Dissociation between muscle metabolism and oxygen kinetics during recovery from exercise in patients with chronic heart failure

Hanada, Akiko; Okita, Koichi; Yonezawa, Kazuya; Ohtsubo, Mitsunori; Kohya, Tetsuro; Murakami, Takeshi; Nishijima, Hirotaka; Tamura, Mamoru; Kitabatake, Akira

doi:10.1136/heart.83.2.161

Cited by 54 publications

(55 citation statements)

References 22 publications

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“…Yoshida et al postulated that this delay Q̇in recovery kinetics serves to maintain sufficient O 2 delivery to skeletal muscles for a high oxygen uptake [13]. Studies in CHF patients using near infrared spectroscopy to estimate the temporal profile of local O 2 delivery during recovery of exercise, yielded conflicting results [27,28]. In the present study, we did not observe a difference between Q̇onset and recovery kinetics.…”

Section: Discussioncontrasting

confidence: 54%

Are oxygen uptake kinetics in chronic heart failure limited by oxygen delivery or oxygen utilization?

Kemps

Schep

Zonderland

et al. 2010

International Journal of Cardiology

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Section: Discussioncontrasting

confidence: 54%

Are oxygen uptake kinetics in chronic heart failure limited by oxygen delivery or oxygen utilization?

Kemps

Schep

Zonderland

et al. 2010

International Journal of Cardiology

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“…CHF (chronic heart failure) is associated with a prolonged recovery of skeletal muscle energy stores after submaximal exercise [1][2][3][4]. As daily life is characterized by repetitive submaximal activities, it can be assumed that this delayed recovery is an important contributor to exercise intolerance in these patients.…”

Section: Introductionmentioning

confidence: 99%

Skeletal muscle metabolic recovery following submaximal exercise in chronic heart failure is limited more by O2 delivery than O2 utilization

et al. 2010

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CHF (chronic heart failure) is associated with a prolonged recovery of skeletal muscle energy stores following submaximal exercise, limiting the ability to perform repetitive daily activities.However, the pathophysiological background of this impairment is not well established. The aim of the present study was to investigate whether muscle metabolic recovery following submaximal exercise in patients with CHF is limited by O2 delivery or O2 utilization. A total of 13 stable CHF patients (New York Heart Association classes II-III) and eight healthy subjects, matched for age and BMI (body mass index), were included. All subjects performed repetitive submaximal dynamic single leg extensions in the supine position. Post-exercise PCr (phosphocreatine) resynthesis was assessed by 31P-MRS (magnetic resonance spectroscopy). NIRS (near-IR spectroscopy) was applied simultaneously, using the rate of decrease in HHb (deoxygenated haemoglobin) as an index of post-exercise muscle re-oxygenation. As expected, PCr recovery was slower in CHF patients than in control subjects (time constant, 47+/-10 compared with 35+/-12 s respectively; P=0.04). HHb recovery kinetics were also prolonged in CHF patients (mean response time, 74+/-41 compared with 44+/-17 s respectively; P=0.04). In the patient group, HHb recovery kinetics were slower than PCr recovery kinetics (P=0.02), whereas no difference existed in the control group(P=0.32). In conclusion, prolonged metabolic recovery in CHF patients is associated with an even slower muscle tissue re-oxygenation, indicating a lower O(2) delivery relative to metabolic demands. Therefore we postulate that the impaired ability to perform repetitive daily activities in these patients depends more on a reduced muscle blood flow than on limitations in O(2) utilization.

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“…In support of this notion, other research indicates that SmO 2 desaturation in muscle during exercise occurs more rapidly when central blood flow is limited (Matsui et al, 1995). Similarly, SmO 2 resaturation in muscle after exercise occurs more slowly as a result of reduced central (Hanada et al, 2000) and peripheral (McCully et al, 1997) blood flow. The differences in SmO 2 may also reflect delayed activation of the muscle metaboreflex in response to cold water immersion (Ray et al, 1997).…”

Section: O N T R a C T I O Nsupporting

confidence: 63%

Cellular, molecular and physiological effects of post-resistance exercise cold water immersion: Implications for subsequent perofrmance

Roberts¹

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The objective of this thesis was to examine the efficacy of cold water immersion as a recovery therapy after resistance exercise. To achieve this objective, the research had two distinct aims, (1) to investigate how cold water immersion influences acute (short-term) physiological and performance responses following a single bout of resistance exercise, and (2) to investigate how regular (longer-term) use of cold water immersion following resistance training sessions may effect training-induced adaptation.Recovery following resistance exercise is a complex, multi-faceted process that can involve the combination of a variety of recovery therapies, all with the common goal of restoring physiological and psychological homeostasis. The timing of subsequent exercise bout(s) and the desired outcome from the preceding exercise bout will heavily determine the recovery duration, and whether emphasis is placed upon a single recovery therapy over another. Cold water immersion is a popular post-exercise recovery therapy with extensive use worldwide, largely due to its simplicity, and cost-effective nature of implementation. However, the use of cold water immersion is largely supported only by anecdotal evidence from athletes and practitioners. Little physiological evidence is available as to its mechanisms of action following exercise, both in acute, and long term settings.There is a paucity of physiological knowledge available regarding post-exercise cold water immersion per se, and this is accompanied with a disparity in the reported physiological and performance responses. The degree of disparity can be attributed not only to the use of cold water immersion protocols differing in e.g. temperature (5 -15 o C), duration (5 -20 min), immersion depth (individual limb(s) compared with whole-body) and application frequency (single compared with multiple post-exercise immersions), but also to exercise protocols with varied degrees of ecological validity.In a first experimental study, detailed in chapter 2, I investigated how a bout of active recovery (stationary, low-intensity cycling) compared with a 10 min bout of CWI at 10 o C performed after a single high-intensity resistance training session in influencing physiological and performance responses over a 6-hour recovery period. Large physiological responses were observed over the initial period of recovery that could be attributed to a decrease in central (cardiac output) and peripheral (muscle artero-venous) blood flow following cold water immersion. Despite such physiological responses, participants were able to perform more work during a resistance exercise training simulation exercise when cold water immersion was used. Therefore, a second iii experimental study, detailed in chapter 3 was undertaken to more closely investigate how performing cold water immersion or active recovery after resistance exercise influence physiological responses over the initial 60 min following the recovery therapy, and how these physiological responses correspond with exercise perf...

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Dissociation between muscle metabolism and oxygen kinetics during recovery from exercise in patients with chronic heart failure

Cited by 54 publications

References 22 publications

Are oxygen uptake kinetics in chronic heart failure limited by oxygen delivery or oxygen utilization?

Are oxygen uptake kinetics in chronic heart failure limited by oxygen delivery or oxygen utilization?

Skeletal muscle metabolic recovery following submaximal exercise in chronic heart failure is limited more by O2 delivery than O2 utilization

Cellular, molecular and physiological effects of post-resistance exercise cold water immersion: Implications for subsequent perofrmance

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