Bronchodilators accelerate the dynamics of muscle O-2 delivery and utilisation during exercise in COPD
Autor(a) principal: | |
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Data de Publicação: | 2010 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.1136/thx.2009.120857 http://repositorio.unifesp.br/handle/11600/32650 |
Resumo: | Background Expiratory flow limitation and lung hyperinflation promote cardiocirculatory perturbations that might impair O-2 delivery to locomotor muscles in patients with chronic obstructive pulmonary disease (COPD). the hypothesis that decreases in lung hyperinflation after the inhalation of bronchodilators would improve skeletal muscle oxygenation during exercise was tested.Methods Twelve non-or mildly hypoxaemic males (forced expiratory volume in 1 s (FEV1)=38.5+/-12.9% predicted; Pao(2)>60 mm Hg) underwent constant work rate cycle ergometer exercise tests (70-80% peak) to the limit of tolerance (Tlim) after inhaled bronchodilators (salbutamol plus ipratropium) or placebo. Muscle (de) oxygenation (similar to fractional O-2 extraction) was determined in the vastus lateralis by changes (Delta) in the deoxyhaemoglobin/myoglobin signal ([HHb]) from near-infrared spectroscopy, and cardiac output (QT) was monitored by impedance cardiography.Results Bronchodilators reduced lung hyperinflation and increased Tlim compared with placebo (454+/-131 s vs 321+/-140 s, respectively; p<0.05). On-exercise kinetics of QT and pulmonary O-2 uptake ((V) over doto(2)) were accelerated with active treatment; Delta[HHb] dynamics, however, were delayed by similar to 78% and the signal amplitude diminished by similar to 21% (p<0.01). Consequently, the ratio between (V) over doto(2) and Delta[HHb] dynamics decreased, suggesting improved microvascular O-2 delivery (tau-(V) over doto(2)/MRT-Delta [HHb]=4.48+/-1.57 s vs 2.08+/-1.15 s, p<0.05). of note, reductions in lung hyperinflation were related to faster QT kinetics and larger decrements in tau-(V) over doto(2)/MRT-Delta[HHb] (p<0.01).Conclusions Decreases in operating lung volumes after the inhalation of bronchodilators are associated with faster 'central' cardiovascular adjustments to high-intensity exercise with beneficial consequences on muscle oxygenation in patients with moderate to severe COPD. |
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Bronchodilators accelerate the dynamics of muscle O-2 delivery and utilisation during exercise in COPDBackground Expiratory flow limitation and lung hyperinflation promote cardiocirculatory perturbations that might impair O-2 delivery to locomotor muscles in patients with chronic obstructive pulmonary disease (COPD). the hypothesis that decreases in lung hyperinflation after the inhalation of bronchodilators would improve skeletal muscle oxygenation during exercise was tested.Methods Twelve non-or mildly hypoxaemic males (forced expiratory volume in 1 s (FEV1)=38.5+/-12.9% predicted; Pao(2)>60 mm Hg) underwent constant work rate cycle ergometer exercise tests (70-80% peak) to the limit of tolerance (Tlim) after inhaled bronchodilators (salbutamol plus ipratropium) or placebo. Muscle (de) oxygenation (similar to fractional O-2 extraction) was determined in the vastus lateralis by changes (Delta) in the deoxyhaemoglobin/myoglobin signal ([HHb]) from near-infrared spectroscopy, and cardiac output (QT) was monitored by impedance cardiography.Results Bronchodilators reduced lung hyperinflation and increased Tlim compared with placebo (454+/-131 s vs 321+/-140 s, respectively; p<0.05). On-exercise kinetics of QT and pulmonary O-2 uptake ((V) over doto(2)) were accelerated with active treatment; Delta[HHb] dynamics, however, were delayed by similar to 78% and the signal amplitude diminished by similar to 21% (p<0.01). Consequently, the ratio between (V) over doto(2) and Delta[HHb] dynamics decreased, suggesting improved microvascular O-2 delivery (tau-(V) over doto(2)/MRT-Delta [HHb]=4.48+/-1.57 s vs 2.08+/-1.15 s, p<0.05). of note, reductions in lung hyperinflation were related to faster QT kinetics and larger decrements in tau-(V) over doto(2)/MRT-Delta[HHb] (p<0.01).Conclusions Decreases in operating lung volumes after the inhalation of bronchodilators are associated with faster 'central' cardiovascular adjustments to high-intensity exercise with beneficial consequences on muscle oxygenation in patients with moderate to severe COPD.Fed Univ São Paulo UNIFESP, Dept Med, Pulm Funct & Clin Exercise Physiol Unit SEFICE, Div Resp Dis, BR-04020050 São Paulo, BrazilUniv Kentucky, Dept Physiol, Lexington, KY USAFed Univ São Paulo UNIFESP, Dept Med, Pulm Funct & Clin Exercise Physiol Unit SEFICE, Div Resp Dis, BR-04020050 São Paulo, BrazilWeb of ScienceCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)B M J Publishing GroupUniversidade Federal de São Paulo (UNIFESP)Univ KentuckyBerton, Danilo C. [UNIFESP]Barbosa, Priscila B. [UNIFESP]Takara, Luciana S. [UNIFESP]Chiappa, Gaspar R. [UNIFESP]Siqueira, Ana Cristina B. [UNIFESP]Bravo, Daniela M. [UNIFESP]Ferreira, Leonardo F.Neder, J. Alberto [UNIFESP]2016-01-24T13:59:49Z2016-01-24T13:59:49Z2010-07-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion588-593http://dx.doi.org/10.1136/thx.2009.120857Thorax. London: B M J Publishing Group, v. 65, n. 7, p. 588-593, 2010.10.1136/thx.2009.1208570040-6376http://repositorio.unifesp.br/handle/11600/32650WOS:000279806400008engThoraxinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2021-09-30T17:26:14Zoai:repositorio.unifesp.br/:11600/32650Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652021-09-30T17:26:14Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Bronchodilators accelerate the dynamics of muscle O-2 delivery and utilisation during exercise in COPD |
