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Antioxidant enzymes response to endurance exercise training and dietary proteins in rat skeletal muscle and liver.

This study was conducted to observe the effects of endurance exercise training on antioxidant enzyme activity in the liver and gastrocnemius muscle of rats being fed dietary casein and soy protein. The respective influences of dietary casein and soy protein on the activity of antioxidant enzymes were also compared. Thirty-nine male Wistar rats, aged 3 weeks, were randomly assigned to six groups: a normal protein control group, a normal protein endurance training group, a casein protein control group, a casein protein endurance training group, a soy protein control group, and a soy protein endurance training group. The endurance exercise training groups were adapted to a treadmill for 2 weeks prior to the date the rats were forced to run for 60 min at 25 m/min, 5 days/week for 12 weeks. We found that antioxidant enzyme activity in the gastrocnemius muscle was neither effected by the dietary proteins (casein and soy protein) nor by the above endurance exercise training load. However, hepatic Cu,Zn-SOD activity increased significantly for the dietary casein and soy protein diet groups as compared with the normal protein diet group (P < 0.01). Furthermore, significant increases both in hepatic Cu,Zn-SOD activity in the normal protein group and hepatic GSHpx activity in the casein and soy protein groups were observed when rats were loaded with 25 m/min of endurance exercise training (P < 0.01). These results suggest that, under the above experimental conditions, a casein or soy protein diet increase hepatic Cu,Zn-SOD activity, while endurance exercise training is effective in increasing hepatic Cu;Zn-SOD activity on a normal protein diet and in increasing hepatic GSHpx activity for cysteine and methionine deficient diets.

Animals↗

Endurance exercise training increases insulin responsiveness in isolated adipocytes through IRS/PI3-kinase/Akt pathway.

Endurance exercise training promotes important metabolic adaptations, and the adipose tissue is particularly affected. The aim of this study was to investigate how endurance exercise training modulates some aspects of insulin action in isolated adipocytes and in intact adipose tissue. Male Wistar rats were submitted to daily treadmill running (1 h/day) for 7 wk. Sedentary age-matched rats were used as controls. Final body weight, body weight gain, and epididymal fat pad weight did not show any statistical differences between groups. Adipocytes from trained rats were smaller than those from sedentary rats (205 +/- 16.8 vs. 286 +/- 26.4 pl; P < 0.05). Trained rats showed decreased plasma glucose (4.9 +/- 0.13 vs. 5.3 +/- 0.07 mM; P < 0.05) and insulin levels (0.24 +/- 0.012 vs. 0.41 +/- 0.049 mM; P < 0.05) and increased insulin-stimulated glucose uptake (23.1 +/- 3.1 vs. 12.1 +/- 2.9 pmol/cm(2); P < 0.05) compared with sedentary rats. The number of insulin receptors and the insulin-induced tyrosine phosphorylation of insulin receptor-beta subunit did not change between groups. Insulin-induced tyrosine phosphorylation insulin receptor substrates (IRS)-1 and -2 increased significantly (1.57- and 2.38-fold, respectively) in trained rats. Insulin-induced IRS-1/phosphatidylinositol 3 (PI3)-kinase (but not IRS-2/PI3-kinase) association and serine Akt phosphorylation also increased (2.06- and 3.15-fold, respectively) after training. The protein content of insulin receptor-beta subunit, IRS-1 and -2, did not differ between groups. Taken together, these data support the hypothesis that the increased adipocyte responsiveness to insulin observed after endurance exercise training is modulated by IRS/PI3-kinase/Akt pathway.

Adipocytes↗

Twelve weeks of endurance exercise training does not affect iron status measures in women.

