Scholars@Duke publication: Kinetics of muscle deoxygenation are accelerated at the onset of heavy-intensity exercise in patients with COPD: relationship to central cardiovascular dynamics.

Kinetics of muscle deoxygenation are accelerated at the onset of heavy-intensity exercise in patients with COPD: relationship to central cardiovascular dynamics.

Publication , Journal Article

Chiappa, GR; Borghi-Silva, A; Ferreira, LF; Carrascosa, C; Oliveira, CC; Maia, J; Gimenes, AC; Queiroga, F; Berton, D; Ferreira, EMV; Nery, LE ...

Published in: J Appl Physiol (1985)

May 2008

Published version (DOI) Link to item

Patients with chronic obstructive pulmonary disease (COPD) have slowed pulmonary O(2) uptake (Vo(2)(p)) kinetics during exercise, which may stem from inadequate muscle O(2) delivery. However, it is currently unknown how COPD impacts the dynamic relationship between systemic and microvascular O(2) delivery to uptake during exercise. We tested the hypothesis that, along with slowed Vo(2)(p) kinetics, COPD patients have faster dynamics of muscle deoxygenation, but slower kinetics of cardiac output (Qt) following the onset of heavy-intensity exercise. We measured Vo(2)(p), Qt (impedance cardiography), and muscle deoxygenation (near-infrared spectroscopy) during heavy-intensity exercise performed to the limit of tolerance by 10 patients with moderate-to-severe COPD and 11 age-matched sedentary controls. Variables were analyzed by standard nonlinear regression equations. Time to exercise intolerance was significantly (P < 0.05) lower in patients and related to the kinetics of Vo(2)(p) (r = -0.70; P < 0.05). Compared with controls, COPD patients displayed slower kinetics of Vo(2)(p) (42 +/- 13 vs. 73 +/- 24 s) and Qt (67 +/- 11 vs. 96 +/- 32 s), and faster overall kinetics of muscle deoxy-Hb (19.9 +/- 2.4 vs. 16.5 +/- 3.4 s). Consequently, the time constant ratio of O(2) uptake to mean response time of deoxy-Hb concentration was significantly greater in patients, suggesting a slower kinetics of microvascular O(2) delivery. In conclusion, our data show that patients with moderate-to-severe COPD have impaired central and peripheral cardiovascular adjustments following the onset of heavy-intensity exercise. These cardiocirculatory disturbances negatively impact the dynamic matching of O(2) delivery and utilization and may contribute to the slower Vo(2)(p) kinetics compared with age-matched controls.

Duke Scholars

Author Leonardo F Ferreira Orthopaedic Surgery, Physical Therapy

Published In

J Appl Physiol (1985)

DOI

10.1152/japplphysiol.01364.2007

ISSN

8750-7587

Publication Date

May 2008

Volume

104

Issue

Start / End Page

1341 / 1350

Location

United States

Related Subject Headings

Stroke Volume
Spirometry
Spectroscopy, Near-Infrared
Respiratory Function Tests
Pulmonary Gas Exchange
Pulmonary Disease, Chronic Obstructive
Physiology
Oxygen Consumption
Muscle, Skeletal
Middle Aged

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Chiappa, G. R., Borghi-Silva, A., Ferreira, L. F., Carrascosa, C., Oliveira, C. C., Maia, J., … Neder, J. A. (2008). Kinetics of muscle deoxygenation are accelerated at the onset of heavy-intensity exercise in patients with COPD: relationship to central cardiovascular dynamics. J Appl Physiol (1985), 104(5), 1341–1350. https://doi.org/10.1152/japplphysiol.01364.2007

Chiappa, Gaspar R., Audrey Borghi-Silva, Leonardo F. Ferreira, Claúdia Carrascosa, Cristino Carneiro Oliveira, Joyce Maia, Ana Cristina Gimenes, et al. “Kinetics of muscle deoxygenation are accelerated at the onset of heavy-intensity exercise in patients with COPD: relationship to central cardiovascular dynamics.” J Appl Physiol (1985) 104, no. 5 (May 2008): 1341–50. https://doi.org/10.1152/japplphysiol.01364.2007.

Chiappa GR, Borghi-Silva A, Ferreira LF, Carrascosa C, Oliveira CC, Maia J, et al. Kinetics of muscle deoxygenation are accelerated at the onset of heavy-intensity exercise in patients with COPD: relationship to central cardiovascular dynamics. J Appl Physiol (1985). 2008 May;104(5):1341–50.

Chiappa, Gaspar R., et al. “Kinetics of muscle deoxygenation are accelerated at the onset of heavy-intensity exercise in patients with COPD: relationship to central cardiovascular dynamics.” J Appl Physiol (1985), vol. 104, no. 5, May 2008, pp. 1341–50. Pubmed, doi:10.1152/japplphysiol.01364.2007.

Chiappa GR, Borghi-Silva A, Ferreira LF, Carrascosa C, Oliveira CC, Maia J, Gimenes AC, Queiroga F, Berton D, Ferreira EMV, Nery LE, Neder JA. Kinetics of muscle deoxygenation are accelerated at the onset of heavy-intensity exercise in patients with COPD: relationship to central cardiovascular dynamics. J Appl Physiol (1985). 2008 May;104(5):1341–1350.