Circulation, Vol 73, 1137-1144, Copyright © 1986 by American Heart Association
KE Sietsema, DM Cooper, JK Perloff, MH Rosove, JS Child, MM Canobbio, BJ Whipp and K Wasserman
The dynamic increase in oxygen uptake (VO2) at the start of exercise
reflects the circulatory adjustments to metabolic changes induced by the
exercise. Because VO2 measured at the lungs is the product of pulmonary
blood flow and arteriovenous oxygen difference, pathologic conditions
affecting the capacity of these factors to change would be expected to
alter VO2 kinetics. To determine whether measurement of VO2 kinetics can
detect conditions in which the pulmonary blood flow response to exercise is
abnormal, VO2 was measured, breath-by-breath, during the transition from
rest to exercise in 13 adults with cyanotic congenital heart disease
(central venoarterial shunting) and in nine normal subjects. The increase
in VO2 above baseline during the first 20 sec of exercise (phase I),
reflecting the immediate increase in pulmonary blood flow, was diminished
in the patients compared with that in normal subjects (14.8 +/- 10.9 vs.
49.8 +/- 19.2 ml of oxygen) (p less than .001). The patients' phase I
responses correlated with their reported physical activity tolerance (p
less than .01). In addition, the second phase of the VO2 response kinetics
was prolonged in patients compared with normal subjects (half-time = 63 +/-
13 vs 15 +/- 13 sec) (p less than .001). We conclude that striking
disturbances in VO2 kinetics occur in patients with cyanotic congenital
heart disease and that these measurements provide a useful noninvasive
means of evaluating the degree to which the increase in pulmonary blood
flow is constrained in response to exercise.
ARTICLES
Dynamics of oxygen uptake during exercise in adults with cyanotic congenital heart disease
This article has been cited by other articles:
 |
|
 |
|
  G.-P. Diller, K. Dimopoulos, H. Kafka, S. Y. Ho, and M. A. Gatzoulis Model of chronic adaptation: right ventricular function in Eisenmenger syndrome Eur. Heart J. Suppl., December 1, 2007; 9(suppl_H): H54 - H60. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Dimopoulos, D. O. Okonko, G.-P. Diller, C. S. Broberg, T. V. Salukhe, S. V. Babu-Narayan, W. Li, A. Uebing, S. Bayne, R. Wensel, et al. Abnormal Ventilatory Response to Exercise in Adults With Congenital Heart Disease Relates to Cyanosis and Predicts Survival Circulation, June 20, 2006; 113(24): 2796 - 2802. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. C. Brunken, J. K. Perloff, J. Czernin, R. Campisi, S. Purcell, P. D. Miner, J. S. Child, and H. R. Schelbert Myocardial perfusion reserve in adults with cyanotic congenital heart disease Am J Physiol Heart Circ Physiol, November 1, 2005; 289(5): H1798 - H1806. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. P Wilkerson, I. T Campbell, and A. M Jones Influence of nitric oxide synthase inhibition on pulmonary O2 uptake kinetics during supra-maximal exercise in humans J. Physiol., December 1, 2004; 561(2): 623 - 635. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G H Markovitz, J W Sayre, T W Storer, C B Cooper, and D A Gordon On issues of confidence in determining the time constant for oxygen uptake kinetics * Commentary Br. J. Sports Med., October 1, 2004; 38(5): 553 - 560. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. H. Malek, E. W. Fonkalsrud, and C. B. Cooper Ventilatory and Cardiovascular Responses to Exercise in Patients With Pectus Excavatum Chest, September 1, 2003; 124(3): 870 - 882. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. P Bolger, A. J.S Coats, and M. A Gatzoulis Congenital heart disease: the original heart failure syndrome Eur. Heart J., May 2, 2003; 24(10): 970 - 976. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
X.-G. Sun, J. E. Hansen, R. J. Oudiz, and K. Wasserman Gas Exchange Detection of Exercise-Induced Right-to-Left Shunt in Patients With Primary Pulmonary Hypertension Circulation, January 1, 2002; 105(1): 54 - 60. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.U. Wessel D-transposition of the great arteries: post-operative evaluation by breath-by-breath analysis of ventilation and pulmonary gas exchange during exercise Eur. Heart J., June 2, 2001; 22(12): 987 - 989. [PDF]
|
|
|
|
|
|
T. Reybrouck Gas Exchange Kinetics in Patients With Cardiovascular Disease Chest, August 1, 2000; 118(2): 285 - 286. [Full Text] [PDF]
|
|
|
|
|
|
H. Adachi, A. Koike, A. Niwa, A. Sato, T. Takamoto, F. Marumo, and M. Hiroe Percutaneous Transluminal Coronary Angioplasty Improves Oxygen Uptake Kinetics During the Onset of Exercise in Patients With Coronary Artery Disease Chest, August 1, 2000; 118(2): 329 - 335. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Mettauer, Q. M. Zhao, E. Epailly, A. Charloux, E. Lampert, B. Heitz-Naegelen, F. Piquard, P. E. di Prampero, and J. Lonsdorfer VO2 kinetics reveal a central limitation at the onset of subthreshold exercise in heart transplant recipients J Appl Physiol, April 1, 2000; 88(4): 1228 - 1238. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Bauer, J. G. Regensteiner, E. P. Brass, and W. R. Hiatt Oxygen uptake kinetics during exercise are slowed in patients with peripheral arterial disease J Appl Physiol, August 1, 1999; 87(2): 809 - 816. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Regensteiner, T. A. Bauer, J. E. B. Reusch, S. L. Brandenburg, J. M. Sippel, A. M. Vogelsong, S. Smith, E. E. Wolfel, R. H. Eckel, and W. R. Hiatt Abnormal oxygen uptake kinetic responses in women with type II diabetes mellitus J Appl Physiol, July 1, 1998; 85(1): 310 - 317. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Cohen-Solal, T. Laperche, D. Morvan, M. Geneves, B. Caviezel, and R. Gourgon Prolonged Kinetics of Recovery of Oxygen Consumption After Maximal Graded Exercise in Patients With Chronic Heart Failure : Analysis With Gas Exchange Measurements and NMR Spectroscopy Circulation, June 15, 1995; 91(12): 2924 - 2932. [Abstract] [Full Text]
|
|
|
|
|
|
A. Koike, T. Yajima, H. Adachi, N. Shimizu, H. Kano, K. Sugimoto, A. Niwa, F. Marumo, and M. Hiroe Evaluation of Exercise Capacity Using Submaximal Exercise at a Constant Work Rate in Patients With Cardiovascular Disease Circulation, March 15, 1995; 91(6): 1719 - 1724. [Abstract] [Full Text]
|
|