Beginning Of Exercise Research Articles

Predicting the severity of coronary lesions by the continuous recording method of exercise two-dimensional echocardiography

We estimated the severity of coronary artery disease by the continuous-recording method of exercise two-dimensional echocardiography (Ex.2DE) in 56 patients with angiographically significant coronary artery stenosis ( > 50% diameter narrowing) who had undergone both Ex.2DE and coronary angiography. Patients were divided into two groups on the basis of findings of coronary angiography: group 1 had 50% to 89% stenosis (n = 24) and group 2 had 90% or greater stenosis (n = 32). The sensitivity and specificity of Ex.2DE for the detection of ischemic segments were 82% and 88%, respectively in the overall patient population. The sensitivity was 67% in group 1 and 94% in group 2. Hyperkinesis occurred at the beginning of exercise in 21 (88%) of 24 patients in group 1 and 15 (47%) of 32 patients in group 2 (p < 0.05). Our findings demonstrated that patients who did not show hyperkinesis at the beginning of exercise had more severe coronary artery disease. Careful observation of serial wall motion during exercise by the continuous-recording method may provide important information about myocardial ischemia.

Kinetics of the transplanted heart. Implications for the choice of field-test exercise protocol.

The transplanted heart shows a slow increase (on transient) of both heart rate (HR) and oxygen consumption (VO2) at the beginning of exercise. The hypothesis used in this study was that this would lead to unacceptably large systematic errors when field predictions of maximal oxygen intake (VO2max) were derived from cycle ergometer tests with a steep ramp function. The subjects (27 patients who had received orthotopic heart transplants 6 months previously, and 45 age-matched control subjects) each performed a rapid progressive cycle ergometer test (increments of 16.7 Watts [W] per minute to subjective exhaustion) and a "steady-state" test (two 6-minute stages at one third and two thirds of peak power output). Time constants for HR and VO2 were determined by fitting single exponent equations to the "steady-state" data and noting the time for the difference from the plateau value to reach 36.8% of its initial value. Heart rate and VO2 also were compared between rapid progressive and "steady-state" tests at one third and two thirds of peak power output. At one third of peak power output (46 W in patients, 73 W in control subjects), the respective time constants (mean +/- SE [standard error]) were 60.4 +/- 6.4 and 40.5 +/- 3.0 seconds for VO2 (P < .01), and 130.0 +/- 14.3 and 67.9 +/- 10.0 seconds for HR (P < .001). At two thirds of peak power, the corresponding values were 49.2 +/- 5.5 and 34.7 +/- 2.7 seconds for VO2 (P < .05), and 147.9 +/- 13.0 and 122.2 +/- 4.8 seconds for HR (P < .10). Comparing rapid progressive and "steady-state" readings, the control subjects showed identical values for HR and VO2 at one third of peak power, but at two thirds, the rapid progressive test HR lagged behind the "steady-state" value by 8 +/- 3 beats per minute. The cardiac transplant patients showed a larger HR lag in the rapid progressive tests (109 +/- 12 vs 117 +/- 10 beats per minute, P < .05; 125 +/- 14 vs 141 +/- 14 beats per minute, P < .005). Oxygen consumption also tended to lag slightly at two thirds of peak power (118 +/- 76 mL/min, not significant). The rapid progressive test protocol yields acceptable field estimates of aerobic power in normal individuals, but the slow acceleration of HR after cardiac transplantation leads to unacceptably large errors if the HR from a rapid progressive test protocol is used to predict maximal oxygen intake (VO2max) in such patients.

Rate adaptive cardiac pacing using right ventricular venous oxygen saturation: quantification of chronotropic behavior during daily activities and maximal exercise.