OBJECTIVE: This study examined the effects of 12 weeks of endurance exercise training on iron status measures in previously inactive women and compared the effects of weight-bearing endurance exercise training and non-weight-bearing endurance exercise on iron status measures. DESIGN: Randomized, experimental study. SUBJECTS: Thirty-one healthy, inactive women (aged 23 to 43 years) with apparently normal iron stores (serum ferritin concentration > or = 20 micrograms/L) were recruited from the local area by newspaper advertisements and campus mailings. Twenty-one subjects completed the study (mean +/- standard deviation for age = 32 +/- 5 years, for body mass index = 23.1 +/- 4.9, and for maximum oxygen consumption [VO2max] = 33.8 +/- 6.3 mL/kg per minute). INTERVENTION: Subjects were randomly assigned to one of three groups: an inactive control group, a walking/running group, or a cycling group. Subjects in the two exercise groups trained three to four times per week at 80% VO2max for 12 weeks. Exercise training sessions were monitored and energy expenditure increased from 150 kcal per session (week 1) to 375 kcal per session (weeks 9 to 12). Subjects in the inactive control group were instructed to maintain their normal activity patterns for the duration of the study. All subjects were instructed to maintain their normal dietary habits. MAIN OUTCOME MEASURES: Serum ferritin concentration, serum iron concentration, percentage saturation of transferrin, total iron-binding capacity, serum haptoglobin concentration, and other selected hematologic variables were measured at baseline and at weeks 2, 4, 8, and 12. STATISTICAL ANALYSES: Repeated measures analysis of variance was used to examine group x time interactions in changes in iron status measures. Statistical significance was reached at P < .05. RESULTS: Analysis of variance indicated that serum ferritin concentration did not change significantly (P = .59) during the 12 weeks in the walking/running group (mean +/- standard deviation from 41.28 +/- 14.22 to 27.41 +/- 9.74 micrograms/L) or the cycling group (from 65.81 +/- 37.62 to 41.06 +/- 26.38 micrograms/L) compared with the control group (from 47.55 +/- 15.87 to 31.56 +/- 10.57 micrograms/L). Values for serum iron, total iron-binding capacity, percentage saturation of transferrin, and haptoglobin also did not change significantly (P > .30) in the walking/running or cycling groups compared with the control group. APPLICATIONS/CONCLUSIONS: Results of this study suggest that participation in 12 weeks of moderate-intensity endurance exercise training (walking/running or cycling) is not associated with negative effects on selected measures of iron status in healthy, previously untrained women with normal iron stores (serum ferritin > or = 20 micrograms/L).

Adult↗

Effects of exhaustive endurance exercise and its one-week daily repetition on neutrophil count and functional status in untrained men.

Whereas endurance exercise is known to induce marked neutrophilia, it remains to be fully understood as to whether the cell functions are altered as well as whether the adaptability of the responses to training occurs. To address both of these issues, we undertook the present longitudinal investigation in ten healthy untrained men (20-24 years, VO2max 39.1 +/- 4.2 ml/kg/min). The exercise protocol was 7 consecutive sessions of the same workload performed each day for 1.5 h at an intensity of 70% of VO2max. Peripheral blood samples were obtained before, immediately after, and 1 h after exercise on Days 1, 4, and 7, and served for determination of total and differential leukocyte counts, chemotaxis and chemiluminescence of neutrophils. Acute endurance exercise caused marked peripheral neutrophilia with significant increase in both absolute number and relative proportion of band neutrophils (p < 0.01, respectively), indicating partial recruitment of bone marrow neutrophils. While chemotaxis remained unaltered following exercise, reactive oxygen species generation of neutrophils, measured by luminol-dependent chemiluminescence upon stimulation with opsonized zymosan, was not only significantly enhanced following exercise (p < 0.01), but also associated with the proportional increase in band neutrophils (r = 0.727, p < 0.05), suggesting that neutrophils mobilized from the bone marrow following endurance exercise may possess higher responsiveness. On the other hand, the magnitude of the exercise-induced changes was reduced gradually by daily repeated exposure to endurance exercise, but none of the trends were significant except the decline in resting segmented neutrophil counts (p < 0.05) at least during a 1-wk period of repeated exercise sessions.

Adaptation, Physiological↗

Aerobic power and insulin action improve in response to endurance exercise training in healthy 77-87 yr olds.

