBJECTIVES: To investigate whether a 12-week pulmonary rehabilitation program that includes moderately intensive exercise training performed twice weekly can induce a training effect in patients with a wide variation of airflow limitation. PARTICIPANTS: Sixty patients with COPD (38 men) with a mean +/- SD FEV(1) % predicted of 55.1 +/- 19.8 (range, 0.51 to 2.99). All patients performed identical incremental symptom-limited cycle ergometer testing before and after a 12-week study period. MEASUREMENTS AND RESULTS: After 12 weeks, the patients demonstrated a significant (p < 0.05) increase in the peak values for work rate (WR; 77 +/- 30 vs 91 +/- 36 W) and oxygen uptake (1.14 +/- 0.45 vs 1.20 +/- 0.52 L/min). Furthermore, at a given WR during incremental symptom-limited cycle ergometer testing, there were significant (p < 0.05) reductions in minute ventilation (42.4 +/- 16.1 vs 37.0 +/- 13. 6 L/min), carbon dioxide output (1.13 +/- 0.49 vs 1.03 +/- 0.42 L/min), ventilatory equivalent for oxygen (37.6 +/- 8.1 vs 36.0 +/- 6.3), and heart rate (135 +/- 15 vs 128 +/- 16 beats/min). None of the observed physiologic changes correlated with FEV(1) % predicted. CONCLUSIONS: A pulmonary rehabilitation program performed twice weekly with moderate exercise workloads can lead to a physiologic training response irrespective of the degree of airflow limitation.

Exercise↗

Changes in ventilation related to changes in electromyograph activity during repetitive bouts of isometric exercise in simulated sailing.

This study examined the control of ventilation during repetitive bouts of isometric exercise in simulated sailing. Eight male sailors completed four successive 3-min bouts of similar isometric effort on a dinghy simulator; bouts were separated by 15-s rest intervals. Quadriceps muscle integrated electromyograph activity (iEMG) was recorded during each bout and expressed as a percentage of activity during maximal voluntary contraction (%iEMGmax). From the first to the fourth bout, the 3-min mean averages for ventilation and for %iEMGmax increased from 19.8 (SEM 1.1) to 37.5 (SEM 3.0) l.min-1 and from 31 (SEM 4) to 39 (SEM 4)% respectively; also, ventilation and %iEMGmax over each minute throughout the four bouts were significantly correlated (r = 0.85; P < 0.05). Progressive hyperventilation reduced the mean end-tidal partial pressure of carbon dioxide from 5.0 (SEM 0.3) kPa during bout 1 to 4.3 (SEM 0.4) kPa during bout 4 [37.7 (SEM 2.0) to 32.4 (SEM 3.0) mmHg]. From the first to the fourth bout the end-of-bout blood lactate concentration did not increase significantly although the concentration from the third bout onwards was significantly greater than at rest. The results suggested that the development of muscle fatigue, which was enhanced by the insufficiency of recovery during the 15-s intervals and mirrored in the progressive increase in iEMG, was linked with stimuli causing progressive hyperventilation. Though these changes in ventilation and iEMG could not be associated with changes in blood lactate concentration, they could both have been related to accumulating metabolites within the muscles themselves.

Adult↗

Assessment of aerobic and anaerobic demands of dinghy sailing at different wind velocities.

The aim of this study was to assess the oxygen uptake (VO2), heart rate (HR) and blood lactate concentration ([Lab]) during actual dinghy sailing at different wind velocities. Eight top class Laser sailors volunteered to participate in the study. In the laboratory, each subject performed an incremental exercise test on a cycle ergometer to the point of exhaustion. Maximum oxygen uptake (VO2max) and maximum heart rate (HR max) were assessed by means of a Cosmed K2 (K2) portable oxygen analyser while the accuracy of the K2 was simultaneously examined by comparing it with the Douglas bag method. On water each subject underwent a 10 minute continuous upwind sailing test. The average percentages of VO2max and HR max during sailing and the post-test [La(b)] were 39 +/- 6%, 74 +/- 11% and 2.3 +/- 0.8 mM, respectively. Values of the three measured variables for each subject were significantly correlated to wind velocity (r = 0.73, 0.87 and 0.88, respectively). The results of the study suggest that the metabolic and cardiorespiratory demands of dinghy sailing predominantly depend on the wind conditions. Aerobic capacity is only moderately taxed in dinghy sailing and should not be emphasized in training, whereas anaerobic metabolism plays an increasing role in stronger winds.

Adult↗