Comparaison de la performance à l’exercice de patients souffrant d’insuffisance cardiaque sévère à une épreuve d’effort maximal, une épreuve sous-maximale et un test de marche

L’insuffisance cardiaque est une pathologie provoquant une diminution importante des capacités fonctionnelles des patients ainsi qu’une diminution drastique de la qualité de vie. L’évaluation des capacités fonctionnelles est généralement effectuée par une épreuve d’effort maximal. Cependant pour plusieurs patients, cet effort est difficile à compléter. Les objectifs de l’étude présentée dans ce mémoire sont : (1) valider trois méthodes d’évaluation de la capacité fonctionnelle et aérobie des sujets souffrant d’insuffisance cardiaque avec un complexe QRS élargi; (2) chercher à établir le profil des patients démontrant une meilleure tolérance à l’exercice malgré une consommation maximale d’oxygène identique; et (3) démontrer les conséquences de la présence et de la magnitude de l’asynchronisme cardiaque dans la capacité fonctionnelle et la tolérance à l’exercice. Tous les sujets ont été soumis à un test de marche de six minutes, un test d’endurance à charge constante sur tapis roulant et à une épreuve d’effort maximal avec mesure d’échanges gazeux à la bouche. Les résultats ont montré une association significative entre les épreuves maximale et plus spécifiquement sous-maximale. De plus, une meilleure tolérance à l’exercice serait associée significativement à une plus grande masse du ventricule gauche. Finalement, les résultats de notre étude n’ont pas montré d’effet d’un asynchronisme cardiaque sur la performance à l’effort tel qu’évalué par nos protocoles.

A comparison of two time-domain analysis procedures in the determination of VO2 kinetics by pseudorandom binary sequence exercise testing

The purpose of this study was to apply and compare two time-domain analysis procedures in the determination of oxygen uptake (VO2) kinetics in response to a pseudorandom binary sequence (PRBS) exercise test. PRBS exercise tests have typically been analysed in the frequency domain. However, the complex interpretation of frequency responses may have limited the application of this procedure in both sporting and clinical contexts, where a single time measurement would facilitate subject comparison. The relative potential of both a mean response time (MRT) and a peak cross-correlation time (PCCT) was investigated. This study was divided into two parts: a test-retest reliability study (part A), in which 10 healthy male subjects completed two identical PRBS exercise tests, and a comparison of the VO2 kinetics of 12 elite endurance runners (ER) and 12 elite sprinters (SR; part B). In part A, 95% limits of agreement were calculated for comparison between MRT and PCCT. The results of part A showed no significant difference between test and retest as assessed by MRT [mean (SD) 42.2 (4.2) s and 43.8 (6.9) s] or by PCCT [21.8 (3.7) s and 22.7 (4.5) s]. Measurement error (%) was lower for MRT in comparison with PCCT (16% and 25%, respectively). In part B of the study, the VO2 kinetics of ER were significantly faster than those of SR, as assessed by MRT [33.4 (3.4) s and 39.9 (7.1) s, respectively; P<0.01] and PCCT [20.9 (3.8) s and 24.8 (4.5) s; P < 0.05]. It is possible that either analysis procedure could provide a single test measurement Of VO2 kinetics; however, the greater reliability of the MRT data suggests that this method has more potential for development in the assessment Of VO2 kinetics by PRBS exercise testing.