Previous studies have demonstrated that frail octogenarians have an attenuated capacity for cardiovascular adaptations to endurance exercise training. In the present study, we determined the magnitude of cardiovascular and metabolic adaptations to high-intensity endurance exercise training in healthy, nonfrail elderly subjects. Ten subjects [8 men, 2 women, 80.3 yr (SD2.5)] completed 10-12 mo (108 exercise sessions) of a supervised endurance exercise training program consisting of 2.5 sessions/wk (SD 0.2), 58 min/session (SD 6), at an intensity of 83% (SD 5) of peak heart rate. Primary outcomes were maximal attainable aerobic power [peak aerobic capacity (Vo(2peak))]; serum lipids, oral glucose tolerance, and insulin action during a hyperglycemic clamp; body composition by dual-energy X-ray absorptiometry, and energy expenditure using doubly labeled water and indirect calorimetry. The training program resulted in an increase in Vo(2peak) of 15% (SD 7) [22.9 (SD 3.3) to 26.2 ml.kg(-1).min(-1) (SD 4.0); P < 0.0001]. Favorable lipid changes included reductions in total cholesterol (-8%; P = 0.002) and LDL cholesterol (-10%; P = 0.003), with no significant change in HDL cholesterol or triglycerides. Insulin action improved, as evidenced by a 29% increase in glucose disposal rate relative to insulin concentration during the hyperglycemic clamp. Fat mass decreased by 1.8 kg (SD 1.4) (P = 0.003); lean mass did not change. Total energy expenditure increased by 400 kcal/day because of an increase in physical activity. No change occurred in resting metabolism. In summary, healthy nonfrail octogenarians can adapt to high-intensity endurance exercise training with improvements in aerobic power, insulin action, and serum lipid and lipoprotein risk factors for coronary heart disease; however, the adaptations in aerobic power and insulin action are attenuated compared with middle-aged individuals.

Adaptation, Physiological↗

Oxidative stress in athletes during extreme endurance exercise.

Despite the many known health benefits of exercise, there is a body of evidence suggesting that endurance exercise is associated with oxidative stress. To determine whether extreme endurance exercise induces lipid peroxidation, 11 athletes (3 females, 8 males) were studied during a 50 km ultramarathon (trial 1) and during a sedentary protocol (trial 2) 1 month later. The evening before each trial, with dinner, subjects consumed 75 mg each d(3)-RRR and d(6)-all rac-alpha-tocopheryl acetates. Blood was obtained at baseline, 30 min pre-race, mid-race, post-race, 1 h post-race, 24 h post-race, and at corresponding times during trial 2. All 11 subjects completed the race; average run time was 391 +/- 23 min. Plasma F(2)-isoprostanes increased from 75 +/- 7 pg/ml at pre-race to 131 +/- 17 (p <.02) at post-race, then returned to baseline at 24 h post-race; F(2)-isoprostanes were unchanged during trial 2. Deuterated alpha-tocopherol disappearance rates were faster (2.8 x 10(-4) +/- 0.2 x 10(-4)) during the race compared to the sedentary trial (2.3 x 10(-4) +/- 0.2 x 10(-4); p <.03). These data suggest that extreme endurance exercise results in the generation of lipid peroxidation with a concomitant increase in vitamin E disappearance.

Adult↗

Acute effects of short duration maximal endurance exercise on lipid, phospholipid and lipoprotein levels.

AIM: The acute effects of maximal endurance exercise (15 min) on lipid and lipoprotein levels were examined, in order to determine whether the level of response produced could be affected by maximal exercise intensity (incremental stress test). METHODS: Participants in this cross sectional study were male athletes (n=78) of national level: basketball (n=10), swimming (n=9), long distance (LD) running (n=23) and wrestling (n=35); also a group of non-athlete volunteers as controls (n=19). Athletes had trained an average of 3 h/day and 5 years. The ergometric test used for the determination of maximal oxygen uptake on a treadmill was based on a stepwise stress protocol. RESULTS: Immediately after a maximal effort all groups (controls included) showed significant increases in total cholesterol (TC), triglycerides (TG), phospholipids (PL) and high-density cholesterol (HDL-C), from rest values. Low-density cholesterol (LDL-C) increased significantly in basketball, LD running and wrestling, while it did not change significantly in swimming and controls, after maximal effort. Hemoconcentration was of the order of +12.5%. CONCLUSIONS: The level of these increases might be directly related to the intensity and duration of exercise performed. Acute endurance exercise (100% VO(2max)) may induce acute modification of the above lipid parameters potentiating the systematic chronic exercise effects already present.

