Limitations to systemic and locomotor limb muscle oxygen delivery and uptake during maximal exercise in humans

Reductions in systemic and locomotor limb muscle blood flow and O2 delivery limit aerobic capacity in humans. To examine whether O2 delivery limits both aerobic power and capacity, we first measured systemic haemodynamics, O2 transport and O2 uptake during incremental and constant (372 ± 11 W; 85% of peak power; mean ±s.e.m.) cycling exercise to exhaustion (n= 8) and then measured systemic and leg haemodynamics and during incremental cycling and knee‐extensor exercise in male subjects (n= 10). During incremental cycling, cardiac output and systemic O2 delivery increased linearly to 80% of peak power (r2= 0.998, P < 0.001) and then plateaued in parallel to a decline in stroke volume (SV) and an increase in central venous and mean arterial pressures (P < 0.05). In contrast, heart rate and increased linearly until exhaustion (r2= 0.993; P < 0.001) accompanying a rise in systemic O2 extraction to 84 ± 2%. In the exercising legs, blood flow and O2 delivery levelled off at 73–88% of peak power, blunting leg per unit of work despite increasing O2 extraction. When blood flow increased linearly during one‐legged knee‐extensor exercise, per unit of work was unaltered on fatigue. During constant cycling, , SV, systemic O2 delivery and reached maximal values within ∼5 min, but dropped before exhaustion (P < 0.05) despite increasing or stable central venous and mean arterial pressures. In both types of maximal cycling, the impaired systemic O2 delivery was due to the decline or plateau in because arterial O2 content continued to increase. These results indicate that an inability of the circulatory system to sustain a linear increase in O2 delivery to the locomotor muscles restrains aerobic power. The similar impairment in SV and O2 delivery during incremental and constant load cycling provides evidence for a central limitation to aerobic power and capacity in humans.

[1]  José González-Alonso,et al.  Reductions in Systemic and Skeletal Muscle Blood Flow and Oxygen Delivery Limit Maximal Aerobic Capacity in Humans , 2003, Circulation.

[2]  J. Dempsey,et al.  Respiratory muscle work compromises leg blood flow during maximal exercise. , 1997, Journal of applied physiology.

[3]  B. Ekblom,et al.  Cardiac output in athletes. , 1968, Journal of applied physiology.

[4]  N. Gledhill,et al.  Endurance athletes' stroke volume does not plateau: major advantage is diastolic function. , 1994, Medicine and science in sports and exercise.

[5]  L. Rowell,et al.  Human cardiovascular adjustments to exercise and thermal stress. , 1974, Physiological reviews.

[6]  E H WOOD,et al.  The oxygen saturation of blood in the venae cavae, right-heart chambers, and pulmonary vessels of healthy subjects. , 1957, The Journal of laboratory and clinical medicine.

[7]  B J Whipp,et al.  Oxygen uptake kinetics for various intensities of constant-load work. , 1972, Journal of applied physiology.

[8]  M C Lancaster,et al.  A comparison of three maximal treadmill exercise protocols. , 1974, Journal of applied physiology.

[9]  J. Parker,et al.  Normal left ventricular function. , 1979, Circulation.

[10]  B. Saltin,et al.  Cardiac output during submaximal and maximal exercise in active middle-aged athletes. , 1966, Journal of applied physiology.

[11]  V. Froelicher,et al.  Effect of sampling on variability and plateau in oxygen uptake. , 1990, Journal of applied physiology.

[12]  B. Saltin,et al.  Maximal perfusion of skeletal muscle in man. , 1985, The Journal of physiology.

[13]  L. Rowell,et al.  Dependence of cardiac filling pressure on cardiac output during rest and dynamic exercise in dogs. , 1993, The American journal of physiology.

[14]  D. Poole,et al.  High muscle blood flow in man: is maximal O2 extraction compromised? , 1993, Journal of applied physiology.

[15]  A HOLMGREN,et al.  Circulatory changes during muscular work in man; with special reference to arterial and central venous pressures in the systemic circulation. , 1956, Scandinavian journal of clinical and laboratory investigation.

[16]  C. G. Blomqvist,et al.  Left Ventricular Performance in Normal Subjects: A Comparison of the Responses to Exercise in the Upright and Supine Positions , 1980, Circulation.

[17]  N. Secher,et al.  Leg vasoconstriction during dynamic exercise with reduced cardiac output. , 1992, Journal of applied physiology.

[18]  E. Asmussen,et al.  The cardiac output in rest and work determined simultaneously by the acetylene and the dye injection methods. , 1953, Acta physiologica Scandinavica.

[19]  L. Rowell,et al.  LIMITATIONS TO PREDICTION OF MAXIMAL OXYGEN INTAKE. , 1964, Journal of applied physiology.

[20]  W Schaffartzik,et al.  Relationship between body and leg VO2 during maximal cycle ergometry. , 1992, Journal of applied physiology.

[21]  B. Saltin,et al.  CARDIAC OUTPUT DURING SUBMAXIMAL AND MAXIMAL WORK. , 1964, Journal of applied physiology.

[22]  A HENSCHEL,et al.  Maximal oxygen intake as an objective measure of cardio-respiratory performance. , 1955, Journal of applied physiology.

[23]  B. Rubal,et al.  Left ventricular performance of the athletic heart during upright exercise: a heart rate-controlled study. , 1986, Medicine and science in sports and exercise.