Central venous oxygen saturation (SvO2) closely reflects cardiac output and tissue oxygen consumption. In the absence of an adequate chronotropic response during exercise, SvO2 will decrease and the extent of desaturation may be used as a parameter for rate adaptive cardiac pacing. Eight patients with sinoatrial disease received a DDDR pacemaker capable of DDDR pacing by sensing either SvO2 or piezoelectric detected body movement. Both sensors were programmed to attain a rate of about 100 beats/min during walking, and with the lower and upper rates set at 50% and 90% of age predicted maximum, respectively. Chronotropic behavior of the two sensors were compared in the DDD mode with measurement of sensor responses, during everyday activities (walking, stair climbing, postural changes, and physiological stresses) and at each quartile of workload during a continuous treadmill exercise test. During walking at 2.5 mph, both sensors showed no significant difference in delay time (both react within 15 secs) or half-time (SvO2 = 36 +/- 12 sec and activity 24 +/- 3 sec; P = NS), although SvO2 driven pacing achieved 90% target rate response slower than activity sensing (124 +/- 16 sec vs 77 +/- 10 sec; P < 0.02). SvO2 pacing was associated with a more physiological rate response during walking upslope (68 +/- 12 beats/min vs 57 +/- 10 beats/min; P < 0.05), ascending stairs (59 +/- 10 beats/min vs 31 +/- 6 beats/min; P < 0.05), and standing (34 +/- 7 beats/min vs 9 +/- 2 beats/min; P < 0.05). The SvO2 sensor significantly overpaced in the first quartile of exercise (51.8 +/- 25.6% in excess of heart rate expected from workload), but the rate was within 20% of expected for the remainder of exercise. "Underpacing" was observed with the activity sensor at the higher workload. In conclusion, the SvO2 sensor demonstrated a more physiological response to activities of daily living compared with the activity sensor. Using a quantitative method, the speed of onset of rate response of the SvO2 sensor was comparable to activity sensing, and was more proportional in rate response. Significant overpacing occurs at the beginning of exercise during SvO2 driven pacing, which may be improved with the use of a curvilinear algorithm.

Plasma lactate concentration increases as a parabola with delay during ramp exercise.

This study presents an elementary model of a system which relates plasma lactate concentration ([La-]) during ramp exercise to its rate of accumulation (Rc) within its extramuscular distribution space (S). Under the parsimonious assumptions that Rc increases linearly with time (t) with a kinetic delay (delta), and that the volume of S is constant, it is shown that plasma [La-] increases as a parabola with the kinetic delay delta when t increases. This elementary system model describes changes in plasma [La-] observed in five healthy young subjects during ramp exercise on the cycle ergometer (1 W every 2 s) with great accuracy (r > 0.99) with very small residuals (average value less than 0.01 mmol.l-1), randomly distributed around the fitting curves. The delay between the beginning of exercise and the onset of increase in Rc could be due to the fact that at the corresponding work rates: (1) rate of lactate appearance (Ra), which is equal to the rate of lactate disappearance (Rd), is not modified from rest, since the exercising muscles work in fully aerobic conditions (hypothesis of the anaerobic threshold); or (2) the increase in Ra is associated with a similar increase in Rd. An alternate or complementary hypothesis is that, during ramp exercise, plasma [La-] could reflect metabolic events within the muscles, with a significant delay.

Maximal hemodynamic response after the Fontan procedure: Doppler evaluation during the treadmill test.

After undergoing the Fontan procedure for congenital heart disease, 16 young patients performed a maximal treadmill test according to the Bruce protocol. The peak velocity of the blood flow in the ascending aorta, stroke index, and cardiac index were measured by continuous-wave Doppler echocardiography at rest and at each stage of the test. The results were compared with those from 18 normal children. The body surface area was similar in the two groups. The endurance time was 37% shorter in the Fontan group than in the control group. From the beginning of exercise until the sixth minute, the increase in stroke index was lower in the Fontan group (NS). After that point, the stroke index was maintained at a high level in the control group but decreased toward its original level in the Fontan group. The response of cardiac index to exercise in the two groups was comparable until the sixth minute, after which the Fontan group failed to maintain an ascending curve. All the hemodynamic values were significantly higher in the control group at maximal exercise; at this point the cardiac index had increased 79% in the Fontan group and 170% in the control group. The subnormal response of the stroke volume at submaximal exercise and the subsequent decrease at maximal exercise following the Fontan procedure are important hemodynamic findings.

Volume changes in the legs of paraplegic subjects during arm exercise.

The purpose of this study was to examine the inability of paraplegic (P) subjects to redistribute fluid below the spinal cord lesion during arm exercise, with emphasis on the role of the sympathetic system in this redistribution failure. Fifteen male P and 15 male able-bodied [control (C)] subjects performed arm cranking exercise, and volume changes in the calf were measured by strain gauge plethysmography before, during, and after exercise. Muscle pump activity in the legs of C subjects was eliminated. The rate of calf volume decrease at the beginning and halfway points of the exercise period, the total volume decrease during exercise, and the volume increase during recovery were significantly lower in P than in C subjects. Whereas completeness of the lesion had no influence on leg volume changes, the rate of calf volume decrease at the beginning of exercise and the total volume decrease during exercise were significantly correlated with the level of the spinal cord lesion. This study confirms that P subjects are unable to redistribute fluid effectively below the spinal cord injury during arm exercise, which is partly caused by a loss of sympathetically induced vasoconstriction and which appears to be independent of the completeness of the lesion but dependent on its level.