Adult↗

Physiologic versus pathologic hypertrophy: endurance exercise and chronic pressure overload.

Endurance exercise requires that the heart maintain a highly elevated cardiac output for an extended period of time, working against a slightly elevated afterload. Endurance athletes manifest a large ventricular volume, characterized on echocardiogram by an increased end-diastolic internal diameter and wall thickness. This article describes the structural, functional, and biochemical alterations in the heart as a result of the physiologic stress of exercise, along with the signaling mechanisms for these changes. The article also compares exercise-induced hypertrophy and hypertrophy from chronic pressure overload.

Adaptation, Physiological↗

[Long-term effects of bicycle-ergometry training on exercise endurance and dyspnea in patients with chronic pulmonary emphysema].

Exercise reconditioning has long been considered an essential component of the pulmonary rehabilitation regime. To investigate the long-term effects of exercise training on exercise endurance and dyspnea in patients with chronic pulmonary emphysema (CPE), we developed a supervised exercise program using bicycle ergometers. Nineteen patients (mean age: 67) with moderate to severe airflow limitation (average FEV1/FVC, 39.8%) were enrolled in a predominantly outpatient rehabilitation program. After their lactate thresholds were measured by an incremental symptom-limited maximum test, patients engaged in exercise training 15 to 30 minutes per day in an arbitrary frequency and at a work rate at or below their lactate threshold (average: 20.1 w). No significant improvements were observed in resting pulmonary function, blood gas, nutrition, or systemic muscle volume. After long-term exercise training (average period: 33 months; average frequency: 6.5 times per month, individually), the patients demonstrated significantly improved exercise endurance and relief of their dyspnea during exercise. These findings provide a physiologic rationale for long-term exercise training by patients with CPE.

Aged↗

Effects of short- and long-term detraining on the metabolic response to endurance exercise.

Changes in the metabolic response to an endurance exercise were studied (18 rowing km at 75 % of maximal aerobic velocity) during detraining in ten rowers previously highly-trained. Maximal aerobic velocity (VO2 max) and the metabolic response to exercise were determined in the 1 st, 24 th, and 47 th week (training), and in the 52 nd, 76 th, and 99 th week (detraining). Over the decrease of VO2 max, detraining induced a biphasic alteration of the previously observed training adaptations: 1-short-term detraining (5 weeks) resulted in a lower adipose tissue triglyceride (TG) delivery during exercise (p = 0.029), but this one did not represent a direct metabolic limit to exercise since the liver TG delivery increased (p = 0.039), allowing that total fatty acid concentration remained unchanged (12.1 +/- 2.4 vs. 11.8 +/- 2.1 mmol/l; weeks 47 vs. 52); 2-long-term detraining (52 weeks) altered even more the metabolic response to exercise with a decreased total fatty acid concentration during exercise (week 99: 10.6 +/- 2.0 mmol/l; p = 0.022), which induced a higher glycolysis utilization. At this moment, a hemolytic response to endurance exercise was observed through haptoglobin and transferrin concentration changes (weeks 47 vs. 99; p = 0.029 and 0.027, respectively), which resulted probably from higher red blood cell destruction. Endurance-trained athletes should avoid detraining periods over a few weeks since alterations of the metabolic adaptations to training may become rapidly chronic after such delays.

Adaptation, Physiological↗

Endurance exercise and pregnancy outcome.

