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Int J Sports Med 2021; 42(01): 56-65
DOI: 10.1055/a-1179-6093
Training & Testing

Exercise with End-expiratory Breath Holding Induces Large Increase in Stroke Volume

Xavier Woorons 
1   URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Univ. Lille, Univ. Artois, Univ. Littoral Côte d’Opale, ULR 7369, LILLE, France
2   Association pour la Recherche et la Promotion de l'Entraînement en Hypoventilation, ARPEH, LILLE, France
,
Frederic Lemaitre
3   Faculte des Sciences du Sport, Université de Rouen, Rouen, France
,
Guido Claessen
4   Department of Cardiovascular Sciences , KU Leuven, Leuven, Belgium
,
Cloé Woorons
2   Association pour la Recherche et la Promotion de l'Entraînement en Hypoventilation, ARPEH, LILLE, France
,
Henri Vandewalle
5   UFR de Santé, Médecine et Biologie Humaine, Université Paris 13, Bobigny, France
› Author Affiliations Funding Information The authors declare that they received no funding for this work.
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Abstract

Eight well-trained male cyclists participated in two testing sessions each including two sets of 10 cycle exercise bouts at 150% of maximal aerobic power. In the first session, subjects performed the exercise bouts with end-expiratory breath holding (EEBH) of maximal duration. Each exercise bout started at the onset of EEBH and ended at its release (mean duration: 9.6±0.9 s; range: 8.6–11.1 s). At the second testing session, subjects performed the exercise bouts (same duration as in the first session) with normal breathing. Heart rate, left ventricular stroke volume (LVSV), and cardiac output were continuously measured through bio-impedancemetry. Data were analysed for the 4 s preceding and following the end of each exercise bout. LVSV (peak values: 163±33 vs. 124±17 mL, p<0.01) was higher and heart rate lower both in the end phase and in the early recovery of the exercise bouts with EEBH as compared with exercise with normal breathing. Cardiac output was generally not different between exercise conditions. This study showed that performing maximal EEBH during high-intensity exercise led to a large increase in LVSV. This phenomenon is likely explained by greater left ventricular filling as a result of an augmented filling time and decreased right ventricular volume at peak EEBH.

Key words

hypoxia - hypoventilation - hypoxaemia - cycling


Publication History

Received: 10 February 2020

Accepted: 04 May 2020

Article published online:
25 August 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
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  • References

