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Biomedical subjects

B J Whipp

Publications and source records attributed to B J Whipp.

At least 73 records · Page 4Linked to original sources
PubMed1994

The slow component of O2 uptake kinetics during heavy exercise.

During constant-load exercise of moderate intensity, pulmonary O2 uptake (VO2) is characterized by two temporal response components. The first occurs during the transit delay from the exercising limbs and is mediated predominantly by increased pulmonary blood flow. Thereafter, this response is supplemented by the influence of increased O2 extraction, causing VO2 to increase monoexponentially to its steady state, with a time constant that does not vary appreciably with work rate, at this intensity. At work rates that engender a lactic acidosis, however, an additional slow phase of VO2 is superimposed upon the underlying kinetics: this is of delayed onset and prolongs the time to steady state over the range within which the increases in blood lactate and [H+] stabilize or even decrease (heavy exercise). At higher work rates (severe exercise) a steady state is unattainable, with the VO2 trajectory resulting in VO2max progressively earlier the higher the work rate: it is therefore a fundamental determinant of exercise tolerance. Although the kinetic features of this slow VO2 component (other than its delay) remain to be determined, current evidence suggests that it is manifest predominantly in the exercising limbs, with the recruitment profile and metabolic features of fast-twitch fiber activation being the major contributor.

Exercise↗
PubMed1994

VO2 slow component: physiological and functional significance.

This paper offers a brief synopsis of the five preceding papers which constitute the proceedings of the symposium "Mechanistic basis of the slow component of VO2 kinetics during heavy exercise." The key features have been taken from each paper and a coherent position regarding the site and potential underlying mechanisms for the "excess" VO2 is presented. The hypothesis is developed that some aspect of fiber type recruitment patterns might be responsible for this phenomenon. Elucidation of the precise determinants of VO2 during heavy exercise is fundamental to our understanding of muscle energetics. Furthermore, certain patient populations, whose exercise tolerance is limited by impaired cardiovascular and/or respiratory capacity, may benefit from interventions designed to constrain the magnitude of the VO2 slow component.

Exercise↗
PubMed1994

The bioenergetic and gas exchange basis of exercise testing.

Exercise intolerance results when a subject is unable to sustain a required work rate sufficiently long for the successful completion of the task. The ability to sustain muscular exercise depends in large part on the ability to transport oxygen to its site of utilization as the terminal oxidant of the mitochondrial electron transport chain. This requires a coordinated interaction of skeletal muscle energetics and cardiovascular and pulmonary responses to the task. This article considers the fundamentals of the normal operation of these systems and their patterns of response to particular stress profiles to provide a frame of reference for the normalcy of responses to exercise testing.

Carbon Dioxide↗
PubMed1994

Peripheral chemoreceptor control of exercise hyperpnea in humans.

Estimates of the proportional contribution of the peripheral chemoreceptors (i.e., the carotid bodies) to human ventilatory control during moderate exercise (i.e., below the lactate threshold, theta L) suggest that they: (a) exert no discernible influence on the initial (usually rapid) phase I component; (b) provide significant modulation of the slower, exponential phase II dynamics, therefore contributing to the tightness of arterial PCO2 regulation and the magnitude of the transient hypoxemia in this phase; and (c) account for approximately 20% of the steady-state phase III drive, which can rise to over 50% in hypoxia (PaO2 approximately 50 mm Hg). Above theta L, the carotid bodies constrain the transient fall in arterial pH by mediating much (but not all) of the compensatory hyperventilation for the metabolic acidemia. The carotid body contribution above theta L, estimated by Dejours O2 testing, is not appreciably different from subthreshold estimates, suggesting that: (a) the respiratory alkalosis in blood and cerebrospinal fluid resulting from the hyperventilation may suppress carotid chemosensitivity; (b) an artifact resulting from secondary hyperoxia-induced stimulation of central chemoreceptors may lead to underestimation of the carotid body contribution; or (c) the carotid bodies may not be entirely "silenced" by hyperoxia during a metabolic acidemia.

Carotid Body↗
PubMed1993

Evidence for an intramuscular ventilatory stimulus during dynamic exercise in man.