Exercise chronotropy in patients with normal and impaired sinus node function after cardiac transplantation.

The chronotropic response during graded, symptom limited exercise was investigated in 32 cardiac transplant recipients a mean of 49 +/- 18 days after transplantation. All patients had systematic evaluation of postoperative donor sinus node (SN) function and the cardioacceleratory response was compared according to the SN function. Twenty-one patients had normal postoperative SN studies (corrected SN recovery time < 520 msec, group I) while the SN function was impaired postoperatively in the remainder (n = 11, group II; corrected SN recovery time 4,149 +/- 6,283 msec in 5 patients, junctional escape rhythm in 6 patients). All patients had regained sinus rhythm at time of the exercise test. Patients in group II had lower basal sinus rates at the beginning of exercise (91.5 +/- 11 vs 101.4 +/- 7 beats/min, P < 0.02). This lower chronotropy was maintained over every incremental step (F rate between groups = 30, P = 0.0001, F rate vs workload = 15, P = 0.0001 by two-way ANOVA) and resulted in a significantly lower heart rate at individual peak exercise (108.3 +/- 20 vs 124.2 +/- 13 beats/min, P < 0.02). A total of 14/16 patients in group I but only 2/16 patients in group II accomplished a peak heart rate > or = 120 beats/min (P = 0.009). The workload achieved did not differ between the groups (107 +/- 29 vs 102 +/- 32 watts, P > 0.5). These data show a lower SN chronotropy during rest and at peak exercise in cardiac transplant recipients with postoperative SN deficiency and apparent normalization of SN function.

Comparison of two methods for computing exogenous substrate oxidation using 13C-labeling

With 13C stable isotope as tracer, the purposes of this study were to measure the oxidation rates of exogenous glucose by using two computation procedures that take into account changes in isotopic composition of CO2 arising from oxidation of endogenous substrates (Rendo) and compare these results with studies using 14C-glucose. Two different low levels of 13C-enrichment were used in the first procedure, while a very high level of enrichment was used in the second one. Each of the eight subjects completed four exercises (68 +/- 5% VO2max; 90 min) on cycle ergometer, at 7-d intervals. After 30 min of exercise, the subjects ingested in a single bolus of 30 g of 13C-glucose, dissolved in 300 ml of water, enriched at three different levels (trials A and B = -10.9 and +2.5; trial C = +291.9/1000 delta 13C-PDB-1), or water only. The metabolic and endocrine state at rest and its response to exercise with or without glucose ingestion were similar in the four trials, with the exception of FFA and glycerol, which were blunted by the ingestion of glucose. As expected, Rendo significantly increased from rest (-22.7 +/- 0.7/1000 delta 13C-PDB-1) to the beginning of exercise without glucose ingestion (-21.2 +/- 0.5/1000 delta 13C-PDB-1). The amounts of exogenous glucose oxidized over the last hour of exercise and computed from trials A and B and from trial C were 14.9 +/- 4.4 and 13.0 +/- 4.2 g, representing 7.4 and 6.3% of the total energy requirement, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Metabolic consequences of repeated exercise in long distance runners

To assess the rates of change in muscle metabolites such as phosphocreatine (PCr) and inorganic phosphate (Pi) during repeated exercise sessions with rest periods, 31-phosphorus nuclear magnetic resonance spectroscopy was used for continuous and noninvasive measurements. Five long-distance runners and six healthy male subjects as controls performed a 2-min femoral flexion exercise at 20 kg.m.min-1 in a 2.1 T superconducting magnet with a 67-cm bore; they repeated this exercise four times with a 2-min rest period. At the beginning of exercise, PCr decreased exponentially; at the end, it increased. During exercise and in the early phase of the recovery in every exercise session, the PCr values were significantly higher in the long-distance runners than in the control subjects (P < 0.05). The Pi increases and decreases involved with exercise also revealed exponential changes. The Pi values did not significantly differ during exercise; however, Pi recovery was faster in the long-distance runners than in the control subjects (P < 0.05). The Pi:PCr ratio during exercise increased linearly with exercise; and Pi:PCr during recovery was smaller in the long-distance runners than in the control subjects (P < 0.05). In conclusion, the long-distance runners revealed faster PCr and Pi kinetics after exercise and a smaller Pi:PCr during exercise than did the control subjects. It is suggested that these results were attributable to a greater oxidative capacity of muscles in the long-distance runners.

