RSS-Feed abonnieren
DOI: 10.1055/s-2005-865823
© Georg Thieme Verlag KG Stuttgart · New York
Oxygen Uptake Kinetics During Heavy Submaximal Exercise: Effect of Sickle Cell Trait With or Without Alpha-Thalassemia
Publikationsverlauf
Accepted after revision: June 4, 2005
Publikationsdatum:
30. August 2005 (online)
![](https://www.thieme-connect.de/media/sportsmed/200607/lookinside/thumbnails/10.1055-s-2005-865823-1.jpg)
Abstract
Sickle cell trait (SCT) is a genetic disease affecting the synthesis of normal hemoglobin (Hb) marked by the heterozygous presence of HbA and HbS. It is thought that exercise tolerance and aerobic capacity could be limited in SCT carriers, but that the co-existence of α-thalassemia with SCT (SCTAT) could improve exercise response. To examine these issues, we compared the characteristics of V·O2 kinetics during a constant heavy exercise among athletes carrying either the SCT (n = 6), the SCTAT (n = 9), or the normal Hb (control group; n = 10). After determination of maximal power output (Ppeak), all subjects underwent a constant heavy cycling exercise lasting 9 min at ∼ 70 % Ppeak. Pulmonary V·O2 and cardio-respiratory parameters were measured breath-by-breath and the V·O2 response was modelled using non-linear regression techniques. The time constant of the V·O2 primary component and oxygen deficit were not significantly different among the three groups. The V·O2 slow component was 28 % and 33 % higher (p < 0.05) in SCT and SCTAT than in the control groups, respectively. Altogether, athletes with the SCT and the SCTAT had higher heart rate at the beginning (+ 5.2 %) and the end (+ 7.4 %) of the slow component compared to the control group (p < 0.05). These results suggest that SCT and SCTAT subjects are not limited during the first exercise minutes, but are prone to exercise intolerance and to lower aerobic capacity thereafter, due to a higher V·O2 slow component, and that α-thalassemia does not improve exercise response. The finding of a higher slow component in SCT and SCTAT athletes was possibly due to the loss of O2 availability to muscles, additional fiber recruitment and/or higher cardiac load with time.
Key words
Slow component of oxygen uptake - hemoglobinopathies - exercise tolerance and aerobic capacity
References
- 1 Barstow T J, Casaburi R, Wasserman K. O2 uptake kinetics and the O2 deficit as related to exercise intensity and blood lactate. J Appl Physiol. 1993; 75 755-762
- 2 Barstow T J, Jones A M, Nguyen P H, Casaburi R. Influence of muscle fiber type and pedal frequency on oxygen uptake kinetics of heavy exercise. J Appl Physiol. 1996; 81 1642-1650
- 3 Barstow T J, Mole P A. Linear and nonlinear characteristics of oxygen uptake kinetics during heavy exercise. J Appl Physiol. 1991; 71 2099-2106
- 4 Bauer T A, Brass E P, Nehler M, Barstow T J, Hiatt W R. Pulmonary V·O2 dynamics during treadmill and arm exercise in peripheral arterial disease. J Appl Physiol. 2004; 97 627-634
- 5 Bearden S E, Moffatt R J. VO(2) slow component: to model or not to model?. Med Sci Sports Exerc. 2001; 33 677-680
- 6 Bile A, Le Gallais D, Mercier B, Martinez P, Ahmaidi S, Prefaut C, Mercier J. Blood lactate concentrations during incremental exercise in subjects with sickle cell trait. Med Sci Sports Exerc. 1998; 30 649-654
- 7 Bookchin R M, Lew V L. Pathophysiology of sickle cell anemia. Hematol Oncol Clin North Am. 1996; 10 1241-1253
- 8 Borrani F, Candau R, Millet G Y, Perrey S, Fuchslocher J, Rouillon J D. Is the V·O2 slow component dependent on progressive recruitment of fast-twitch fibers in trained runners?. J Appl Physiol. 2001; 90 2212-2220
- 9 Brandao M M, Fontes A, Barjas-Castro M L, Barbosa L C, Costa F F, Cesar C L, Saad S T. Optical tweezers for measuring red blood cell elasticity: application to the study of drug response in sickle cell disease. Eur J Haematol. 2003; 70 207-211
- 10 Cerretelli P, Grassi B, Colombini A, Caru B, Marconi C. Gas exchange and metabolic transients in heart transplant recipients. Respir Physiol. 1988; 74 355-371
- 11 Chong S S, Boehm C D, Higgs D R, Cutting G R. Single-tube multiplex-PCR screen for common deletional determinants of alpha-thalassemia. Blood. 2000; 95 360-362
