Relationship between Body Mass and Tolerance to Physical Stress in Obese Patients

Salvadori, Alberto; Fanari, Paolo; Cavestri, R.; Mazza, P.; Baudo, S.; Longhini, E

doi:10.1159/000195951

Cited by 14 publications

(11 citation statements)

References 13 publications

(17 reference statements)

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“…This has not been noted in obese patients, however. They have a reduced sustainable work capacity (lower AT) when compared to controls [29] and develop lower maximal HR ( fig. 3), prob ably because of their reduced catecholamine availability during physical stress as previously observed by Gustafson et al [30], …”

Section: Discussionmentioning

confidence: 99%

Breathing Pattern during and after Maximal Exercise Testing in Young Untrained Subjects and in Obese Patients

et al. 1993

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More rapid and more shallow breathing (RSB) than usual, manifested by a lower tidal volume and greater breathing frequency at a given level of ventilation, may be caused by ínspiratory muscle fatigue and pulmonary congestion. It has been observed during recovery in young trained adults after very high exercise levels and in middle-aged patients with cardiac disease, after their maximal work load. We studied the breathing pattern during and after exercise testing up to the maximal work capacity in a group of normal untrained, young people and in a group of young obese subjects. RSB was present in normal subjects after a work load which required a maximal O₂ consumption near the theoretical value (93% in our cases) and was not present in obese patients probably because neither inspiratory muscle fatigue, nor pulmonary congestion occurs in these subjects. Maximal heart rate at peak of exercise was significantly higher in normal subjects and a direct correlation between ΔVt and maximal heart rate was found in all normal subjects. This is compatible with the hypothesis that RSB is mainly due to an initial interstitial pulmonary edema, as supposed by other authors.

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Section: Discussionmentioning

confidence: 99%

Breathing Pattern during and after Maximal Exercise Testing in Young Untrained Subjects and in Obese Patients

et al. 1993

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“…36 This reduction is thought to be due to the added energy needed to move the fat mass during exercise. V O 2 and V E were found to be higher in moderate to severe obese individuals 39 than in control subjects during exercise at comparable work rates. The increased V O 2 required for a given work load in obesity was thought to be due to the greater metabolic energy needed to move the increased body mass (ie, the increased leg mass) or to an increased WOB.…”

Section: The Ventilatory Response To Exercisementioning

confidence: 74%

Advanced Mechanical Ventilatory Constraints During Incremental Exercise in Class III Obese Male Subjects

et al. 2015

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BACKGROUND:We investigated the role of mechanical ventilatory constraints in obese class III subjects during incremental exercise. METHODS: We examined 14 control subjects (body mass index [BMI], 23.6 ؎ 3.2 kg/m 2 ), 15 obese class II subjects (BMI, 37.2 ؎ 4.5 kg/m 2 ), and 17 obese class III subjects (BMI, 53.4 ؎ 6.8 kg/m 2 ). All subjects performed pulmonary function tests and maximal inspiratory pressure at rest, ventilatory parameters, flow-volume loops, and rated perceived exertion and breathlessness during exercise. RESULTS: All subjects had normal pulmonary function. Obesity resulted in increased minute ventilation for a given submaximal work rate, although minute ventilation during peak exercise was lowest in the obese class III subjects. Endexpiratory lung volume was significantly lower in the obese subjects at rest and during exercise at the ventilatory threshold but not during peak exercise. During heavy-to-peak exercise, the obese subjects increased their end-expiratory lung volume, whereas the control group continued to decrease this parameter. Compared with controls, end-inspiratory lung volume was significantly lower in obese class II subjects and obese class III subjects at rest and at the ventilatory threshold but not during peak exercise. At maximal exercise, obese class III subjects had a greater endinspiratory lung volume than obese class II subjects and controls. Obese class III subjects displayed a greater expiratory air flow limitation at rest, at the ventilatory threshold, and during peak exercise than both controls and obese class II subjects. CONCLUSIONS: Mechanical ventilatory constraints increase progressively with degrees of obesity, contributing to exercise limitation in obese subjects. Key words: end-expiratory lung volumes; end-inspiratory lung volume; expiratory air flow limitation; breathing strategy; work of breathing; dyspnea. [Respir Care 2015;60(4):549 -560.

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“…Decreased phosphagen stores can affect muscle activity, and be related to the early onset of fatigue and decreased capability of exercise observed in the severely obese (Salvadori et al, 1991). In any case, the data show that creatinine excretion may be rapidly in¯uenced by the overall energy availability, and as a result, may no longer be considered as an unalterable correlate of lean body mass to which the urinary excretion of other materials can be referred.…”

Section: Discussionmentioning

confidence: 96%

Short-term effects of a hypocaloric diet on nitrogen excretion in morbid obese women

et al. 2001

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Objective: To determine whether the daily pattern of urine excretion of N wastes is affected by obesity and very low-calorie diets (VLCD). Design: The plasma amino acid, urea and other energy parameters, as well as the urinary excretion of total nitrogen, urea and creatinine were studied in obese and normal-weight women. The obese women's data were obtained under hospital basal controlled conditions (8.1 MJaday) and after 3 days of VLCD diet (1.9 MJaday) controls were studied only once (5.8 MJaday). The hourly excretion patterns of total N, urea and creatinine were determined from the composition of each bladder voiding. Subjects: Twenty morbidly obese and 10 age-matched normal-weight control women. Results: Plasma amino acid levels were higher in obese women, which showed a limited ability to metabolize amino acid hydrocarbon skeletons. Neither differences in the patterns between groups nor total 24 h values for urine volume were found. Total N and urea excretion diminished under VLCD diet. Hourly creatinine excretion showed a¯at pattern and was higher in obese women than in the controls, VLCD diet diminished the amount of creatinine excreted in 24 h. Conclusions: The early change in energy availability that the creatinine excretion ®gures re¯ect may result from the energy conservation mechanisms induced in response to energy restriction. The early onset of this effect (3 days, and the extent of decrease ( $ 19%) also suggest that the impact of VLCD on the muscle energy budget of the obese is more marked than usually assumed. Sponsorship: Grants FIS-94a0034, BIO98-0316 and 2FD97-0233 of the Government of Spain.

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Relationship between Body Mass and Tolerance to Physical Stress in Obese Patients

Cited by 14 publications

References 13 publications

Breathing Pattern during and after Maximal Exercise Testing in Young Untrained Subjects and in Obese Patients

Breathing Pattern during and after Maximal Exercise Testing in Young Untrained Subjects and in Obese Patients

Advanced Mechanical Ventilatory Constraints During Incremental Exercise in Class III Obese Male Subjects

Short-term effects of a hypocaloric diet on nitrogen excretion in morbid obese women

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