The interaction between maternal endurance exercise at or above a minimal conditioning level, prior to and during pregnancy, and pregnancy outcome was examined prospectively in our obstetrical populace using epidemiologic techniques. Over a 3-month interval all women registering for antepartum care were interviewed. Those planning to continue exercise during pregnancy were re-interviewed between the 28th and 34th gestational weeks. A detailed review of clinical records was used for outcome assessment. Women who continued endurance exercise at or near preconceptual levels during pregnancy gained less weight (-4.6 kg), delivered earlier (-8 d), and had lighter-weight offspring (-500 g) than those who stopped exercising prior to the 28th week. The latter group gained 2.2 kg more weight but delivered similar birthweight infants at a similar gestational age as their sedentary controls.

Adolescent↗

Effects of acute and chronic endurance exercise on mitochondrial uncoupling in human skeletal muscle.

Mitochondrial proteins such as uncoupling protein 3 (UCP3) and adenine nucleotide translocase (ANT) may mediate back-leakage of protons and serve as uncouplers of oxidative phosphorylation. We hypothesized that UCP3 and ANT increase after prolonged exercise and/or endurance training, resulting in increased uncoupled respiration (UCR). Subjects were investigated with muscle biopsies before and after acute exercise (75 min of cycling at 70% of .VO2peak) or 6 weeks endurance training. Mitochondria were isolated and respiration measured in the absence (UCR or state 4) and presence of ADP (coupled respiration or state 3). Protein expression of UCP3 and ANT was measured with Western blotting. After endurance training, .VO2peak, citrate synthase activity (CS), state 3 respiration and ANT increased by 24, 47, 40 and 95%, respectively (all P < 0.05), whereas UCP3 remained unchanged. When expressed per unit of CS (a marker of mitochondrial volume) UCP3 and UCR decreased by 54% and 18%(P < 0.05). CS increased by 43% after acute exercise and remained elevated after 3 h of recovery (P < 0.05), whereas the other muscle parameters remained unchanged. An intriguing finding was that acute exercise reversibly enhanced the capacity of mitochondria to accumulate Ca2+(P < 0.05) before opening of permeability transition pores. In conclusion, UCP3 protein and UCR decrease after endurance training when related to mitochondrial volume. These changes may prevent excessive basal thermogenesis. Acute exercise enhances mitochondrial resistance to Ca2+ overload but does not influence UCR or protein expression of UCP3 and ANT. The increased Ca2+ resistance may prevent mitochondrial degradation and the mechanism needs to be further explored.

Adenosine Diphosphate↗

Glycogenolytic effect of adrenaline in skeletal muscle of rats adapted to endurance exercise.

Rats were adapted to endurance exercise (swimming) for six weeks. During the training program each rat swum totally for 108 hours. It was found that the training applied reduced markedly glycogenolytic effect of adrenaline (0.1 mg/kg) in each of the examined type of muscle (the white, red and intermediate ones). The reduction of the glycogenolytic effect of adrenaline in the trained rats was less pronounced in the intermediate muscle than in the other two muscles. The hyperglycemic effect of adrenaline was also reduced in the trained group. It is concluded that the decreased reactivity of glycogenolytic system in skeletal muscles to adrenaline could be partly responsible for the slower rate of the intramuscular glycogen mobilization during exercise in the trained individuals.

Animals↗

Increases in high-density lipoprotein cholesterol with endurance exercise training are blunted in obese compared with lean men.