- 12 Cleuziou C, Perrey S, Lecoq A M, Candau R, Courteix D, Obert P. Oxygen uptake kinetics during moderate and heavy intensity exercise in humans: the influence of hypoxia and training status. Int J Sports Med. in Press
- 13 Coast J R, Rasmussen S A, Krause K M, O'Kroy J A, Loy R A, Rhodes J. Ventilatory work and oxygen consumption during exercise and hyperventilation. J Appl Physiol. 1993; 74 793-798
- 14 Crow M T, Kushmerick M J. Chemical energetics of slow- and fast-twitch muscles of the mouse. J Gener Physiol. 1982; 79 147-166
- 15 Freund H, Lonsdorfer J, Oyono-Enguelle S, Lonsdorfer A, Bogui P. Lactate exchange and removal abilities in sickle cell patients and in untrained and trained healthy humans. J Appl Physiol. 1992; 73 2580-2587
- 16 Freund H, Lonsdorfer J, Oyono-Enguelle S, Lonsdorfer A, Dah C, Bogui P. Lactate exchange and removal abilities in sickle cell trait carriers during and after incremental exercise. Int J Sports Med. 1995; 16 428-434
- 17 Gaesser G A, Poole D C. The slow component of oxygen uptake kinetics in humans. Exerc Sport Sci Rev. 1996; 24 35-71
- 18 Gozal D, Thiriet P, Mbala E, Wouassi D, Gelas H, Geyssant A, Lacour J R. Effect of different modalities of exercise and recovery on exercise performance in subjects with sickle cell trait. Med Sci Sports Exerc. 1992; 24 1325-1331
- 19 Grassi B. Skeletal muscle VO2 on-kinetics: set by O2 delivery or by O2 utilization? New insights into an old issue. Med Sci Sports Exerc. 2000; 32 108-116
- 20 Harkness D R. Sickle cell trait revisited. Am J Med. 1989; 87 30-34
- 21 Hepple R T, Liu P P, Plyley M J, Goodman J M. Oxygen uptake kinetics during exercise in chronic heart failure: influence of peripheral vascular reserve. Clin Sci. 1999; 97 569-577
- 22 Hofrichter J, Ross P D, Eaton W A. Kinetics and mechanism of deoxyhemoglobin S relation: a new approach to understanding sickle cell disease. Proc Natl Acad Sci USA. 1974; 71 4864-4868
- 23 Jones A M, Wilkerson D P, Koppo K, Wilmshurst S, Campbell I T. Inhibition of nitric oxide synthase by L-NAME speeds phase II pulmonary. V·O2 kinetics in the transition to moderate-intensity exercise in man. J Physiol. 2003; 552 265-272
- 24 Kark J A, Posey D M, Schumacher H R, Ruehle C J. Sickle-cell trait as a risk factor for sudden death in physical training. N Engl J Med. 1987; 317 781-787
- 25 Kaul D K, Nagel R L. Sickle cell vasoocclusion: many issues and some answers. Experientia. 1993; 49 5-15
- 26 Koga S, Shiojiri T, Shibasaki M, Kondo N, Fukuba Y, Barstow T J. Kinetics of oxygen uptake during supine and upright heavy exercise. J Appl Physiol. 1999; 87 253-260
- 27 Lamarra N, Whipp B J, Ward S A, Wasserman K. Effect of interbreath fluctuations on characterizing exercise gas exchange kinetics. J Appl Physiol. 1987; 62 2003-2012
- 28 Le Gallais D, Lonsdorfer A, Buguet J P, Daures J, Mercier J, Macabies J, Prefaut C. Aptitude physique des porteurs du trait drépanocytaire. Sci Sports. 1987; 2 269-277
- 29 Le Gallais D, Prefaut C, Dulat C, Macabies J, Lonsdorfer J. Sickle cell trait in Ivory Coast athletic champions, 1956 - 1989. Int J Sports Med. 1991; 12 509-510
- 30 Le Gallais D, Prefaut C, Mercier J, Bile A, Bogui P, Lonsdorfer J. Sickle cell trait as a limiting factor for high-level performance in a semi-marathon. Int J Sports Med. 1994; 15 399-402
- 31 May A, Huehns E R. The concentration dependence of the oxygen affinity of haemoglobin S. Br J Haematol. 1975; 30 317-335
- 32 Motulsky H J, Ransnas L A. Fitting curves to data using nonlinear regression: a practical and nonmathematical review. FASEB J. 1987; 1 365-374
- 33 Noguchi C T, Rodgers G P, Schechter A N. Intracellular polymerization. Disease severity and therapeutic predictions. Ann NY Acad Sci. 1989; 565 75-82
- 34 Noguchi C T, Torchia D A, Schechter A N. Determination of deoxyhemoglobin S polymer in sickle erythrocytes upon deoxygenation. Proc Natl Acad Sci USA. 1980; 77 5487-5491
- 35 Okamoto T, Kanazawa H, Hirata K, Yoshikawa J. Evaluation of oxygen uptake kinetics and oxygen kinetics of peripheral skeletal muscle during recovery from exercise in patients with chronic obstructive pulmonary disease. Clin Physiol Funct Imaging. 2003; 23 257-262