During incremental work rate exercise, ventilation (VE) typically increases in proportion to the metabolic rate until the onset of a progressive metabolic acidemia induces an additional compensatory hyperpnea. We examined the control characteristics of this compensatory mechanism in seven healthy subjects performing incremental cycle ergometry to their limit of tolerance at different levels of lower-body positive pressure (LBPP) at 0, 15, 30, and 45 Torr in order to determine if LBPP could alter the occurrence of the ventilatory threshold. Ventilatory responses and pulmonary gas exchange variables were measured breath-by-breath while 'arterialized'-venous blood was sampled from the dorsum of the heated hand for determination of [lactate], pH, and [K+]. The ventilatory threshold was progressively reduced with increasing levels of LBPP: Ventilatory threshold = 2.33-(0.0173.LBPP); (r2 = 0.59, P < 0.001). Ventilatory equivalents for oxygen (VE/VO2) and carbon dioxide (VE/VCO2) were systematically elevated at work rates above 50 W by increases in respiratory frequency which also resulted in lower PETCO2 and higher PETO2 values. As [lactate] was only slightly elevated above control (delta lactate < 1 mEq.L-1) while pH and [K+] were unchanged, it seems unlikely that the LBPP-induced hyperpnea can be attributed to activation of peripheral arterial or central chemoreceptors. These findings suggest a ventilatory stimulus may be generated by an LBPP-induced reduction in perfusion with the subsequent accumulation of intramuscular metabolites at the working limb and/or a direct effect of increased intramuscular tissue pressure.

Adult↗
PubMed1993

Femoral vascular occlusion and ventilation during recovery from heavy exercise.

Ventilation and cardiac output subside gradually following cessation of exercise, which is commonly linked to the slow wash-out of materials from the recovering muscles. The effect of hindering the removal of the metabolic products of heavy cycle exercise on the kinetics of ventilation and gas exchange was studied in 5 subjects by occluding the femoral circulation with cuffs during the first 2 min of recovery (15 tests). Fifteen undisturbed recoveries served as controls. Compared to spontaneous recovery, circulatory obstruction induced an immediate (from the first breath) decrease in minute ventilation (VE), while end-tidal CO2 (PETCO2) as well as lactate and K+ in venous blood at forearm did not change significantly. A ventilatory deficit of 27 +/- 9 L was observed from the 2 min of occlusion. Following cuff deflation, VE rose 2-3 breaths after PETCO2 began to increase in every subject. The mechanisms of the normocapnic reduction of VE during occlusion, as well as the rise of ventilation following cuff release, are still unclear. However, these results argue against any significant role for hyperpnea-inducing intramuscular chemoreception, or point to muscular perfusion as a prerequisite of such a mechanism to operate.

Adult↗
PubMed1993

Role of muscle perfusion and baroreception in the hyperpnea following muscle contraction in dog.

The influence of impeding muscle perfusion on the time course of ventilatory decline during recovery from electrically induced hindlimb contractions has been studied in 14 anesthetized dogs. When intravascular balloons, placed in abdominal aorta and inferior vena cava just rostral to the iliac bifurcation, were inflated at the cessation of contraction bout, minute ventilation (VE) was significantly reduced during recovery compared with control. The subsequent restoration of iliac circulation rapidly augmented VE, which peaked at the fifth breath after release, by an average of +4.97 L.min-1; VE then returned exponentially to resting (pre-contraction) level. Breathing 100% O2 did not affect the VE recovery pattern neither during iliac occlusion nor immediately after its release (the peak average delta VE = +4.42 L.min-1). When a local anesthetic (5% Lidocaine) was applied bilaterally to the regions of carotid bifurcation, systemic blood pressure was significantly increased and the VE response to both iliac occlusion and release were nearly abolished. The VE response to inhalation of 5% CO2 in air was not affected by this procedure, whereas the stimulation of VE with 2 mg i.v. bolus of NaCN was attenuated. When the local anesthetic was thoroughly washed out (and systemic blood pressure had returned to control level) the previously observed VE responses to iliac occlusion and release were restored. These results and analysis of the VE response timing (transits and latencies) suggest that the vascular rather than humoral effects or tissue 'metaboreception' modulate ventilatory recovery from muscular contractions; baroreception appears to be important in this process.

Animals↗
PubMed1993

Pulmonary mechanics and entrainment of respiration and stroke rate during rowing.