Sweat rate and rectal and skin temperatures in tetraplegic men during exercise

Three endurance‐trained tetraplegic men with spinal cord lesions complete (C) at C5/6, and incomplete (I/C) at C5/6 and C6/7 pushed their sport wheelchairs on a motor‐driven treadmill at a pace simulating a competitive 5 km race. Rate of oxygen consumption, ventilation per minute, carbon dioxide output, and heart rate were measured at selected times. Rectal (Trec) and skin temperatures (Tsk), measured at head, back, chest, abdomen, thigh, and calf, were monitored throughout. Forehead sweat rate (SR) was calculated at the beginning of exercise and at 5‐minute intervals. The environment was controlled at 23°C dry bulb, 17°C wet bulb. The heart rate response throughout the exercise indicated little evidence of cardiovascular drift. The highest Trec recorded was 37.08°C and this occurred 2 minutes postexercise in the C6/7 (I/C) subject. The lowest Trec (36.50°C) was also recorded in C6/7 (I/C) subject prior to exercise. The calf Tsk showed little change during the exercise for the C5/6 tetraplegic men. No swe...

Ventilatory mechanisms of exercise intolerance in chronic heart failure

Mechanisms that have been suggested to underlie the abnormal ventilatory response to exercise in patients with chronic congestive heart failure (CHF) include high pulmonary pressures, ventilation-perfusion mismatching, early metabolic acidosis, and abnormal respiratory control. To evaluate the role that ventilation and gas exchange play in limiting exercise capacity in patients with CHF, data from 33 patients with CHF and 34 normal subjects of similar age who underwent maximal exercise testing were analyzed. Maximal oxygen uptake was higher among normal subjects (31.7 ± 6 ml/kg/min) than among patients with CHF (17.7 ± 4 ml/kg/min; p < 0.001). The ventilatory equivalent for oxygen, expressed as a percentage of maximal oxygen uptake, was 25% to 35% higher among patients with CHF compared with normal subjects throughout exercise ( p < 0.01). A steeper component effect of ventilation on maximal oxygen uptake was observed among normal subjects compared with patients with CHF, which suggests that a significant portion of ventilation in CHF is wasted. Maximal oxygen uptake was inversely related to the ratio of maximal estimated ventilatory dead space to maximal tidal volume ( VD VT ) in both groups ( r = −0.73, p < 0.001). Any given oxygen uptake at high levels of exercise among patients with CHF was accompanied by a higher VD VT , lower tidal volume, and higher respiratory rate compared with normal subjects ( p < 0.01). Relative hyperventilation in patients with CHF started at the beginning of exercise and was observed both below and above the ventilatory threshold, which suggests that the excess ventilation was not directly related to earlier than normal metabolic acidosis. Thus abnormal ventilatory mechanisms contribute to exercise intolerance in CHF, and excess ventilation is associated with both a higher physiologic dead space and an abnormal breathing pattern. The high dead space is most likely due to ventilation-perfusion mismatching in the lungs, which is related to poor cardiac output, and the abnormal breathing pattern appears to be an effort to reduce the elevated work of breathing that is caused by high pulmonary pressures and poor lung compliance.