  • 1 Woorons X. Hypoventilation Training, Push Your Limits!. 1st ed. Lille: Arpeh; 2014
    Google Scholar
  • 2 Yamamoto Y, Mutoh Y, Kobayashi H. et al. Effects of reduced frequency breathing on arterial hypoxemia during exercise. Eur J Appl Physiol Occup Physiol 1987; 56: 522-527
    CrossrefPubMedGoogle Scholar
  • 3 Woorons X, Mollard P, Pichon A. et al. Prolonged expiration down to residual volume leads to severe arterial hypoxemia in athletes during submaximal exercise. Respir Physiol Neurobiol 2007; 15: 75-82
    CrossrefPubMedGoogle Scholar
  • 4 Woorons X, Bourdillon N, Lamberto C. et al. Cardiovascular responses during hypoventilation at exercise. Int J Sports Med 2011; 32: 438-445
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Woorons X, Bourdillon N, Vandewalle H. et al. Exercise with hypoventilation induces lower muscle oxygenation and higher blood lactate concentration: Role of hypoxia and hypercapnia. Eur J Appl Physiol 2010; 110: 367-377
    CrossrefPubMedGoogle Scholar
  • 6 Woorons X, Mucci P, Aucouturier J. et al. Acute effects of repeated cycling sprints in hypoxia induced by voluntary hypoventilation. Eur J Appl Physiol 2017; 117: 2433-2443
    CrossrefPubMedGoogle Scholar
  • 7 Kume D, Akahoshi S, Yamagata T. et al. Does voluntary hypoventilation during exercise impact EMG activity?. Springerplus 2016; 5: 149
    CrossrefPubMedGoogle Scholar
  • 8 Woorons X, Dupuy O, Mucci P. et al. Cerebral and muscle oxygenation during repeated shuttle run sprints with hypoventilation. Int J Sports Med 2019; 40: 376-384
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Convertino VA. Mechanisms of inspiration that modulate cardiovascular control: The other side of breathing. J Appl Physiol (1985) 2019; 127: 1187-1196
    CrossrefPubMedGoogle Scholar
  • 10 Woorons X, Millet GP, Mucci P. Physiological adaptations to repeated sprint training in hypoxia induced by voluntary hypoventilation at low lung volume. Eur J Appl Physiol 2019; 119: 1959-1970
    CrossrefPubMedGoogle Scholar
  • 11 Whipp BJ, Higgenbotham MB, Cobb FC. Estimating exercise stroke volume from asymptotic oxygen pulse in humans. J Appl Physiol (1985) 1996; 81: 2674-2679
    CrossrefPubMedGoogle Scholar
  • 12 Harriss DJ, Macsween A, Atkinson G. Ethical standards in sport and exercise science research: 2020 update. Int J Sports Med 2019; 40: 813-817
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Wainwright B, Cooke CB, O'Hara JP. The validity and reliability of a sample of 10 Wattbike cycle ergometers. J Sports Sci 2017; 35: 1451-1458
    CrossrefPubMedGoogle Scholar
  • 14 Costa VP, Matos DG, Pertence LC. et al. Reproducibility of cycling time to exhaustion at VO2max in competitive cyclists. JEP online 2011; 14: 28-34
    PubMedGoogle Scholar
  • 15 Charloux A, Lonsdorfer-Wolf E, Richard R. et al. New impedance cardiograph device for the non-invasive evaluation of cardiac output at rest and during exercise: comparison with the “direct” Fick method. Eur J Appl Physiol 2000; 85: 313-320
    CrossrefPubMedGoogle Scholar
  • 16 Richard R, Lonsdorfer-Wolf E, Charloux A. et al. Non-invasive cardiac output evaluation during a maximal progressive exercise test, using a new impedance cardiograph device. Eur J Appl Physiol 2001; 85: 202-207
    CrossrefPubMedGoogle Scholar
  • 17 Welsman J, Bywater K, Farr C. et al. Reliability of peak VO2 and maximal cardiac output assessed using thoracic bioimpedance in children. Eur J Appl Physiol 2005; 94: 228-234
    CrossrefPubMedGoogle Scholar
  • 18 Amann M, Romer LM, Subudhi AW. et al. Severity of arterial hypoxaemia affects the relative contributions of peripheral muscle fatigue to exercise performance in healthy humans. J Physiol 2007; 581: 389-403
    CrossrefPubMedGoogle Scholar
  • 19 Trincat L, Woorons X, Millet GP. Repeated-sprint training in hypoxia induced by voluntary hypoventilation in swimming. Int J Sports Physiol Perform 2017; 12: 329-335