During rowing, the respiratory musculature is confronted with dual demands: assisting the propulsive force generation and as the effector for ventilatory control. We determined the pulmomechanical and breathing pattern features of rowing-induced hyperpnea in five national class rowers (18 years old). Each subject performed incremental exercise on a mechanically braked rowing ergometer. Power was increased by 50 W each 3 min, from 150 W to 350 W. Breathing was through a low-resistance, ultrasonic flow-sensing device. Respired gas concentrations were measured by mass spectrometry. Intrapleural pressure (Pp1) was monitored by an esophageal balloon. Ventilation (VE) increased by increasing tidal volume (VT) at constant breathing frequency (fb). Above approximately 701.min-1 there was little change in VT and further increase in VE was dominated by fb. Two breathing patterns were identified: (1) one expiration per stroke and one inspiration during recovery and (2) one complete breath during stroke and one breath during recovery. Stroke frequency (fs) and fb increased in concert, i.e., all subjects entrained their breathing. Pp1 indicated dynamic airway compression during exhalation at high work rates and also that VT did encroach upon the flat part of the compliance curve. With the constrained VT, the demand for increased fb to effect the hyperpneic response at high work rates may result in an entrainment of the stroke frequency to that of breathing.

Adolescent↗
PubMed1992

Effect of dopamine on ventilatory response to incremental exercise in man.

We investigated whether dopamine, an inhibitory neuromodulator in the carotid body, would alter the ventilatory response typically associated with metabolic (lactic) acidosis during exercise. Six subjects performed incremental cycle ergometer exercise to exhaustion during infusions of dopamine (3 micrograms.kg-1.min-1) or saline. Ventilation and pulmonary gas exchange were computed breath-by-breath; arterialized venous blood was collected every 90 sec for measurement of lactate, potassium and blood gases. The resting ventilatory response to an isocapnic step decrease in end-tidal PO2 to 50 Torr was used as an index of carotid body drive. Dopamine diminished the hypoxic ventilatory response but had no effect on the ventilatory response during exercise. Peak lactate, potassium, and ventilation were unaffected by dopamine, and the degree of respiratory compensation for the metabolic acidosis was the same as in control experiments. Therefore, either the carotid bodies respond differently to hypoxia than to acute metabolic acidosis and/or hyperkalemia during heavy exercise, or the carotid bodies are not the sole mediators of hyperventilation above the lactate threshold.

Adult↗
PubMed1992

Physiologic changes following bilateral carotid-body resection in patients with chronic obstructive pulmonary disease.

In an attempt to establish the characteristic pattern of change in (1) indices of pulmonary function, (2) arterial blood gas, and (3) arterial acid-base status which result from bilateral carotid body resection (BCBR), we analyzed the results of 146 consecutive patients with severe chronic obstructive pulmonary disease who had undergone BCBR at a single hospital site. In addition, we analyzed the results of incremental exercise testing in 21 similar patients, performed at a separate hospital. On average, TLC, FRC, and RV all decreased after surgery, whereas FEV1 increased. Although the data were highly variable, PaO2 decreased on average in proportion to the increase in PaCO2. The smaller group exercised to a higher metabolic rate after surgery; maximum ventilation, however, was unchanged. This led to a further fall in PaO2 and increase in PaCO2. We conclude that individual patient responses to BCBR are highly variable, but the procedure typically results in a small further hypoxemia and hypercapnia with no further impairment to pulmonary function.

Adult↗
PubMed1992

Pulmonary gas exchange dynamics and the tolerance to muscular exercise: effects of fitness and training.

Oxygen uptake (VO2) kinetics are generally agreed to be first-order for moderate work rates with a time constant (tau VO2) that is thought to reflect the kinetics of intramuscular creatine phosphate depletion. However, when there is a concomitant lactic acidosis, tau VO2 is appreciably longer, reflecting an additional, delayed and slowed component that leads to VO2S greater than the aerobic equivalent of that work rate and which therefore invalidates current techniques for O2 deficit estimation. This "excess" VO2 is no more than approximately 250-300 ml/min at work rates for which [lactate] and [H+]a can be stabilized. At higher work rates which demand sustained and progressive increases in [lactate] and [H+]a, however, VO2 also continues to increase progressively, yielding excess VO2S greater than 11/min at exhaustion. The trajectory of excess VO2 therefore is to the maximum VO2: the resulting exercise limitation becomes progressively more pronounced the higher the work rate, which accounts for the hyperbolic character of the power-duration curve. Factors which speed VO2 kinetics in this domain reduce the excess VO2 mechanism and lead to improved exercise performance. We have demonstrated that, in addition to appropriately-designed training regimens, induction of a metabolic acidosis prior to exercise speeds VO2 kinetics at high work rates, reducing the increase in both [lactate] and [H+]a and reducing the CO2 load to ventilation during the transient phase of the work. The optimum procedure for inducing these improved pulmonary gas-exchange kinetics, however, remains to be determined.