3

Our understanding of the control of the cutaneous circulation has increased over the past decade, but is still far from complete. There is a cutaneous vasoconstriction at the beginning of exercise that usually effectively competes with concurrent thermoregulatory drives for vasodilation. This cutaneous vasoconstrictor response, however, requires dynamic activity by a significant muscle mass as small muscle groups or isometric exercise are ineffective or nearly so. Also, exercise causes the threshold internal temperature relative to rest such that SKBF is lower during exercise than in resting conditions for a given thermal stimulus. A further influence by exercise on the cutaneous circulation is to limit the degree of cutaneous vasodilation when heat stress and exercise are combined. These three roles for exercise compete with the thermogenic role that promotes vasodilation. The previously described effects act through the adrenergic vasoconstrictor system and the separate active vasodilator system. The increase in SKBF with heat stress represents the combination of withdrawal of vasoconstrictor activity and elevation of active vasodilator activity. The vasoconstrictor effect of the initiation of exercise is accomplished strictly through enhanced vasoconstrictor activity; vasodilator withdrawal does not participate [72]. However, both the exercise-induced elevation in thermoregulatory threshold for raising SKBF and the limitation to cutaneous vasodilation during exercise are strictly functions of the active vasodilator system [69, 73, 78]. In the first case, active vasodilation is delayed until a higher (relative to rest) level of internal temperature is reached. In the second case, the plateau in SKBF during exercise in the heat is due to a similar plateau in active vasodilator activity. Exercise has also served as a tool for the study of other influences on the cutaneous circulation. The influences of alterations in body fluid volumes, osmolarity, acclimatization, hypertension, time of day, menstrual phase, and others on the control of SKBF have been assessed by using exercise as a calorigenic source. The question as to whether the nonthermoregulatory influences of exercise interact with these other influences to give a modification of the pattern of control different from what might be observed at rest is largely unanswered. Future directions for research are numerous, but several fundamental questions are outstanding. The mechanism of active cutaneous vasodilation has been elusive since its discovery and remains an exceptionally important question. Second, the sensory elements associated with exercise giving rise to the alterations in the pattern of control are unclear. This problem is made challenging by the fact that the efferent control by exercise differs between its initiation and events later in exercise.(ABSTRACT TRUNCATED AT 400 WORDS)

Pre-exercise feeding does not affect endurance cycle exercise but attenuates post-exercise starvation-like response

The effects of ingesting a mixed-snack food (CB), fructose (FRU), or placebo (PBO) prior to exercise (70% peak VO2) on the metabolic response during and after cycle exercise were studied in eight normal healthy volunteers with a wide range of peak VO2 (30-70 cc.kg-1.min-1). The study was designed to minimize the impact of confounding factors by using various strategies. First, the volunteers were grouped in teams with stratification by peak VO2, and the tests were randomized by a Latin-square design. Second, subjects received two acclimation trials in the cycle ergometer to diminish the effect of learning experiences and allow them to get used to the room and equipment. In addition, financial incentives were offered for team and individual endurance times. The test meals were administered 30 min prior to the beginning of exercise, and the subjects exercised to exhaustion, which was defined with clear-cut endpoints. Gas and blood samples were taken at regular intervals before, during, and for 60 min after each exercise bout. CB and FRU induced higher pre-exercise glucose and insulin concentrations. Blood lactate increased 100% with FRU ingestion. Despite these differences; endurance time, substrate, and hormone concentrations as well as rates of substrate oxidation during exercise were identical among the three conditions. During the post-exercise recovery period, PBO was associated with a starvation-like pattern of substrate utilization in which lipid oxidation was 60% greater and carbohydrate oxidation 50% less than following either CB (75 +/- 11, 248 +/- 27 mg.min-1, P less than 0.05) or F ingestion (93 +/- 4, 221 +/- 14 mg.min-1).(ABSTRACT TRUNCATED AT 250 WORDS)

Evidence for an intrinsic mechanism regulating heart rate variability in the transplanted and the intact heart during submaximal dynamic exercise?

The aim was to assess the changes in sympatho-vagal balance which occur with exercise. The power spectrum of RR interval fluctuations (low frequency [LF] and high frequency components [HF]) was determined before, during, and after graded work load exercise on a cycle ergometer. The power spectrum of the respiratory signal, oxygen consumption, and respiratory volumes were also evaluated. In all subjects HF was considered to be an index of respiratory sinus arrhythmia. In normal subjects HF and LF were considered to be indices of relative vagal and sympathetic activity, respectively, whereas in heart transplant subjects HF was considered as a respiratory modulation of the intrinsic heart rate, and not dependent on autonomic tone. Heart rate variability was evaluated as RR interval variance. 15 normal subjects (six trained cyclists and nine healthy sedentary subjects) and six orthotopic heart transplant recipients took part in the study. During the first part of exercise, heart rate increased, RR interval variance decreased, HF decreased, and the relative amount of LF increased both in sedentary and athletic subjects, suggesting a relative increase in sympathetic tone. However, when approaching peak exercise, while heart rate further increased and the variance slightly decreased, the relative proportion of LF decreased and HF proportionally increased. At peak exercise HF accounted for 99.9% of heart rate variability in athletic subjects and for 88.9% in sedentary subjects (p less than 0.001 v baseline and v LF in both groups). In heart transplant subjects both the variance and the HF increased from the beginning of exercise (p less than 0.05), and showed a direct correlation with ventilatory variables and an inverse correlation with heart rate (r = 0.794, p less than 0.001, multiple regression analysis). No measurable LF components could be obtained in these subjects. During recovery, while the heart rate decreased and the RR interval variance increased, there was a relative increase in LF and a relative decrease in HF in normal subjects (either sedentary or athletic). Similarly, in heart transplant subjects, there was a decrease in HF during recovery. Thus the increase in HF at peak exercise in normal subjects contrasts with all the other data which suggest a prevalence in sympathetic tone during the entire exercise and the early recovery period, but appears similar to the increase in HF observed in heart transplant subjects due to the effect of increased ventilation during exercise. These findings suggest that at peak exercise a non-autonomic mechanism, possibly intrinsic to the heart muscle, may determine heart rate fluctuations in synchrony with ventilation in the intact as well as in the denervated human heart.