The effect of a perceptual cognitive task on exercise performance: the dual-task condition after brain injury

Objective: To examine the effect of additional cognitive demand on cycling performance in individuals with acquired brain injury (ABI). Design: Prospective observational study. Setting: Rivermead Rehabilitation Centre. Participants: Ten individuals with ABI ( 7 men, 3 women) ( traumatic brain injury 7, tumour 1, stroke 2) and 10 healthy controls ( 6 men, 4 women). Intervention: Individuals were asked to maintain a set cadence during a three-stage incremental cycling test in both single-task ( no additional task) and dual-task ( whilst performing an additional cognitive task) conditions. Results: The ABI group showed a slight slowing in cadence in stages 1 and 3 of the graded exercise test from the single-to the dual-task condition, although this was not significant ( p less than or equal to 0.05). The control group showed no slowing of cadence at any incremental stage. When directly comparing the ABI with the control group, the change in cadence observed in dual-task conditions was only significantly different in stage 3 ( p less than or equal to 0.05). Conclusions: Clinicians should be aware of the possibility that giving additional cognitive tasks ( such as monitoring exercise intensity) while individuals with acquired brain injury are performing exercises may detrimentally affect performance. The effect may be more marked when the individuals are performing exercise at higher intensities.

Aminophylline affects glycemia control and increases anaerobic glycolysis in horses during incremental exercise

A study was conducted on the effects of acute administration of aminophylline on physiological variables in purebred Arabian horses submitted to incremental exercise test. Twelve horses were submitted to two physical tests separated by a 10-day interval in a crossover study. These horses were divided into two groups: control (C, n = 12) and aminophylline (AM, n = 12). The drug at 10 mg/kg body weight or saline was given intravenously, 30 minutes before the incremental exercise test. The treadmill exercise test consisted of an initial warmup followed by gradually increasing physical exigency. Blood samples were assayed for lactic acid, glucose, and insulin. Maximal lactic acidemia was greater (P = .0238) in the AM group. Both V-2 and V-4 (velocities at which lactate concentrations were 2 and 4 mmol/ L, respectively) were reduced in the AM group by 15.85% (P = .0402) and 17.76% (P = .0 109), respectively. At rest as well as at 4 minutes, insulinemia was greater in the AM group (P = .0417 and .0393), Glycemia group at times 8 was statistically lower in the Al (P = .0138) and 10 minutes (P = .0432). Use of ammophylline in horses during incremental exercise does not seem to be beneficial, because this drug has a tendency to cause hypoglycemia and to increase dependence on anaerobic glucose metabolism.

Determination of anaerobic threshold in rats using the lactate minimum test

The break point of the curve of blood lactate vs exercise load has been called anaerobic threshold (AT) and is considered to be an important indicator of endurance exercise capacity in human subjects. There are few studies of AT determination in animals. We describe a protocol for AT determination by the lactate minimum test in rats during swimming exercise. The test is based on the premise that during an incremental exercise test, and after a bout of maximal exercise, blood lactate decreases to a minimum and then increases again. This minimum value indicates the intensity of the AT. Adult male (90 days) Wistar rats adapted to swimming for 2 weeks were used. The initial state of lactic acidosis was obtained by making the animals jump into the water and swim while carrying a load equivalent to 50% of body weight for 6 min (30-s exercise interrupted by a 30-s rest). After a 9-min rest, blood was collected and the incremental swimming test was started. The test consisted of swimming while supporting loads of 4.5, 5.0, 5.5, 6.0 and 7.0% of body weight. Each exercise load lasted 5 min and was followed by a 30-s rest during which blood samples were taken. The blood lactate minimum was determined from a zero-gradient tangent to a spline function fitting the blood lactate vs workload curve. AT was estimated to be 4.95 ± 0.10% of body weight while interpolated blood lactate was 7.17 ± 0.16 mmol/l. These results suggest the application of AT determination in animal studies concerning metabolism during exercise.

Predicting MAOD Using Only a Supramaximal Exhaustive Test

The objective of this study was to propose an alternative method (MAOD(ALT)) to estimate the maximal accumulated oxygen deficit (MAOD) using only one supramaximal exhaustive test. Nine participants performed the following tests: (a) a maximal incremental exercise test, (b) six submaximal constant workload tests, and (c) a supramaximal constant workload test. Traditional MAOD was determined by calculating the difference between predicted O(2) demand and accumulated O(2) uptake during the supramaximal test. MAOD(ALT) was established by summing the fast component of excess post-exercise oxygen consumption and the O(2) equivalent for energy provided by blood lactate accumulation, both of which were measured during the supramaximal test. There was no significant difference between MAOD (2.82 +/- 0.45 L) and MAOD(ALT) (2.77 +/- 0.37 L) (p = 0.60). The correlation between MAOD and MAOD(ALT) was also high (r = 0.78; p = 0.014). These data indicate that the MAOD(ALT) can be used to estimate the MAOD.