title |
Bronchodilators accelerate the dynamics of muscle O-2 delivery and utilisation during exercise in COPD |
spellingShingle |
Bronchodilators accelerate the dynamics of muscle O-2 delivery and utilisation during exercise in COPD Berton, Danilo C. [UNIFESP] |
title_short |
Bronchodilators accelerate the dynamics of muscle O-2 delivery and utilisation during exercise in COPD |
title_full |
Bronchodilators accelerate the dynamics of muscle O-2 delivery and utilisation during exercise in COPD |
title_fullStr |
Bronchodilators accelerate the dynamics of muscle O-2 delivery and utilisation during exercise in COPD |
title_full_unstemmed |
Bronchodilators accelerate the dynamics of muscle O-2 delivery and utilisation during exercise in COPD |
title_sort |
Bronchodilators accelerate the dynamics of muscle O-2 delivery and utilisation during exercise in COPD |
author |
Berton, Danilo C. [UNIFESP] |
author_facet |
Berton, Danilo C. [UNIFESP] Barbosa, Priscila B. [UNIFESP] Takara, Luciana S. [UNIFESP] Chiappa, Gaspar R. [UNIFESP] Siqueira, Ana Cristina B. [UNIFESP] Bravo, Daniela M. [UNIFESP] Ferreira, Leonardo F. Neder, J. Alberto [UNIFESP] |
author_role |
author |
author2 |
Barbosa, Priscila B. [UNIFESP] Takara, Luciana S. [UNIFESP] Chiappa, Gaspar R. [UNIFESP] Siqueira, Ana Cristina B. [UNIFESP] Bravo, Daniela M. [UNIFESP] Ferreira, Leonardo F. Neder, J. Alberto [UNIFESP] |
author2_role |
author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) Univ Kentucky |
dc.contributor.author.fl_str_mv |
Berton, Danilo C. [UNIFESP] Barbosa, Priscila B. [UNIFESP] Takara, Luciana S. [UNIFESP] Chiappa, Gaspar R. [UNIFESP] Siqueira, Ana Cristina B. [UNIFESP] Bravo, Daniela M. [UNIFESP] Ferreira, Leonardo F. Neder, J. Alberto [UNIFESP] |
description |
Background Expiratory flow limitation and lung hyperinflation promote cardiocirculatory perturbations that might impair O-2 delivery to locomotor muscles in patients with chronic obstructive pulmonary disease (COPD). the hypothesis that decreases in lung hyperinflation after the inhalation of bronchodilators would improve skeletal muscle oxygenation during exercise was tested.Methods Twelve non-or mildly hypoxaemic males (forced expiratory volume in 1 s (FEV1)=38.5+/-12.9% predicted; Pao(2)>60 mm Hg) underwent constant work rate cycle ergometer exercise tests (70-80% peak) to the limit of tolerance (Tlim) after inhaled bronchodilators (salbutamol plus ipratropium) or placebo. Muscle (de) oxygenation (similar to fractional O-2 extraction) was determined in the vastus lateralis by changes (Delta) in the deoxyhaemoglobin/myoglobin signal ([HHb]) from near-infrared spectroscopy, and cardiac output (QT) was monitored by impedance cardiography.Results Bronchodilators reduced lung hyperinflation and increased Tlim compared with placebo (454+/-131 s vs 321+/-140 s, respectively; p<0.05). On-exercise kinetics of QT and pulmonary O-2 uptake ((V) over doto(2)) were accelerated with active treatment; Delta[HHb] dynamics, however, were delayed by similar to 78% and the signal amplitude diminished by similar to 21% (p<0.01). Consequently, the ratio between (V) over doto(2) and Delta[HHb] dynamics decreased, suggesting improved microvascular O-2 delivery (tau-(V) over doto(2)/MRT-Delta [HHb]=4.48+/-1.57 s vs 2.08+/-1.15 s, p<0.05). of note, reductions in lung hyperinflation were related to faster QT kinetics and larger decrements in tau-(V) over doto(2)/MRT-Delta[HHb] (p<0.01).Conclusions Decreases in operating lung volumes after the inhalation of bronchodilators are associated with faster 'central' cardiovascular adjustments to high-intensity exercise with beneficial consequences on muscle oxygenation in patients with moderate to severe COPD. |
publishDate |
2010 |
dc.date.none.fl_str_mv |
2010-07-01 2016-01-24T13:59:49Z 2016-01-24T13:59:49Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1136/thx.2009.120857 Thorax. London: B M J Publishing Group, v. 65, n. 7, p. 588-593, 2010. 10.1136/thx.2009.120857 0040-6376 http://repositorio.unifesp.br/handle/11600/32650 WOS:000279806400008 |
url |
http://dx.doi.org/10.1136/thx.2009.120857 http://repositorio.unifesp.br/handle/11600/32650 |
identifier_str_mv |
Thorax. London: B M J Publishing Group, v. 65, n. 7, p. 588-593, 2010. 10.1136/thx.2009.120857 0040-6376 WOS:000279806400008 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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Thorax |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
588-593 |
dc.publisher.none.fl_str_mv |
B M J Publishing Group |
publisher.none.fl_str_mv |
B M J Publishing Group |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
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1814268441441337344 |