Effect of hyperglycaemia on muscle glycogen mobilization during muscle contractions in the rat

In the rat, muscle glycogen is mobilized during the first stage of exercise, despite normoglycaemia. The aim of the present study was to examine if this process could be prevented or reduced by hyperglycaemia. Three experiments were carried out: in the first, rats were forced to run on a treadmill; in the second the gastrocnemius muscle group was made to contract by stimulation of the sciatic nerve and in the third adrenaline was administered subcutaneously. Each group was divided into two subgroups: control and enriched with glucose (hyperglycaemic). It was shown that hyperglycaemia has no effect on running-induced glycogen mobilization in hind-limb muscles of different fibre composition but prevented it totally in diaphragm muscle. Hyperglycaemia also did not affect the glycogen mobilization induced by stimulation of the sciatic nerve. However, it delayed and reduced markedly the glycogenolytic effect of adrenaline. It is concluded that increased glycogenolysis in muscles at the beginning of exercise may be a consequence of a delay in the activation of glucose transporting mechanisms in muscle cells.

A Randomized Double‐Blind, Cross‐Over Study of the Linear and Nonlinear Algorithms for the QT Sensing Rate Adaptive Pacemaker

We have compared the pacing rate responses during cardiopulmonary exercise testing in 11 patients (mean 59 years, six female) with implanted QT sensing rate adaptive pacemakers who were randomly programmed to 1-month periods in the linear and nonlinear algorithms using a double-blind, cross-over design. Exercise testing was performed at the end of each month block and symptoms were scored with the MacMaster questionnaire. With exercise, the time to a 10 beats/min increment in rate was significantly less with the nonlinear compared to the linear algorithm (126 sec vs 255 sec, P = 0.02) but there were no significant differences in exercise duration, the peak pacing rate, the peak VO2, the VO2 at the anaerobic threshold or the mean correlation coefficients of the pacing rate VO2 relationship. Rate oscillation occurred in seven patients in the linear algorithm and in two patients in the nonlinear setting. Initial deceleration of the pacing rate at the onset of exercise occurred in seven patients in the linear algorithm and in four patients in the nonlinear setting. The nonlinear algorithm is associated with a faster response time during exercise and fewer instances of rate instability. However, it has not overcome the problem of a dip in the pacing rate at the beginning of exercise. The major difference in the function of the two algorithms is faster initial acceleration with the nonlinear algorithm. This is explained by the significantly higher values of the slope setting at the lower rate limit for the nonlinear versus the linear algorithm (6.3 ms/ms vs 5.1 ms/ms).

Roles of absolute and relative load in skin vasoconstrictor responses to exercise

Systemic hemodynamic responses to exercise (e.g., heart rate, blood pressure) depend on the relative intensity, the active muscle mass, and the mode of exercise. It is not known whether regional vasomotor responses follow the same pattern. To answer this question, in five men we examined cutaneous vascular responses to dynamic and isometric exercise of two legs, one leg, one arm, and one hand, each at high and low work loads. Skin blood flow was monitored by laser-Doppler flowmetry (LDF) at the forearm. Mean arterial pressure (MAP) was measured each minute. Cutaneous vascular conductance (CVC) was indexed as LDF/MAP. Reductions in CVC during the 1st min of dynamic exercise were statistically significant for two-leg exercise at either level and for one-leg exercise at the higher level. Dynamic exercise of smaller muscle groups at either intensity was not associated with significant changes in CVC. The reduction in CVC correlated with external work load (r = 0.75). Work load relative to the capacity of a given muscle group had no identifiable role in the response of CVC to dynamic exercise but did have a role in the increase in MAP at the beginning of exercise. Isometric exercise did not have a measurable effect on CVC regardless of the muscle group or the intensity of the exercise. We conclude that the level of external work determines the redistribution of blood flow from skin to active muscle. Furthermore, absolute rather than relative work and dynamic rather than isometric modes of exercise are the dominant factors.

