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Effect of Exercise Intensity on Relationship ˙ O2max and Cardiac Output between V

PIERRE-MARIE LEPRETRE1, JEAN-PIERRE KORALSZTEIN2, and VERONIQUE L. BILLAT1,2 LIGE, Department of Sciences and Technology in Sports and Physical Activities (STAPS), University of Evry Val d’Essonne, Evry, FRANCE; and 2Sport Medical Center of the CCAS, Paris, FRANCE
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ABSTRACT ˙ O2max and LEPRETRE, P.-M., J.-P. KORALSZTEIN, and V. L. BILLAT. Effect of Exercise Intensity on Relationship between V Cardiac Output. Med. Sci. Sports Exerc., Vol. 36, No. 8, pp. 1357–1363, 2004. Purpose: The purpose of this study was to determine ˙ O2max) is attained with the same central and peripheral factors according to the exercise whether the maximal oxygen uptake (V intensity. Methods: Nine well-trained males performed an incremental exercise test on a cycle ergometer to determine the maximal ˙ O2max (pV ˙ O2max) and maximal cardiac output (Q ˙ max). Two days later, they performed two continuous cycling power associated with V ˙ O2max exercises at 100% (tlim100 ϭ 5 min 12 s Ϯ 2 min 25 s) and at an intermediate work rate between the lactate threshold and pV (tlim⌬50 ϭ 12 min 6 s Ϯ 3 min 5 s). Heart rate and stroke volume (SV) were measured (by impedance) continuously during all tests. ˙ ) and arterial-venous O2 difference (a-vO2 diff) were calculated using standard equations. Results: Repeated measures Cardiac output (Q ˙ E, blood lactate, and V ˙ O2 (V ˙ O2max) were not different between the three exercises ANOVA indicated that: 1) maximal heart rate, V ˙ was lower in tlim⌬50 than in the incremental test (24.4 Ϯ 3.6 L·minϪ1 vs 28.4 Ϯ 4.1 L·minϪ1; P Ͻ 0.05) due to a lower SV but Q (143 Ϯ 27 mL·beatϪ1 vs 179 Ϯ 34 mL·beatϪ1; P Ͻ 0.05), and 2) maximal values of a-vO2 diff were not significantly different between all the exercise protocols but reduced later in tlim⌬50 compared with tlim100 (6 min 58 s Ϯ 4 min 29 s vs 3 min 6 sϮ 1 min 3 s, P ϭ 0.05). This reduction in a-vO2 diff was correlated with the arterial oxygen desaturation (SaO2 ϭ Ϫ15.3 Ϯ 3.9%) in tlim⌬50 (r ϭ ˙ O2max was not attained with the same central and peripheral factors in exhaustive exercises, and Ϫ0.74, P ϭ 0.05). Conclusion: V ˙ . This might be taken into account if the training aim is to enhance the central factors of V ˙ O2max tlim⌬50 did not elicit the maximal Q ˙ O2max but not necessarily Q ˙ max. Key Words: STROKE VOLUME, ARTERIAL-VENOUS using exercise intensities eliciting V DIFFERENCE, CYCLING, HYPOXEMIA

xercise workloads between 85 and 100% of the ˙ O2max in an incremental test power associated with V ˙ O2max) will elicit V ˙ O2max, provided they are per(pV formed for a sufficient time duration (5–15min according to the exercise intensity) (6). However, the respective contri˙ ) and peripheral bution of central (the cardiac output: Q factors (the arterial-venous oxygen difference: a-vO2 diff) in ˙ O2max according to the workload is not the attainment of V clear. McCole et al. (21) have reported that an incremental test of a total duration of 12 min (with four stages of 3-min ˙ O2max with a lower cardiac output (due duration) elicited V to lower value of stroke volume) compared with an incremental protocol lasting 6 min only (including six stages of 1 min). The authors hypothesized that, in contrast with the longer duration test, the temperature necessary to elicit cutaneous vasodilatation was not reached during the shorter

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Address for correspondence: Pierre-Marie Lepretre, department of STAPS, University of Evry Val d’Essonne, Sport Medical Center of the CCAS, 2 avenue Richerand, Paris, F-75010, France. E-mail: lepretre.pierre-marie@wanadoo.fr. Submitted for publication October 2003. Accepted for publication March 2004. 0195-9131/04/3608-1357 MEDICINE & SCIENCE IN SPORTS & EXERCISE® Copyright © 2004 by the American College of Sports Medicine DOI: 10.1249/01.MSS.0000135977.12456.8F