The effectiveness of endurance exercise training (without concomitant weight loss) for improving lipoprotein lipid levels in obese individuals remains controversial. The purpose of this study was to determine whether lipoprotein lipid responses to endurance exercise training are affected by obesity. Healthy middle-aged and older (57 +/- 2 years) lean (n = 16; body mass index [BMI], 22 to 26 kg/m2), moderately obese (n = 15; BMI, 27 to 30 kg/m2), and obese (n = 15; BMI, 31 to 37 kg/m2) men underwent a 9-month endurance exercise training program. The groups differed in the initial degree of obesity, waist circumference, and waist to hip ratio (WHR), but not in age or maximal aerobic capacity ( VO2max). The obese group had lower baseline levels of high-density lipoprotein cholesterol (HDL-C) and HDL2-C, and higher triglyceride (TG) levels than the lean group. Exercise training increased VO2max to a comparable degree in lean, moderately obese, and obese groups (18%, 24%, and 18%, respectively, P < .01). Exercise training significantly decreased TG levels in all groups, whereas total cholesterol and low-density lipoprotein cholesterol (LDL-C) decreased only in the obese group. Exercise training increased HDL-C and HDL2-C levels in lean (14% and 81%, respectively, P < .05) and moderately obese (7% and 59%, respectively, P < .05) men, whereas neither HDL-C nor HDL2-C changed in obese men. The change in HDL-C correlated negatively with initial BMI (r = -.42, P < .01) and waist circumference (r = -.43, P < .01). These results show that the effects of exercise training on HDL-C are blunted in obese middle-aged and older men, whereas improvements in TG occur independently of the degree of obesity.

Body Composition↗

Quadriceps femoris muscle resistance to fatigue using an electrically elicited fatigue test following intense endurance exercise training.

BACKGROUND AND PURPOSE: Electrical stimulation has been used to assess skeletal muscle resistance to fatigue. The purpose of this study was to test the hypothesis that 12 weeks of intense endurance exercise training on a bicycle ergometer would reduce the percentage of decline in quadriceps femoris muscle torque during an electrically elicited fatigue test. SUBJECTS AND METHODS: Eleven nondisabled subjects performed 12 weeks of high-intensity endurance exercise training, and 6 subjects served as controls and did not exercise. Two electrically elicited fatigue tests, one with and one without prior voluntary fatiguing exercise, were administered to each subject before and after the 12-week training period. RESULTS: The percentage of decline in peak torque of the quadriceps femoris muscle over 50 electrically elicited muscle contractions did not change as a result of endurance exercise training, despite significant improvements in maximal oxygen consumption and quadriceps femoris muscle endurance. The recovery of maximal isometric torque immediately after exhausting voluntary exercise followed by electrical stimulation was significantly greater after 12 weeks of intense exercise training. CONCLUSION AND DISCUSSION: The percentage of decline in peak torque during an electrically elicited fatigue test does not detect improvements in quadriceps femoris muscle endurance induced by endurance exercise training. The percentage of initial torque recovered immediately after fatiguing exercise, however, is improved by endurance training. [Sinacore Dr, Jacobson RB, Delitto A. Quadriceps femoris muscle resistance to fatigue using an electrically elicited fatigue test following intense endurance exercise training.

Adult↗

The effect of low frequency fatigue on endurance exercise in the sternomastoid muscle of normal humans.

It is not certain to what extent low frequency fatigue affects the performance of a muscle. We studied the endurance capacity of the sternomastoid muscle to undergo repetitive isometric neck flexion contractions for 2 s every 4 s at 35% of its maximal voluntary contraction force (MVC) in 5 normal subjects starting with different levels of fatigue. The endurance time, the duration the subjects were able to achieve the target force before exhaustion, was measured in each subject on 3 occasions: Study 1: in the fresh state, with a normal frequency/force curve and 20:50 ratio (ratio of force response at 20 Hz to that at 50 Hz) before the start of the endurance exercise; Study 2: with a moderately reduced 20:50 ratio before the start of endurance exercise (mean +/- SEM reduction in 20:50 ratio 11.4 +/- 0.8%); Study 3: with a substantially reduced 20:50 ratio before the start of the endurance exercise (29.2 +/- 3.7%). These reductions in 20:50 ratio were produced by the subjects performing 150 isometric neck flexion contractions at 50% of their MVC, followed by a period of rest to allow the 20:50 ratio to recover to approximately 10% of the starting value in Study 2, and to within 20 to 40% of the starting value in Study 3. Endurance exercise was then carried out.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Effect of bisoprolol and atenolol on endurance exercise capacity in healthy men.