    CrossrefPubMedGoogle Scholar
  • 20 Wei J, Carroll RJ, Harden KK. et al. Comparisons of treatment means when factors do not interact in two-factorial studies. Amino Acids 2012; 42: 2031-2035
    CrossrefPubMedGoogle Scholar
  • 21 Woorons X, Gamelin FX, Lamberto C. et al. Swimmers can train in hypoxia at sea level through voluntary hypoventilation. Respir Physiol Neurobiol 2014; 190: 33-39
    CrossrefPubMedGoogle Scholar
  • 22 Robotham JL, Lixfeld W, Holland L. et al. Effects of respiration on cardiac performance. J Appl Physiol Respir Environ Exerc Physiol 1978; 44: 703-709
    PubMedGoogle Scholar
  • 23 Xing CY, Cao TS, Yuan LJ. et al. Mechanism study of pulsus paradoxus using mechanical models. PLos One 2013; 8: e57512
    CrossrefPubMedGoogle Scholar
  • 24 Claessen G, Claus P, Delcroix M. et al. Interaction between respiration and right versus left ventricular volumes at rest and during exercise: a real-time cardiac magnetic resonance study. Am J Physiol Heart Circ Physiol 2014; 306: H816-H824
    CrossrefPubMedGoogle Scholar
  • 25 Butler J. The heart is in good hands. Circulation. 1983; 67: 1163-1168
    CrossrefPubMedGoogle Scholar
  • 26 Lin YC, Shida KK, Hong SK. Effects of hypercapnia, hypoxia, and rebreathing on circulatory response to apnea. J Appl Physiol Respir Environ Exerc Physiol 1983; 54: 172-177
    PubMedGoogle Scholar
  • 27 Cross TJ, Breskovic T. Sabapathy et al. Respiratory muscle pressure development during breath holding in apnea divers. Med Sci Sports Exerc 2013; 45: 93-101
    CrossrefPubMedGoogle Scholar
  • 28 Batinic T, Mihanovic F, Breskovic T. et al. Dynamic diaphragmatic MRI during apnea struggle phase in breath-hold divers. Respir Physiol Neurobiol 2016; 222: 55-62
    CrossrefPubMedGoogle Scholar
  • 29 Palada I, Bakovic D, Valic Z. et al. Restoration of hemodynamics in apnea struggle phase in association with involuntary breathing movements. Respir Physiol Neurobiol 2008; 161: 174-181
    CrossrefPubMedGoogle Scholar
  • 30 Ahn B, Nishibayashi Y, Okita S. et al. Heart rate response to breath-holding during supramaximal exercise. Eur J Appl Physiol Occup Physiol 1989; 59: 146-151
    CrossrefPubMedGoogle Scholar
  • 31 Lindholm P, Nordh J, Linnarsson D. Role of hypoxemia for the cardiovascular responses to apnea during exercise. Am J Physiol Regul Integr Comp Physiol 2002; 283: R1227-R1235
    CrossrefPubMedGoogle Scholar
  • 32 Fitz-Clarke JR. Breath-hold diving. Compr Physiol 2018; 8: 585-630
    CrossrefPubMedGoogle Scholar
  • 33 Lindholm P, Sundblad P, Linnarsson D. Oxygen-conserving effects of apnea in exercising men. J Appl Physiol (1985) 1999; 87: 2122-2127
    CrossrefPubMedGoogle Scholar
  • 34 Lin YC, Shida KK, Hong SK. Effects of hypercapnia, hypoxia, and rebreathing on heart rate response during apnea. J Appl Physiol Respir Environ Exerc Physiol 1983; 54: 166-171
    PubMedGoogle Scholar
  • 35 Astorino TA, Bovee C, DeBoe A. Estimating hemodynamic responses to the Wingate test using thoracic impedance. J Sports Sci Med 2015; 14: 834-840
    PubMedGoogle Scholar
  • 36 Bougault V, Lonsdorfer-Wolf E, Charloux A. et al. Does thoracic bioimpedance accurately determine cardiac output in COPD patients during maximal or intermittent exercise?. Chest 2005; 127: 1122-1131
    PubMedGoogle Scholar
  • 37 Monnet X, Teboul JL. Transpulmonary thermodilution: Advantages and limits. Crit Care 2017; 21: 147
    CrossrefPubMedGoogle Scholar
  • 38 Guilleminault C, Motta J, Mihm F. et al. Obstructive sleep apnea and cardiac index. Chest 1986; 89: 331-334
    CrossrefPubMedGoogle Scholar
  • 39 Sakka SG, Reuter DA, Perel A. The transpulmonary thermodilution technique. J Clin Monit Comput 2012; 26: 347-353
    CrossrefPubMedGoogle Scholar
  • 40 Siebenmann C, Rasmussen P, Sørensen H. et al. Cardiac output during exercise: A comparison of four methods. Scand J Med Sci Sports 2015; 25: e20-e27
    CrossrefPubMedGoogle Scholar