Heart rate recovery is associated with ventilatory constraints and excess ventilation during exercise in patients with chronic obstructive pulmonary disease

Crisafulli, Ernesto; Vigna, Matteo; Ielpo, Antonella; Tzani, Panagiota; Mangia, Alessandro; Teopompi, Elisabetta; Aiello, Marina; Alfieri, Veronica; Bertorelli, Giuseppina; Palange, Paolo; Chetta, Alfredo

doi:10.1177/2047487318789756

Cited by 11 publications

(10 citation statements)

References 38 publications

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“…Both elevated pH and decreased PCO 2 can increase the affinity of Hb with O 2 and increase blood PO 2 [59]. It is known that heart rate recovery and PO 2 are positively correlated, while hypoxia and cardiac autonomic nervous dysfunction are closely related [60]. We found, however, that the rate of heart rate recovery in both groups increased after six weeks of intervention, and there was no significant difference between groups in heart rate recovery ( p > 0.05).…”

Section: Discussionmentioning

confidence: 99%

Effect of sodium bicarbonate ingestion during 6 weeks of HIIT on anaerobic performance of college students

Wang

Qiu

Liu

et al. 2019

Journal of the International Society of Sports Nutrition

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Background Past studies have found that sodium bicarbonate ingestion prior to exercise has a performance-enhancing effect on high-intensity exercise. The aim of this study was to investigate the effects of continuous sodium bicarbonate (NaHCO 3 ) supplementation on anaerobic performance during six weeks of high-intensity interval training (HIIT). Methods Twenty healthy college-age male participants were randomly assigned to either the HCO 3 − group (SB) or the placebo group (PL), with 10 subjects in each group. Both groups completed 6 weeks (3 days/week) of HIIT with the SB ingesting an orange-flavored solution containing 15 g xylitol and 0.2 g HCO 3 − /kg body mass during each training day, and PL ingesting a similar beverage that was HCO 3 − -free. This study separated 6 weeks of training into two stages with different training intensities, with the first 3 weeks at a lower intensity than the second 3 weeks. Blood samples to measure serum HCO 3 − were obtained 5 min before and 30 min after the following HIIT training sessions: Week 1, training session 1; week 3, training session 3; week 6, training session 3. Three 30s Wingate tests (WAnT) were conducted before, in the middle, and after the training and the supplementation interventions, with peak power, mean power, and fatigue index obtained during WAnT, and blood lactate and heart rate obtained after WAnT. Results Our findings indicate the following: 1) Serum HCO 3 − level of SB was significantly higher than PL ( p < 0.05) both before and after each HIIT; 2) Relative peak power in WAnT was significantly higher in the SB group after 6 weeks ( p < 0.01); 3) Lactate clearance rate and the lactate clearance velocity after 10 min of WAnT were both significantly higher in SB in the post-test (p < 0.01); 4) Heart rate recovery rate at 10 min after WAnT in both SB and PL after 6 weeks were significantly improved (p < 0.01 and p < 0.05, respectively), resulting in no difference between groups on these measures. Conclusions These data suggest that supplementation of HCO 3 − at the level of 0.2 g/kg body mass before HIIT training enhances the effect of HIIT on anaerobic performance, and improves the blood lactate clearance rate and the blood lactate clearance velocity following anaerobic exercise.

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Section: Discussionmentioning

confidence: 99%

Effect of sodium bicarbonate ingestion during 6 weeks of HIIT on anaerobic performance of college students

Wang

Qiu

Liu

et al. 2019

Journal of the International Society of Sports Nutrition

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“…Since delayed post-exercise HR recovery is frequently observed in lung disease patients and associated with dynamic hyperinflation [73] and poor prognosis [74,75], HR recordings may offer additional useful information. Furthermore, assessment of perceived exertion, dyspnoea and leg fatigue is done using standardised scales suggested by BORG et al [76,77] and GIFT [78].…”

Section: Recovery Phasementioning

confidence: 99%

ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases

et al. 2019

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The objective of this document was to standardise published cardiopulmonary exercise testing (CPET) protocols for improved interpretation in clinical settings and multicentre research projects. This document: 1) summarises the protocols and procedures used in published studies focusing on incremental CPET in chronic lung conditions; 2) presents standard incremental protocols for CPET on a stationary cycle ergometer and a treadmill; and 3) provides patients' perspectives on CPET obtained through an online survey supported by the European Lung Foundation. We systematically reviewed published studies obtained from EMBASE, Medline, Scopus, Web of Science and the Cochrane Library from inception to January 2017. Of 7914 identified studies, 595 studies with 26 523 subjects were included. The literature supports a test protocol with a resting phase lasting at least 3 min, a 3-min unloaded phase, and an 8- to 12-min incremental phase with work rate increased linearly at least every minute, followed by a recovery phase of at least 2–3 min. Patients responding to the survey (n=295) perceived CPET as highly beneficial for their diagnostic assessment and informed the Task Force consensus. Future research should focus on the individualised estimation of optimal work rate increments across different lung diseases, and the collection of robust normative data.

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“…Of note, lung hyperinflation added to V′ E /V′ CO 2 to predict mortality due to respiratory and nonrespiratory causes (figure 3) [67]. Increased sympathetic stimulation, as inferred by a slow decrease in post-exercise heart rate, was observed in COPD patients with higher and worsening mechanical constraints [42], providing a potential clue for the mechanisms underlying the association between these variables and the risk of a future negative event. Furthermore, a high V′ E /V′ CO 2 nadir compound impaired right ventricular systolic function to predict poor outcome in COPD-heart failure [68].…”

Section: Impact Of Copd Comorbidities On V′ E /V′ Comentioning

confidence: 99%

Exertional ventilation/carbon dioxide output relationship in COPD: from physiological mechanisms to clinical applications

et al. 2021

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There is well established evidence that the minute ventilation (V′E)/carbon dioxide output (V′CO2) relationship is relevant to a number of patient-related outcomes in COPD. In most circumstances, an increased V′E/V′CO2 reflects an enlarged physiological dead space (“wasted” ventilation), although alveolar hyperventilation (largely due to increased chemosensitivity) may play an adjunct role, particularly in patients with coexistent cardiovascular disease. The V′E/V′CO2 nadir, in particular, has been found to be an important predictor of dyspnoea and poor exercise tolerance, even in patients with largely preserved forced expiratory volume in 1 s. As the disease progresses, a high nadir might help to unravel the cause of disproportionate breathlessness. When analysed in association with measurements of dynamic inspiratory constraints, a high V′E/V′CO2 is valuable to ascertain a role for the “lungs” in limiting dyspnoeic patients. Regardless of disease severity, cardiocirculatory (heart failure and pulmonary hypertension) and respiratory (lung fibrosis) comorbidities can further increase V′E/V′CO2. A high V′E/V′CO2 is a predictor of poor outcome in lung resection surgery, adding value to resting lung hyperinflation in predicting all-cause and respiratory mortality across the spectrum of disease severity. Considering its potential usefulness, the V′E/V′CO2 should be valued in the clinical management of patients with COPD.

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Heart rate recovery is associated with ventilatory constraints and excess ventilation during exercise in patients with chronic obstructive pulmonary disease

Cited by 11 publications

References 38 publications

Effect of sodium bicarbonate ingestion during 6 weeks of HIIT on anaerobic performance of college students

Effect of sodium bicarbonate ingestion during 6 weeks of HIIT on anaerobic performance of college students

ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases

Exertional ventilation/carbon dioxide output relationship in COPD: from physiological mechanisms to clinical applications

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