test, preventing the increased competition for the distribu˙ (21). tion of Q However, the 1-min stage duration protocol allowed reaching almost a twice higher treadmill slope than the 3-min stage duration (14% vs 8%). This could induce a larger muscular mass recruitment during shorter than longer progressive exercises, and it is well known than the stroke volume is influenced by the muscle mass recruited which itself influences the muscle pump and hence the venous return (20). The large difference in power output (as 2% represents 1 km·hϪ1 of speed increment, ˙ O2 i.e., 1 MET: 3.5 mL·kgϪ1·minϪ1) and the absence of V steady states makes it difficult to make conclusions about the ˙ O2 and Q ˙ during exercise. disassociation between maximal V Furthermore, it has been reported that the time course of the stroke volume was affected by the exercise mode (22) and that cardiac output declines more during cycling versus running exercise. This is due to the development of high intramuscular forces in cycling that would compress or even partially occlude venous blood return from the leg (22). A notable difference was also reported with the time course of oxygen uptake between running and cycling at the same relative supra-threshold intensity in well-trained triathletes (5). Indeed, few studies have reported the time course of these central and peripheral factors during supra-lactate threshold exercises and have examined subthreshold exercises. Cheatham et al. (11) have shown that the increase in a-vO2 ˙ O2 during 40 min of an diff was associated with that of V ˙ O2max. They interpreted exercise performed at 64.5% of V 1357

Wisconsin). The pV ˙ O2max (7). Three tests (one incremental and two constant work exercises) were performed at 1-wk intervals. Bioanalytical Products. pV and handlebar heights were set for each subject and kept constant for all the tests. After a 3-min warm-up at 80 W. The pedaling frequency selected by each subject between 70 and 110 rev·minϪ1. at the same time of the day and 2–3 h after a light breakfast in an air-conditioned room (Fig. and ˙ O2max.0%) concentrations. and a peak heart rate at least equal to 90% of the ˙ O2 was identified if age-predicted maximum. 10-␮L ear blood samples were collected and immediately analyzed for blood lactate concentration (YSI 1500. If during the last as the lowest power eliciting V ˙ O2max without completing the stage. In this incremental ˙ O2max was defined as the highest 30-s oxygen protocol. Their physical characteristics are reported in Table 1.4 Training Time (h⅐wk؊1) 13 Ϯ 4 1358 Official Journal of the American College of Sports Medicine http://www. the pneumotachograph was calibrated using a 3-L calibration syringe (Hans Rudolph). every 3 min during the all-out exercise. However.4 Ϯ 2.1. In randomized order. The power p⌬50 was within 30 s to p⌬50 or pV defined as the intensity midway between the power associated with the lactate threshold (pLT) and the work requiring ˙ O2max. each subject completed two severe constant workload exercises until exhaustion separated by at least 48 h. blood lactate greater than 8 mM. and the gas analyzers were calibrated using reference gases with known O2 (16. During both exercise tests. a subject achieved V ˙ O2max was calculated as following: 3-min stage. we However. especially in highly fit endurance subjects. Hellige.17). 100. and at 2 and 4 min during recovery after the exercise test. with V which was defined as the intensity midway between the power associated with the lactate threshold (pLT) and ˙ O2max. that is. the same value of central and peripheral factors of V ˙ O2 elicited.0%) and CO2 (5. Indeed. Physical characteristics of the subjects.75 mL·kgϪ1·minϪ1. Incremental exercise. the breath-bybreath data were smoothed and averaged every 5 s. A plateau of V ˙ O2 of the least stage was not greater than the previous the V ˙ O2max was determined one by 1. Billat et al. the drop in CvO2 could be balanced out by the decrease in CaO2 (15). All subjects were free of cardiac and pulmonary disease. After a 15-min warm-up at ˙ O2max (which was below the lactate threshold for 30% of pV all subjects) and 5 min at rest. Sport L-lactate Analyzer. it is of interest to check whether exercise performed at the low and high range of this heavy-intensity domain elicits ˙ O2max.acsm-msse. Time limit (tlim) was the time at which the subject was no longer able to pedal at the given power output. the purpose of this study was to determine in endurance trained subjects and in cycling exercise whether ˙ O2max) is attained with the the maximal oxygen uptake (V same central and peripheral factors in exhaustive constant load exercises performed at 100% of the power associated ˙ O2max in an incremental test (pV ˙ O2max) and at p⌬50. The samples were taken at rest. Therefore. The minute ven˙ E) and gas exchange parameters (V ˙ O2. Seat TABLE 1. 