Humans↗
PubMed1991

Asymmetries of oxygen uptake transients at the on- and offset of heavy exercise in humans.

1. At work rates which do not result in a sustained increase in blood lactate ([L-]), oxygen uptake (VO2) approaches the steady state with first-order kinetics. However, when [L-] is increased, at least two kinetic components are required to characterize the VO2 response dynamics. The purpose of the present investigation was to determine whether these more-complex kinetics are best represented as: (a) two components which operate throughout the exercise or (b) a delayed slow component which is consequent to the lactic acidaemia and which does not influence the early development of the O2 deficit. 2. Six healthy subjects underwent an incremental ramp test on a cycle ergometer, to the limit of tolerance, for determination of the maximum VO2 (micro VO2) and and estimation [symbol: see text] of the threshold for lactic acidaemia (theta L) non-invasively. Subjects then performed, on different days, two to four repetitions of square-wave exercise from a baseline of unloaded pedalling ('O' Watts (W)) to work rates (WR) less than theta L (90% theta L) and greater than theta L (half-way between theta L and micro VO2). Ventilatory and pulmonary gas exchange variables were determined breath-by-breath. For each subject, the VO2 transitions were averaged prior to fitting a least-squares algorithm to the on- and off-transient responses. 3. The less than theta L test resulted in a mono-exponential VO2 response, with a time constant of 31.3 and 31.5 s for the on- and off-transients, respectively. 4. The VO2 responses to the greater than theta L test were fitted to three competing models: (a) a single exponential for the entire period; (b) a double exponential for the entire period; and (c) an initial single exponential with a subsequent phase of delayed onset. Model (c) yielded a significantly lower residual mean-squares error than methods (a) and (b), with a time constant for the initial component of 40.2 s for the on-transient and 32.9 s for the off-transient and a subsequent phase of VO2 increase for the on-transient which averaged 230 ml min-1. The delta VO2/delta WR for the early kinetics of the greater than theta L test were not different from the less than theta L test (9.6 and 9.5 ml min-1 W-1, respectively). 5. These data suggest that the slow phase of the greater than theta L VO2 kinetics is a delayed-onset process. This being the case, the O2 deficit during heavy exercise, as conventionally estimated, would be overestimated.

Exercise↗
PubMed1991

Role of the carotid bodies in the respiratory compensation for the metabolic acidosis of exercise in humans.

1. In response to an acute exercise-induced metabolic acidosis, the fall of arterial pH is constrained by the magnitude of the compensatory hyperventilation. To determine the role of the carotid bodies in this regulatory process, subjects performed prolonged (24 min) square-wave cycle ergometry from a background of unloaded cycling at inspired oxygen fractions (FI,O2) of 0.12 O2 (high carotid body gain), 0.21 O2 (normal carotid body gain) and 0.80 O2 (low carotid body gain). The work rates were selected to provide the same exercise intensity, despite the different inspirates; i.e. resulting in a constant increase in arterial blood [lactate] (delta [L-] approximately 4 mequiv l-1. 2. Ventilatory and pulmonary gas exchange variables were computed breath-by-breath and arterial blood was sampled at intervals throughout the tests and analysed subsequently for [lactate], [pyruvate], arterial partial pressures of oxygen and carbon dioxide (PO2, PCO2), pH, [bicarbonate] and [potassium]. 3. Hypoxia markedly reduced, and hyperoxia magnified, the transient decrease in arterial pH following exercise onset. However, there was a slow acid-base compensatory component, even when carotid chemosensitivity was suppressed by hyperoxia. We therefore conclude that, in humans, carotid body chemosensitivity plays a dominant role in constraining variations of arterial pH in response to the acute metabolic acidosis of heavy exercise, but that secondary-presumably central chemosensory-mechanisms subserve a slower compensatory role.

Acidosis↗
PubMed1991

Effects of chronic acid-base changes on the rebreathing hypercapnic ventilatory response in man.

The CO2 rebreathing method can be very useful to test the hypercapnic ventilatory response in patients, including those with chronic acid-base changes (e.g. chronic metabolic acidosis due to renal failure). The ventilatory response to hypercapnia (CO2-R) was measured in 4 normal men by the rebreathing method under control conditions (CaCO3: 0.1 g.kg-1.day-1) and with induced metabolic acidosis (NH4Cl: 0.3 g.kg-1.day-1) and alkalosis (NaHCO3: 0.7 g.kg-1.day-1). The slope of the CO2-R did not change as a result of the acid-base alterations, but was shifted to the left of normal by metabolic acidosis, and to the right by metabolic alkalosis. These results compare favorably with previous reports on the CO2-R as measured by the steady-state technique, and validate the rebreathing method as a reliable and useful technique for evaluating CO2-R in man with altered acid-base states.