Effects of Exercise Training on Hippocampus Concentrations of Insulin and IGF-1 in Diabetic Rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effects of caffeine on time to exhaustion in exercise performed below and above the anaerobic threshold

Controversy still exists concerning the potential ergogenic benefit of caffeine (CAF) for exercise performance. The purpose of this study was to compare the effects of CAF ingestion on endurance performance during exercise on a bicycle ergometer at two different intensities, i.e., approximately 10% below and 10% above the anaerobic threshold (AT). Eight untrained males, non-regular consumers of CAF, participated in this study. AT, defined as the intensity (watts) corresponding to a lactate concentration of 4 mM, was determined during an incremental exercise test from rest to exhaustion on an electrically braked cycle ergometer. on the basis of these measurements, the subjects were asked to cycle until exhaustion at two different intensities, i.e., approximately 10% below and 10% above AT. Each intensity was performed twice in a double-blind randomized order by ingesting either CAF (5 mg/kg) or a placebo (PLA) 60 min prior to the test. Venous blood was analyzed for free fatty acid, glucose, and lactate, before, during, and immediately after exercise. Rating of perceived exertion and time to exhaustion were also measured during each trial. There were no differences in free fatty acids or lactate levels between CAF and PLA during and immediately after exercise for either intensity. Immediately after exercise glucose increased in the CAF trial at both intensities. Rating of perceived exertion was significantly lower (CAF = 14.1 ± 2.5 vs PLA = 16.6 ± 2.4) and time to exhaustion was significantly higher (CAF = 46.54 ± 8.05 min vs PLA = 32.42 ± 14.81 min) during exercise below AT with CAF. However, there was no effect of CAF treatment on rating of perceived exertion (CAF = 18.0 ± 2.7 vs PLA = 17.6 ± 2.3) and time to exhaustion (CAF = 18.45 ± 7.28 min vs PLA = 19.17 ± 4.37 min) during exercise above AT. We conclude that in untrained subjects caffeine can improve endurance performance during prolonged exercise performed below AT and that the decrease of perceived exertion can be involved in this process

Non-exhaustive test for aerobic capacity determination in swimming rats

The aim of this study was to describe a double-bout exercise test for non-exhaustive aerobic capacity determination in swimming rats. Adult rats were Submitted to 4 swimming tests at different intensities (4%, 6%, 7%, and 8% of body mass), with intervals of 48 h between them. Two exercise bouts of equal intensity lasting 5 min were performed, separated by 2 min with blood collection for lactate analysis. For each intensity, delta lactate was determined by subtracting lactate concentration at the end of the first effort from the lactate at the end of the second effort. Individual linear interpolation of delta lactate concentration enabled determination of a null delta, equivalent to the critical load (CL). Maxima) lactate steady state (MLSS) was also determined. The estimated CL was of 4.8% body mass and the MLSS was observed at 100% of CL, with blood lactate of 5.20 mmol/L. At 90%, blood lactate stabilized, with a progressive increase to 110% CL. These results offer a potential determination of aerobic capacity in swimming rats.