100% of pV Measurements of gas exchange. V uptake value reached during exercise with a respiratory exchange ratio greater than 1. and 40 W was the power output increment between the last of two stages. OH). this raises the question of the balance bepV ˙ O2 during tween the peripheral and the central factors of V ˙ O2max. V ˙ CO2) tilation (V were measured breath-by-breath by an open-circuit metabolic cart with rapid O2 and CO2 analyzers (CPX. the lactate threshold (LT) was defined as Height (cm) 176 Ϯ 4 Body Fat (%) 11. Before each individual exercise test. Yellow Springs. During all tests. Beexhaustive supra-threshold exercises eliciting V cause very heavy exercise is currently and mostly used ˙ O2max during interval training with the goal of improving V (14). Protocol. 1). the work rate was increased ˙ O2max. (8) have reported a hypoxemia in exhaustive constant speed runs performed at 90. pV ˙ O2max ϭ pF ϩ ͓͑t/180͒ ϫ 40͔ pV [1] METHODS Nine healthy male triathletes participated in this study after giving their written voluntary informed consent in accordance with the guidelines of the University of Evry– Val d’Essonne. behind this (similar) maximal V ˙ is not systemathypothesized that the maximal value of Q ically reached and sustained. Subjects (N ‫ ؍‬9) Mean Ϯ SD Age (yr) 33 Ϯ 7 Mass (kg) 71 Ϯ 4 where pF was the power of the last complete stage (W). these intensive exercises may induce hypoxemia. Markett). MedGraphics Cardiorespiratory Systems. Therefore. Medical Graphic Corporation.this as a manifestation of the Bo ¨ hr effect rather than a further decrease in end capillary oxygen pressure and the exercise lactic acidosis might cause different responses in tissue oxygen extraction (11.org . if the Bo ¨ hr effect contributes to enhancing a-vO2 diff by decreasing venous O2 concentration (CvO2) in supra-threshold exercises. Constant-load exercises. Measurement of blood lactates. t was the time the last workload was maintained (s). and the time to exhaustion at 90% of 105% of the pV ˙ O2max was inversely correlated with the degree of hypoxV emia: a longer exercise duration was associated with a more pronounced hypoxemia. All tests were performed with the subjects in the upright position on an electronically braked ergometer (ERGOLINE 900. at the end of cycling. Given that the oxygen pulse (SV ϫ a-vO2 diff) has been reported to be constant in exhaustive running (10 min) at 95% of ˙ O2max (18). each subject performed a 3-min stage incremental exercise test to exhaustion with 40 W work increment for total exercise duration not exceeding 20 min. a larger decrease in arterial oxygen de-saturation (SaO2). For the incremental test.

07 L·minϪ1. it seems that the impedance cardiography provides ˙ measurements during exercise. Datex-Ohmeda). The SVi calculation also depends on the thoracic flow inversion time (TFIT. Afterward. Previously.05. arterial hypoxemia induced by exercise was defined as an arterial O2 saturation Ͻ 88% (or SaO2rest Ϫ end of exercise greater than 10%). 2%) (10).10). TFIT is weighted using a specific algorithm. Jandel. P Ͻ 0. a-vO2 rate. This evaluation keeps the largest impedance variation during the systole (Zmax Ϫ Zmin) and the largest rate of variation of the impedance signal (dZ/dtmax. the stroke volume (SV) was the product between the electrical physical volume of thorax (VEPT).26 L·minϪ1. oxygen uptake kinetics fit by either mono-exponential [4] or mono-exponential plus drop [5] function: a-vO2 diff͑t͒ ϭ a-vO2 diff͑b͒ ϩ A1*͑1 Ϫ eϪ ͑ tϪ TD1͒ / ␶ 1͒ Medicine & Science in Sports & Exerciseா [4] 1359 .6%) and provides an arterial O2 saturation estimate with mean error of 2% (3). SaO2 was recorded pulse-to-pulse using a noninvasive external device (Ohmeda 3800 oximeter. Two sets of electrodes (Ag/AgCl. The theoretical basis for this technique and its application and validity for exercise testing have been previously described (4. N ϭ 