OBJECTIVES: To compare the effects of a highly beta1-selective adrenoceptor antagonist bisoprolol with those of atenolol and placebo on endurance exercise capacity in young, healthy male volunteers. DESIGN: Twelve subjects randomly received oral placebo, atenolol (100 mg/day) or bisoprolol (10 mg/day) for 3 weeks, following a double-blind cross-over design. METHODS: At the end of each period, the subjects performed an endurance exercise test on the bicycle ergometer at 70% of maximal aerobic power. Cardiac output was measured by means of an automated CO2-rebreathing method. Venous blood was sampled before, during and after exercise. RESULTS: Exercise duration was not significantly different between the two drugs tested. Total exercise duration was significantly reduced by bisoprolol (-19.4 +/- 6.7%, P< 0.01) (mean +/- SEM) and by atenolol (-29.8 +/- 6.6%, P< 0.001), compared with placebo. Atenolol and bisoprolol were equally effective in lowering resting plasma renin activity, heart rate and systolic blood pressure. Resting and exercise stroke volume were significantly increased by both drugs, so that cardiac output was not significantly affected. Both drugs induced significant decreases in plasma-free fatty acid concentrations during recovery and blunted the exercise-induced increase. There were no significant relationships between the reduction of exercise duration and the haemodynamic changes or the degree of impairment of the exercise-induced increase in free fatty acid release resulting from beta-blockade. CONCLUSIONS: It is concluded that both drugs affect endurance exercise capacity in young, normotensive men, with a tendency to a smaller reduction during bisoprolol treatment. Haemodynamic variables are unlikely to be involved in the reduction of endurance exercise capacity. The role of the reduced availability of plasma free fatty acids remains unclear.

Adrenergic beta-Antagonists↗

Effect of heliox on lung dynamic hyperinflation, dyspnea, and exercise endurance capacity in COPD patients.

We tested the hypothesis that heliox breathing, by reducing lung dynamic hyperinflation (DH) and dyspnea (Dys) sensation, may significantly improve exercise endurance capacity in patients with chronic obstructive pulmonary disease [n = 12, forced expiratory volume in 1 s = 1.15 (SD 0.32) liters]. Each subject underwent two cycle ergometer high-intensity constant work rate exercises to exhaustion, one on room air and one on heliox (79% He-21% O2). Minute ventilation (VE), carbon dioxide output, heart rate, inspiratory capacity (IC), Dys, and arterial partial pressure of CO2 were measured. Exercise endurance time increased significantly with heliox [9.0 (SD 4.5) vs. 4.2 (SD 2.0) min; P < 0.001]. This was associated with a significant reduction in lung DH at isotime (Iso), as reflected by the increase in IC [1.97 (SD 0.40) vs. 1.77 (SD 0.41) liters; P < 0.001] and a decrease in Dys [6 (SD 1) vs. 8 (SD 1) score; P < 0.001]. Heliox induced a state of relative hyperventilation, as reflected by the increase in VE [38.3 (SD 7.7) vs. 35.5 (SD 8.8) l/min; P < 0.01] and VE/carbon dioxide output [36.3 (SD 6.0) vs. 33.9 (SD 5.6); P < 0.01] at peak exercise and by the reduction in arterial partial pressure of CO2 at Iso [44 (SD 6) vs. 48 (SD 6) Torr; P < 0.05] and at peak exercise [46 (SD 6) vs. 48 (SD 6) Torr; P < 0.05]. The reduction in Dys at Iso correlated significantly (R = -0.75; P < 0.01) with the increase in IC induced by heliox. The increment induced by heliox in exercise endurance time correlated significantly with resting increment in resting forced expiratory in 1 s (R = 0.88; P < 0.01), increase in IC at Iso (R = 0.70; P < 0.02), and reduction in Dys at Iso (R = -0.71; P < 0.01). In chronic obstructive pulmonary disease, heliox breathing improves high-intensity exercise endurance capacity by increasing maximal ventilatory capacity and by reducing lung DH and Dys.

Administration, Inhalation↗