Dependence on exercise intensity of changes in electrolyte secretion from the skin sampled by a simple method

Secreta from the palm and forearm was sampled for 1-min periods by a new technique, using a glass cylinder. Subjects exercised for 10-min periods at successive intensities of 40%, 50% and 65% VO2max with a leg ergometer operated in the supine position. Changes in the concentrations (values) of Na+, K+ and Cl- in their secreta during exercise were investigated. Significant positive correlations were found between the values of any two electrolytes in samples from the palm or the forearm, but the correlations between values for any one of the three electrolytes from the two sites were not significant. Values for concentrations of the electrolytes were significantly higher in samples from the palm than in those from the forearm at rest, 10 min after the beginning of exercise and at the end of exercise. No significant correlation was found between values for electrolytes in samples from the palm and the exercise intensity, but values for Na+ in samples from the forearm increased stepwise with increase in exercise intensity, and similar tendencies were observed for values of K+ and Cl-. The values for the three electrolytes in samples from the forearm, but not the palm, were significantly correlated with values for blood lactate, the percentage of VO2max and the heart rate. These results suggest that the present technique is suitable for successive samplings of secreta from the forearm, and that values for the electrolytes in samples are useful indices of exercise intensity.

Thermoregulatory responses to exercise at low ambient temperature performed after precooling or preheating procedures

Seven male skiers exercised for 30 min on a cycle ergometer at 50% of maximal oxygen uptake and an ambient temperature of 5 degrees C. The exercise was preceded either by cold exposure (PREC) or active warming-up (PREH). The data were compared with control exercise (CONT) performed immediately after entering the thermal chamber from a thermoneutral environment. Cold exposure resulted in negative heat storage (96.1 kJ.m-2, SE 5.9) leading to significantly lower rectal, mean body and mean skin temperatures at the onset of exercise in PREC, as compared to PREH and CONT. The PREC-PREH temperature differences were still significant at the end of the exercise period. During exercise in the PREC test, oxygen uptake was higher than in PREH test (32.8 ml.kg-1.min-1, SE 1.5 vs 30.5 ml.kg-1.min-1, SE 1.3, respectively). Heart rate showed only a tendency to be higher in PREC than in PREH and CONT tests. In the PREH test skin and body temperatures as well as sweat rate were already elevated at the beginning of exercise. Exercise-induced changes in these variables were minimal. Heat storage decreased with the duration of the exercise. Exercise at low ambient temperature preceded by a 30-min rest in a cold environment requires more energy than the same exercise performed after PREH.

Effect of intravenous caffeine on muscle glycogenolysis in fasted exercising rats

Caffeine has been reported to enhance performance by increasing fat utilization and by sparing liver and muscle glycogen. The lipolytic effect of caffeine has been reported to be diminished in response to previous carbohydrate loading of the subjects. The present study was designed to investigate the effects of caffeine during submaximal exercise in rats where the influence of dietary carbohydrate was removed by fasting. Rats were fasted overnight and given injection of 25 mg.kg-1 caffeine (CAF) or 0.9% NaCl (SAL) 60 min before exercise. They were run for 15, 30, and 60 min on a rodent treadmill up a 15% grade at 21 m.min-1. Plasma free fatty acids (FFA) were significantly elevated to 0.72 +/- 0.04 mM in CAF as compared to 0.45 +/- 0.03 mM in SAL at the beginning of exercise. During exercise, however, a significant difference in FFA levels between CAF and SAL was seen only at 30 min and not at other time points. No significant decrease in muscle glycogenolysis was observed in the CAF as compared to SAL rats, and the liver cyclic AMP remained the same in both CAF and SAL. Blood lactate (mM) showed an increase due to caffeine only at 15 min of exercise (CAF = 2.4 +/- 0.2; SAL = 1.7 +/- 0.3). Intravenous caffeine during exercise did not alter plasma glucagon or blood glucose. We conclude that caffeine has no effect on muscle glycogen utilization in fasted rats during exercise even though there was an increased FFA in CAF rats at the beginning of exercise.