Diagnostic yield of the lactate stress test in respiratory chain disorders under absolute and relative workload

Finsterer, Josef; Milvay, Erika

doi:10.1016/s0165-0270(01)00371-5

Cited by 13 publications

(14 citation statements)

References 20 publications

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“…19 Consequently, it may be crucial for exercising muscle cells to delay pH decline and lactate accumulation in the cytosol, to prevent muscle performance impairment. 20 The present study confirms what emerged in a previous one proposed by Barnes et al 28 in which it was investigated the glycogenolytic pathway by using P³¹ magnetic resonance spectroscopy: indeed they revealed an abnormal glycogenolytic ATP-production, during the first minute of aerobic exercise. In addition, the proportion of the total requirement provided by glycogenolysis resulted greater than in controls, revealing values similar to that in the control subject performing heavier works.…”

Section: Discussionsupporting

confidence: 92%

“…17 It is well known that skeletal muscle acidosis could impair oxidative metabolism and a reduced respiratory capacity could contribute to the onset of fatigue during exercise, even if quantitative assessment of this parameter is hard to be explored. 18,19,20 Siciliano et al reported an early activation of anaerobic metabolism, and a lower lactate threshold during a maximal exercise in DM1 patients. 21 In this study we assess the oxidative metabolism efficiency in Myotonic Dystrophy patients, by means of analysis of haematic lactate levels at rest and after an incremental submaximal exercise test on treadmill.…”

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confidence: 97%

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Lactate levels affect motor performance in MD 1

et al. 2014

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Myotonic Dystrophy type 1 (DM1) is a dominantly inherited disease comprehending multiple features. Fatigue and exhaustion during exercise often represent significant factors able to negatively influence their compliance to rehabilitation programs. Mitochondrial abnormalities and a significant increase in oxidative markers, previously reported, suggest the hypothesis of a mitochondrial functional impairment. The study aims at evaluating oxidative metabolism efficiency in 18 DM1 patients and in 15 healthy subjects, through analysis of lactate levels at rest and after an incremental exercise test. The exercise protocol consisted of a submaximal incremental exercise performed on an electronically calibrated treadmill, maintained in predominantly aerobic condition. Lactate levels were assessed at rest and at 5, 10 and 30 minutes after the end of the exercise. The results showed early exercise-related fatigue in DM1 patients, as they performed a mean number of 9 steps, while controls completed the whole exercise. Moreover, while resting values of lactate were comparable between the patients and the control group (p=0.69), after the exercise protocol, dystrophic subjects reached higher values of lactate, at any recovery time (p<0,05). These observations suggest an early activation of anaerobic metabolism, thus evidencing an alteration in oxidative metabolism of such dystrophic patients. As far as intense aerobic training could be performed in DM1 patients, in order to improve maximal muscle oxidative capacity and blood lactate removal ability, then, this safe and validate method could be used to evaluate muscle oxidative metabolism and provide an efficient help on rehabilitation programs to be prescribed in such patients.

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Section: Discussionsupporting

confidence: 92%

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confidence: 97%

Lactate levels affect motor performance in MD 1

et al. 2014

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“…, 2003). A previous study on 16 patients gave a higher sensitivity when applying protocol (ii) as compared with protocol (iii) (Finsterer and Milvay, 2001). A further argument against protocol (iii) is that muscle weakness may not be linearly correlated with the lactate production.…”

Section: Discussionmentioning

confidence: 88%

“…Lactate was measured by means of the commercially available Ektachrome Clinical Chemistry Slide (LAC, Kodak, Rochester, NY, USA) (Dengler et al. , 1996; Finsterer and Milvay, 2001, 2002). A result was interpreted as abnormal, if more than two of the five lactate values exceeded the corresponding cut‐off values.…”

Section: Methodsmentioning

confidence: 99%

Stress lactate in mitochondrial myopathy under constant, unadjusted workload

Finsterer¹,

Milvay²

2004

Euro J of Neurology

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As it is under debate if determination of lactate during cycle ergometry (lactate stress testing, LST) under a continuous, unadjusted, low workload is a valuable diagnostic tool for mitochondrial myopathy (MMP), the present study aimed to investigate how sensitive the LST is in a large cohort of patients with indications for MMP (MMP patients). Serum lactate was determined once before, three times during, and once after a 15-min, constant 30 W-workload on a bicycle ergometer in 115 healthy controls, 166 patients with neurological disorders other than MMP, and 291 MMP patients. Serum lactate's upper reference limit at rest, 5, 10, 15 min after starting, and 15 min after finishing the exercise was 2.0, 2.0, 2.1, 2.0 and 1.7 mmol/l, respectively. Resting lactate was increased in 75 MMP patients (26%). The specificity of resting lactate determination was 84%. The sensitivity of the LST was 66% and the specificity 84%. Among the 192 MMP patients with abnormal LST, 120 (63%) had a normal resting lactate. The LST is abnormal in two thirds of the MMP patients. The sensitivity of the LST is higher than that of resting lactate determination. The LST is a simple and cheap but effective and reliable screening method for detecting the impaired oxidative metabolism in MMP.

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“…Some authors, however, suggest that the constant fixed protocol has a higher sensitivity than the normalized one [73], considering that the lactate values may not be linearly correlated with muscle force and that a very low maximal work output can be inadequate to reach the anaerobic threshold.…”

Section: Aerobic Exercise Testmentioning

confidence: 99%

Metabolic myopathies: functional evaluation by different exercise testing approaches

et al. 2011

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Metabolic myopathies are a clinically and etiologically heterogeneous group of disorders due to defects in muscular energy metabolism. They include glycogen storage diseases, fatty acid oxidation defects, and mitochondrial disorders. The typical manifestations of a metabolic myopathy are exercise-induced myalgias, exercise intolerance, and cramps. Evaluating subjects with such symptoms is not easy because of the frequent lack of clinical features. Exercise tests are, therefore, reliable screening tools. Here, we discuss the possible role of such exercise testing techniques in the diagnostic approach of a patient with suspected metabolic myopathy.

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Diagnostic yield of the lactate stress test in respiratory chain disorders under absolute and relative workload

Cited by 13 publications

References 20 publications

Lactate levels affect motor performance in MD 1

Lactate levels affect motor performance in MD 1

Stress lactate in mitochondrial myopathy under constant, unadjusted workload

Metabolic myopathies: functional evaluation by different exercise testing approaches

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