The Lactate Minimum Test protocol provides valid measures of cycle ergometer VO2 peak

Aim. The aim of the present study was to investigate the validity of the Lactate Minimum Test (LMT) for the determination of peak VO2 on a cycle ergometer and to determine the submaximal oxygen uptake (VO2) and pulmonary ventilation (VE) responses in an incremental exercise test when it is preceded by high intensity exercise (i.e., during a LMT).Methods. Ten trained male athletes (triathletes and cyclists) performed 2 exercise tests in random order on an electromagnetic cycle ergometer: 1) Control Test (CT): an incremental test with an initial work rate of 100 W, and with 25 W increments at 3-min intervals, until voluntary exhaustion; 2) LMT: an incremental test identical to the CT, except that it was preceded by 2 supramaximal bouts of 30-sec (similar to120% VO(2)peak) with a 30-sec rest to induce lactic acidosis. This test started 8 min after the induction of acidosis.Results. There was no significant difference in peak VO2 (65.6+/-7.4 ml.kg(-1).min(-1); 63.8+/-7.5 ml.kg(-1).min(-1) to CT and LMT, respectively). However, the maximal power output (POmax) reached was significantly higher in CT (300.6+/-15.7 W) than in the LMT (283.2+/-16.0 W).VO2 and VE were significantly increased at initial power outputs in LMT.Conclusion. Although the LMT alters the submaximal physiological responses during the incremental phase (greater initial metabolic cost), this protocol is valid to evaluate peak VO2, although the POmax reached is also reduced.

Effect of an acute β-adrenergic blockade on exercise intensity corresponding to the lactate minimum

β-Adrenoreceptor blockade is reported to impair endurance, power output and work capacity in healthy subjects and patients with hypertension. The purpose of this study was to investigate the effect in eighth athletic males of an acute β-adrenergic blockade with propranolol on their individual power output corresponding to a defined lactate minimum (LM). Eight fit males (cyclist or triathlete) performed a protocol to determine the power output corresponding to their individual LM (defined from an incremental exercise test after a rapidly induced exercise lactic acidosis). This protocol was performed twice in a double-blind randomized order by each athlete first ingesting propranolol (80mg) and in a second trial a placebo, 120 minutes respectively prior to the test sequence. The blood lactate concentration obtained 7 minutes after anaerobic exercise (a Wingate test) was significantly lower after acute β-adrenergic blockade (8.6 ± 1.6mM) than under the placebo condition (11.7 ± 1.6mM). The work rate at the LM was lowered from 215.0 ± 18.6 to 184.0 ± 18.6 watts and heart rate at the LM was reduced from 165 ± 1.5 to 132 ± 2.2 beats/minute as a result of the blockade. There was a non-significant correlation (r = 0.29) between the power output at the LM with and without acute β-adrenergic blockade. In conclusion, since the intensity corresponding to the LM is related to aerobic performance, the results of the present study, are able to explain in part, the reduction in aerobic power output produced during β-adrenergic blockade.

The effect of eccentric strength training on heart rate and on its variability during isometric exercise in healthy older men

The purpose of this study was to investigate if chronic eccentric strength training (ST) affects heart rate (HR) and heart rate variability (HRV) during sub-maximal isometric voluntary contractions (SIVC). The training group (TG) (9 men, 62 ± 2) was submitted to ST (12 weeks, 2 days/week, 2 - 4 sets of 8-12 repetitions at 75-80% peak torque (PT). The control group (CG) (8 men, 64 ± 4) did not perform ST. The HR and the HRV (RMSSD index) were evaluated during SIVC of the knee extension (15, 30 and 40% of PT). ST increased the eccentric torque only in TG, but did not change the isometric PT and the duration of SIVC. During SIVC, the HR response pattern and the RMSSD index were similar for both groups in pre- and post-training evaluations. Although ST increased the eccentric torque in the TG, it did not generate changes in HR or HRV. © Springer-Verlag 2008.