40) (10) and during incremental testing (r ϭ 0.001) between the direct Fick and impedance cardiography methods in six healthy male subjects during maximal cycling exercise tests (28). one electrode transmitting and the other sensing. a first evaluation of stroke volume index (SVi) is calculated during a calibration procedure based on 24 consecutive heartbeats recorded in the resting condition (SVical). The pulse oximeter used an exclusive algorithm (Trutrakϩ®.98. according to the manufacturer’s instructions. In addition. For this experiment. Measurements of cardiac parameters (heart ˙ . they also reported that the direct Fick method was highly correlated with the impedance method during steady state exercise (r2 ϭ 0. where BM is body mass in kilograms and H is height in centimeters).. When associated accurate Q ˙ with VO2 measurements. A further set of two electrodes was used to monitor a single ECG (CM5 position).3964.94. stroke volume) and calculation of Q diff. The calculation of the best-fit parameters was chosen by the program so as to minimize the sum of the squared differences between the fitted function and the observed response.e.FIGURE 1—Experimental design.024265 ϫ BM0. and the first nadir after the peak of the ejection velocity (dZ/dtmax).79. the ventricular ejection time (VET). The physioflow device measures impedance changes (dZ) in responses to a small-administered electrical current. respectively. the variation of parameters were analyzed and compared with those obtained during the calibration procedure. and corrected the clinical movement of the subject. i. which identified. and BSA was the body surface area calculated according to the formula of Haycock (BSA ϭ 0. Richard et al.01. IL). With this impedance device. Pulse oximetry has been reported to be accurate across a broad range of SaO2 (from 57. Q calculation by the device is based on the following formula: ˙ ϭ HR ϫ SVi ϫ BSA Q [2] ˙ O2 corresponding to the starting point of an accelerated the V lactate accumulation of ϳ 4 mM and expressed in percent of ˙ O2max (2). In a previous study. called the contractility index). V Arterial oxygen saturation measurements. Datex-Ohmeda. which provides a more stable signal than the ECG signal itself. HR is the heart where Q rate based on the R-R interval measurement. According to the both following equations. Therefore. highly significant correlations were obtained in the stroke volume (r ϭ 0.84. Manatec Type PF05L1.e. quantified. and the maximum rate of the impedance change during the systolic upstroke [(dZ/t)max] divided by the basal thoracic impedance (Z0). a-vO2 diff ϭ V [3] Data kinetics modeling. 1%) and during steady state exercise (0. in m·sϪ1) measured on the first mathematical derivative of the impedance signal. were applied above the supra-clavicular fossa at the left base of the neck and along the xiphoid. Two exponential models were used to describe a-vO2 diff for each work rate. determined on the ECG first derivative. Oxymetry technology.2 to 97. So. The ear pulse oxymeter was calibrated using an internal protocol before each test. ˙ ob(24) showed that the mean difference between the Q tained using direct Fick and the impedance method was not significant at rest (0. During the data acquisition phase. The time course of a-vO2 diff was described by exponential functions fitted to the data with nonlinear regression techniques (Sigma Plot2000. N ϭ 50) (24). TFIT is the time interval between the first zero value after the beginning of the cardiac cycle (beginning of the ECG’s QRS complex) ˙ O2MAX-Q ˙ DISSOCIATION DURING HEAVY EXERCISE V ˙ is expressed in liters per minute. P Ͻ 0. SV and heart rate were measured continuously during each test with beat-to-beat ˙ data smoothed by a 5-s moving averaging algorithm.5378 ϫ H0. P Ͻ 0. Chicago. i..001) and the cardiac output values (r ϭ 0. P Ͻ 0. France). SVi (mL·mϪ2). Each displayed stroke volume (SV) value represents the mean of 15 successive artifact-free beats. KY) and then averaged every 5 s. Hewlett Packard 40493 E). We used a bioimpedance determination for stroke volume and heart rate (Physioflow. According to Dempsey and Wagner (15). Louisville. dECG/dt. it allows the estimation of the arterial-venous difference by the Fick equation: ˙ O2 /Q ˙.