Acid-Base Equilibrium↗
PubMed1990

The effects of training on the metabolic and respiratory profile of high-intensity cycle ergometer exercise.

The tolerable work duration (t) for high-intensity cycling is well described as a hyperbolic function of power (W): W = (W'.t-1) + Wa, where Wa is the upper limit for sustainable power (lying between maximum W and the threshold for sustained blood [lactate] increase, theta lac), and W' is a constant which defines the amount of work which can be performed greater than Wa. As training increases the tolerable duration of high-intensity cycling, we explored whether this reflected an alteration of Wa, W' or both. Before and after a 7-week regimen of intense interval cycle-training by healthy males, we estimated ( ) theta lac and determined maximum O2 uptake (mu VO2); Wa; W'; and the temporal profiles of pulmonary gas exchange, blood gas, acid-base and metabolic response to constant-load cycling at and above Wa. Although training increased theta lac (24%), mu VO2 (15%) and Wa (15%), W' was unaffected. For exercise at Wa, a steady state was attained for VO2, [lactate] and pH both pre- and post-training, despite blood [norepinephrine] and [epinephrine] ([NE], [E]) and rectal temperature continuing to rise. For exercise greater than Wa, there was a progressive increase in VO2 (resulting in mu VO2 at fatigue), [lactate], [NE], [E] and rectal temperature, and a progressive decrease for pH. We conclude that the increased endurance capacity for high-intensity exercise following training reflects an increased W asymptote of the W-t relationship with no effect on its curvature; consequently, there is no appreciable change in the amount of work which can be performed above Wa.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Modulation of muscle and pulmonary O2 uptakes by circulatory dynamics during exercise.

The effect of cardiovascular adjustments on the coupling of cellular to pulmonary gas exchange during unsteady states of exercise remains controversial. Computer simulations were performed to assess these influences on O2 delivery and pulmonary O2 uptake (pVO2). Algorithms were developed representing muscle and "rest-of-body" compartments, connected in parallel by arterial and venous circulations to a pump-and-lungs compartment. Exercise-induced increases in VO2 and cardiac output went to the muscle compartment. Model parameters [e.g., time constants for blood flow and muscle O2 uptake (mVO2)] could be varied independently. Simulation results demonstrated that 1) the rise in pVO2 during exercise contains three phases; 2) the contribution of changes in venous O2 stores to pVO2 kinetics and the O2 deficit occur almost entirely in phase 1; 3) under a wide variety of manipulations, the kinetics of pVO2 in phase 2 were within a couple of seconds of that assigned to mVO2 (i.e., there is not an obligatory slowing of VO2 kinetics at the lungs relative to those at the muscles; 4) by use of available estimates of blood flow adjustment, O2 delivery would not limit mVO2 after exercise onset; and 5) blood flow could limit O2 delivery in recovery, if blood flow returned to base-line levels at rates similar to those during the on-transient phase.

Cardiac Output↗
PubMed1990

Ventilatory control during exercise in calves with artificial hearts.

To determine the role of cardiac reflexes in mediating exercise hyperpnea, we investigated ventilatory responses to treadmill exercise in seven calves with artificial hearts and seven controls. In both groups, the ventilatory responses were adequate for the metabolic demands of the exercise; this resulted in regulation of arterial PCO2 and pH despite the absence of cardiac output increase in the implanted group. In this group, there was a small but significant reduction of arterial PO2 by 4 +/- 3 Torr and a rise of blood lactate by 1.1 +/- 1 mmol/l. When cardiac output was experimentally increased in the implanted calves to a level commensurate with that spontaneously occurring in the control calves, ventilation was not affected. However, experimental reductions of cardiac output led to an immediate augmentation of exercise hyperpnea by 4.56 +/- 4.3 l/min and a further significant lactate increase of 1.2 +/- 1.22 mmol/l that was associated with a significant decrease in the exercise O2 consumption (0.32 +/- 0.13 l/min). These observations indicate that neither cardiac nor hemodynamic effects of increased cardiac output constitute an obligatory cause of exercise hyperpnea in the calf.

Animals↗