Exercise at anaerobic threshold intensity and insulin secretion by isolated pancreatic islets of rats

To evaluate the effect of acute exercise and exercise training at the anaerobic threshold (AT) intensity on aerobic conditioning and insulin secretion by pancreatic islets, adult male Wistar rats were submitted to the lactate minimum test (LMT) for AT determination. Half of the animals were submitted to swimming exercise training (trained), 1 h/day, 5 days/week during 8 weeks, with an overload equivalent to the AT. The other half was kept sedentary. At the end of the experimental period, the rats were submitted to an oral glucose tolerance test and to another LMT. Then, the animals were sacrificed at rest or immediately after 20 minutes of swimming exercise at the AT intensity for pancreatic islets isolation. At the end of the experiment mean workload (% bw) at AT was higher and blood lactate concentration (mmol/L) was lower in the trained than in the control group. Rats trained at the AT intensity showed no alteration in the areas under blood glucose and insulin during OGTT test. Islet insulin content of trained rats was higher than in the sedentary rats while islet glucose uptake did not differ among the groups. The static insulin secretion in response to the high glucose concentration (16.7 mM) of the sedentary group at rest was lower than the sedentary group submitted to the acute exercise and the inverse was observed in relation to the trained groups. physical training at the AT intensity improved the aerobic condition and altered insulin secretory pattern by pancreatic islets. © 2010 Landes Bioscience.

Non-exhaustive test for aerobic capacity determination in running rats

A simple and applicable method for non-exhaustive aerobic evaluation in running rats is described. Wistar rats were submitted to running test at different velocities (10, 15, 20, 25 m/min) with 48 h recovery among them. At each velocity, the rats ran two bouts of 5 min with 2 min of rest between bouts. Blood samples were collected at the end of each bout for lactate determination. For each intensity, delta lactate was calculated and using deltas obtained by four tests, an individual linear interpolation was plotted. The y-intercept of linear interpolation was the null delta lactate equivalent to the critical velocity (CV). To verify the lactate stabilization at CV, the animals were submitted to 25 min of continuous exercise (15, 20, 25 m/min), with blood collection every 5 min. The estimated CV was 16.6±0.7 m/min, with significant linear regressions (R=0.90±0.03). The rats presented maximal lactate steady state (MLSS) at 3.9±0.4 mmol/L, at 20 m/min. The CV was less than MLSS but significantly correlated with this parameter (r=0.78). This non-exhaustive test seems to be valid for the aerobic evaluation of sedentary rats and this protocol underestimates the MLSS in 20%. This test seems to be the interesting method for the evaluation of rats submitted to acute exercise or physical training.

Low dose of dichloroacetate infusion reduces blood lactate after submaximal exercise in horses

The acute administration of an indirect activator of the enzyme pyruvate dehydroge-nase (PDH) in human athletes causes a reduction in blood lactate level during and after exercise. A single IV dose (2.5m.kg-1) of dichloroacetate (DCA) was administered before a submaximal incremental exercise test (IET) with five velocity steps, from 5.0 m.s-1 for 1 min to 6.0, 6.5, 7.0 and 7.5m.s-1 every 30s in four untrained mares. The blood collections were done in the period after exercise, at times 1, 3, 5, 10, 15 and 20 min. Blood lactate and glucose (mM) were determined electro-enzymatically utilizing a YSI 2300 automated analyzer. There was a 15.3% decrease in mean total blood lactate determined from the values obtained at all assessment times in both trials after the exercise. There was a decrease in blood lactate 1, 3, 5, 10, 15 and 20 min after exercise for the mares that received prior DCA treatment, with respective mean values of 6.31±0.90 vs 5.81±0.50, 6.45±1.19 vs 5.58±1.06, 6.07±1.56 vs 5.26±1.12, 4.88±1.61 vs 3.95±1.00, 3.66±1.41 vs 2.86±0.75 and 2.75±0.51 vs 2.04±0.30. There was no difference in glucose concentrations. By means of linear regression analysis, V140, V160, V180 and V200 were determined (velocity at which the rate heart is 140, 160, 180, and 200 beats/minute, respectively). The velocities related to heart rate did not differ, indicating that there was no ergogenic effect, but prior administration of a relatively low dose of DCA in mares reduced lactatemia after an IET.