- 36 Ozyener F, Rossiter H B, Ward S A, Whipp B J. Influence of exercise intensity on the on- and off-transient kinetics of pulmonary oxygen uptake in humans. J Physiol. 2001; 533 891-902
- 37 Perrey S, Betik A, Candau R, Rouillon J D, Hughson R L. Comparison of oxygen uptake kinetics during concentric and eccentric cycle exercise. J Appl Physiol. 2001; 91 2135-2142
- 38 Poillon W N, Kim B C, Labotka R J, Hicks C U, Kark J A. Antisickling effects of 2,3-diphosphoglycerate depletion. Blood. 1995; 85 3289-3296
- 39 Poole D C, Barstow T J, Gaesser G A, Willis W T, Whipp B J. V·O2 slow component: physiological and functional significance. Med Sci Sports Exerc. 1994; 26 1354-1358
- 40 Poole D C, Schaffartzik W, Knight D R, Derion T, Kennedy B, Guy H J, Prediletto R, Wagner P D. Contribution of excising legs to the slow component of oxygen uptake kinetics in humans. J Appl Physiol. 1991; 71 1245-1260
- 41 Pringle J S, Doust J H, Carter H, Tolfrey K, Jones A M. Effect of pedal rate on primary and slow-component oxygen uptake responses during heavy-cycle exercise. J Appl Physiol. 2003; 94 1501-1507
- 42 Regensteiner J G, Bauer T A, Reusch J E, Brandenburg S L, Sippel J M, Vogelsong A M, Smith S, Wolfel E E, Eckel R H, Hiatt W R. Abnormal oxygen uptake kinetic responses in women with type II diabetes mellitus. J Appl Physiol. 1998; 85 310-317
- 43 Rossiter H B, Ward S A, Howe F A, Kowalchuk J M, Griffiths J R, Whipp B J. Dynamics of intramuscular 31 P - MRS P(i) peak splitting and the slow components of PCr and O2 uptake during exercise. J Appl Physiol. 2002; 93 2059-2069
- 44 Sara F, Hardy-Dessources M D, Voltaire B, Etienne-Julan M, Hue O. Lactic response in sickle cell trait carriers in comparison with subjects with normal hemoglobin. Clin J Sport Med. 2003; 13 96-101
- 45 Scheuermann B W, Hoelting B D, Noble M L, Barstow T J. The slow component of O(2) uptake is not accompanied by changes in muscle EMG during repeated bouts of heavy exercise in humans. J Physiol. 2001; 531 245-256
- 46 Serjeant B E, Mason K P, Kenny M W, Stuart J, Higgs D R, Weatherall D J, Hayes R J, Serjeant G R. Effect of alpha thalassaemia on the rheology of homozygous sickle cell disease. Br J Haematol. 1983; 55 479-486
- 47 Shinohara M, Moritani T. Increase in neuromuscular activity and oxygen uptake during heavy exercise. Ann Physiol Anthropol. 1992; 11 257-262
- 48 Steinberg M H, Dreiling B J, Morrison F S, Necheles T F. Mild sickle cell disease. Clinical and laboratory studies. JAMA. 1973; 224 317-321
- 49 Thiriet P, Gozal D, Wouassi D, Oumarou T, Gelas H, Lacour J R. The effect of various recovery modalities on subsequent performance, in consecutive supramaximal exercise. J Sports Med Phys Fitness. 1993; 33 118-129
- 50 Tschakovsky M E, Hughson R L. Interaction of factors determining oxygen uptake at the onset of exercise. J Appl Physiol. 1999; 86 1101-1113
- 51 Ueda Y, Bookchin R M. Effects of carbon dioxide and pH variations in vitro on blood respiratory functions, red blood cell volume, transmembrane pH gradients, and sickling in sickle cell anemia. J Lab Clin Med. 1984; 104 146-159
- 52 Whipp B J. The slow component of O2 uptake kinetics during heavy exercise. Med Sci Sports Exerc. 1994; 26 1319-1326
- 53 Whipp B J, Davis J A, Torres F, Wasserman K. A test to determine parameters of aerobic function during exercise. J Appl Physiol. 1981; 50 217-221
- 54 Whipp B J, Ward S A. Pulmonary gas exchange dynamics and the tolerance to muscular exercise: effects of fitness and training. Ann Physiol Anthropol. 1992; 11 207-214
- 55 Whipp B J, Ward S A, Lamarra N, Davis J A, Wasserman K. Parameters of ventilatory and gas exchange dynamics during exercise. J Appl Physiol. 1982; 52 1506-1513
- 56 Whipp B J, Wasserman K. Oxygen uptake kinetics for various intensities of constant-load work. J Appl Physiol. 1972; 33 351-356
- 57 Wilkerson D P, Koppo K, Barstow T J, Jones A M. Effect of work rate on the functional “gain” of Phase II pulmonary O2 uptake response to exercise. Respir Physiol Neurobiol. 2004; 142 211-223
PhD P. Connes
EA 647 «Centre de Recherche et d'Innovation sur le Sport», Faculté des Sciences du Sport de Lyon, Université Claude Bernard Lyon 1
69622 Villeurbanne
France
eMail: pconnes@yahoo.fr