[24]  B. Whipp,et al.  The maximally attainable VO2 during exercise in humans: the peak vs. maximum issue. , 2003, Journal of applied physiology.

[25]  E. Coyle,et al.  Dehydration markedly impairs cardiovascular function in hyperthermic endurance athletes during exercise. , 1997, Journal of applied physiology.

[26]  G. Templeton,et al.  Left ventricular stiffness during diastole and systole: the influence of changes in volume and inotropic state. , 1972, Cardiovascular research.

[27]  J. Roca,et al.  Evidence for tissue diffusion limitation of VO2max in normal humans. , 1989, Journal of applied physiology.

[28]  J. Keul,et al.  Effect of static and dynamic exercise on heart volume, contractility, and left ventricular dimensions. , 1981, Circulation research.

[29]  C. Chapman,et al.  Behavior of stroke volume at rest and during exercise in human beings. , 1960, The Journal of clinical investigation.

[30]  J. Fleg,et al.  Cardiovascular responses to exhaustive upright cycle exercise in highly trained older men. , 1994, Journal of applied physiology.

[31]  J. González-Alonso,et al.  Circulating ATP‐induced vasodilatation overrides sympathetic vasoconstrictor activity in human skeletal muscle , 2004, The Journal of physiology.

[32]  B. Saltin,et al.  Oxygen uptake during the first minutes of heavy muscular exercise. , 1961, Journal of applied physiology.

[33]  J. Mitchell,et al.  The physiological meaning of the maximal oxygen intake test. , 1958, The Journal of clinical investigation.

[34]  J. Dempsey,et al.  Effects of respiratory muscle work on cardiac output and its distribution during maximal exercise. , 1998, Journal of applied physiology.

[35]  J. Weiss,et al.  Evidence of incomplete left ventricular relaxation in the dog: prediction from the time constant for isovolumic pressure fall. , 1978, The Journal of clinical investigation.

[36]  A. Hill,et al.  Muscular Exercise, Lactic Acid, and the Supply and Utilization of Oxygen , .

[37]  L. Rowell Human Cardiovascular Control , 1993 .

[38]  R ASKEVOLD,et al.  Quantitative determination of barbital in blood serum by ultraviolet absorption spectrophotometry. , 1956, Scandinavian journal of clinical and laboratory investigation.

[39]  K. Beck,et al.  Influence of age and gender on cardiac output-VO2 relationships during submaximal cycle ergometry. , 1998, Journal of applied physiology.

[40]  C. Gray The significance of the van den Bergh reaction. , 1947, The Quarterly journal of medicine.

[41]  J. Holloszy,et al.  Exercise training prevents decline in stroke volume during exercise in young healthy subjects. , 1992, Journal of applied physiology.

[42]  B. Saltin CIRCULATORY RESPONSE TO SUBMAXIMAL AND MAXIMAL EXERCISE AFTER THERMAL DEHYDRATION. , 1964, Journal of applied physiology.

[43]  B. Groves,et al.  Operation Everest II: cardiac filling pressures during cycle exercise at sea level. , 1990, Respiration physiology.

[44]  A HOLMGREN,et al.  Circulatory studies in well trained athletes at rest and during heavy exercise. With special reference to stroke volume and the influence of body position. , 1963, Acta physiologica Scandinavica.

[45]  K. Schechtman,et al.  Enhanced left ventricular performance in endurance trained older men. , 1994, Circulation.

[46]  J. Mitchell,et al.  Response to exercise after bed rest and after training. , 1968, Circulation.

[47]  L. Nybo,et al.  Effects of marked hyperthermia with and without dehydration on VO(2) kinetics during intense exercise. , 2001, Journal of applied physiology.

[48]  E. Coyle,et al.  Stroke volume decline during prolonged exercise is influenced by the increase in heart rate. , 1999, Journal of applied physiology.

[49]  R. Coleman,et al.  Regulation of Stroke Volume during Submaximal and Maximal Upright Exercise in Normal Man , 1986, Circulation research.

[50]  Takuya Osada,et al.  Brain and central haemodynamics and oxygenation during maximal exercise in humans , 2004, The Journal of physiology.

[51]  R. Armstrong,et al.  Distribution of blood flow in muscles of miniature swine during exercise. , 1987, Journal of applied physiology.

[52]  B. Ekblom,et al.  Effect of physical training on oxygen transport system in man. , 1968, Acta physiologica Scandinavica. Supplementum.

[53]  E. Coyle,et al.  Stroke volume during exercise: interaction of environment and hydration. , 2000, American journal of physiology. Heart and circulatory physiology.

[54]  F. Jensen,et al.  Influence of body temperature on the development of fatigue during prolonged exercise in the heat. , 1999, Journal of applied physiology.

[55]  J. Ayres,et al.  A comparative analysis of four protocols for maximal treadmill stress testing. , 1976, American heart journal.

[56]  B. Saltin,et al.  Human muscle blood flow and metabolism studied in the isolated quadriceps muscles. , 1998, Medicine and science in sports and exercise.

[57]  J Bangsbo,et al.  Heat production in human skeletal muscle at the onset of intense dynamic exercise , 2000, The Journal of physiology.

[58]  J. Zmuda,et al.  Cardiovascular hemodynamics with increasing exercise intensities in postmenopausal women. , 1999, Journal of applied physiology.