0 Ϯ 1. A2 was the slope of the linear regression. squares represent heart rate kinetics during ˙ kinetics during tlim100. V ˙ O2max.0 Ϯ 1. SV. and oxygen uptake (V ˙ O2) responses volume (SV).5% of pV lower in the tlim⌬50 test (143 Ϯ 27 mL·beatϪ1) compared with the incremental test (179 Ϯ 34 mL·beatϪ1. In the second model to describe the a-vO2 diff kinetics.3% of pVO2max.04).4 Ϯ 3. In all subjects.8 * P Ͻ 0. level of significance between incremental and constant work rate exercises. maximal power output and maximal blood lactate ˙ O2max) exercises. Time to exhaustion. P ϭ 0.05 level unless stated otherwise. SV reached its maximal value at higher ˙ O2max) compared with p⌬50 work rates (89.0% of V ˙ to 89. level of significance between time to exhaustion at pVO2max and p⌬50.3% of pV ˙ ˙ O2max was reached with Q ˙ max and a-vO2 VO2max.0 Ϯ 6.5 100. and cardiac output (Q ˙ O2max) during the incremental test in maximal oxygen uptake (%V subject 7. a-vO2 diff(b) is the baseline of the value at the end of the warm-up. Descriptive statistics are expressed as mean and SD. FIGURE 2—Example of the evolution of heart rate (HR). ␶2 was the time constant of the drop. During the incremental test.01). the time to exhaustion was ˙ O2max (726 Ϯ 195 s significantly longer at p⌬50 than at pV vs 312 Ϯ 145 s. Squares represent heart rate kinetics during tlim100. SV was (88. full triangles empty lozenges represent Q represent SV kinetics during tlim100. and a-vO2 diff) were made using a ables (V one-way repeated measures ANOVA.05. Therefore.0 10. until the attainment of V ˙ Qmax was reached with the attainment of maximal heart rate. empty lozenges represent Q triangles represent SV kinetics during tlim100. Peak lactate was not significantly different when comparing the three tests (Table 2). ˙ was also lower in tlim⌬50 compared with the Therefore. and tlim100 (pV Subjects (N ‫ ؍‬9) Time to fatigue (s) Power (W) ˙ O2max) Power (% of pV Maximal blood lactate (mmol⅐LϪ1) Incremental Test 1240 Ϯ 153 344 Ϯ 37 100.0 Ϯ 1. respectively).a-vO2 diff͑t͒ ϭ a-vO2 diff͑b͒ ϩ A1*͑1 Ϫ eϪ ͑ tϪ TD1͒ / ␶ 1 Ϫ A2*͑t Ϫ TD2͒/␶2͒ [5] where a-vO2 diff(t) represents arterial venous difference at time (t). FIGURE 3—Example of modeling kinetics of heart rate (HR).3% of pV ˙ O2max. All subjects reached a plateau of V ˙ reached its maximal value at VO2max (Fig. http://www. the normality distribution of the population was analyzed by variance comparison using of the Fisher Snedecor test. So. The arterial-venous O2 difference increased up to 61. ˙ E. ˙ kinetics during tlim100. ␶1 was the time constants.5% ˙ O2max) or 100% of pV ˙ O2max. Q ˙ . RESULTS Maximal values of the peripheral and central fac˙ O2max during the incremental exercise. The rationale for selection of the appropriate model was based on analysis of the residuals around the line of best fit (8).2 Ϯ 2.4% of 23.2 Ϯ ˙ O2max corresponding to 63. and a-vO2 diff) at both difparameters (V TABLE 2. Scheffe post hoc tests were carried out when appropriate.7 Ϯ 1. Circles V ˙ O2 during the workload at pV kinetics during tlim100. V diffmax in the incremental test. of pV Comparison between the maximal values of the ˙ O2max between peripheral and central factors of V constant-load and incremental exercises. tlim⌬50 (p⌬50). full tlim100. HR. § P Ͻ 0.05.05). All significant differences are at the P Ͻ 0. stroke ˙ ).01). then SVmax remained constant ˙ O2max and pV ˙ O2max.acsm-msse. determined during incremental.4 Ϯ 4. cardiac output (Q ˙ O2max (tlim100) in subject 7. P Ͻ 0.0 Ϯ 0.9 11.8 Ϯ 26. Furthermore.6 L·minϪ1 vs 28. maximal value of a-vO2 diff was not significantly different when comparing all the ex- 726 Ϯ 195* 312 Ϯ 145*§ 303 Ϯ 38 344 Ϯ 37 88. Statistical methods. A1 was the asymptotic amplitude for the second exponential of oxygen uptake kinetics. Statistical comparisons over time of the physiological vari˙ O2. and TD1 was the time delay of each exponential. Paired t-tests were used to compare a-vO2 diff kinetics responses. The tors of V maximal values measured during the incremental test are in ˙ O2. and HRmax were reached in the constant-load V exercises whatever their intensities (Table 3).0 11. stroke ˙ ) according to the percentage of volume (SV). According to the data. and TD2 was the time delay for the linear regression. HR.org 1360 Official Journal of the American College of Sports Medicine . Each curve fitting used an iterative least-squares approach.6 Ϯ 2. Figures 3–5 show an example of the responses of cardiorespiratory ˙ O2. This was not the case for the constant-load exercises at work rates of p⌬50 (88. SV.9 tlim⌬50 tlim100 ferent intensities and time to fatigue (tlim100 and tlim⌬50. P Ͻ 0. P Ͻ 0. 2).0 Ϯ 0. Heart rate Table 2.2 Ϯ 5. Therefore. Q incremental test (24.1 L·minϪ1. Stroke vol˙ O2max corresponding ume increased until 93. Q ˙ .2 Ϯ 5.

squares represent heart rate kinetics V ˙ kinetics during tlim100.16). P Ͻ 0. P Ͻ 0.9%) (r ϭ Ϫ0.1 167. P Ͻ 0. NS).e. cardiac output (Q during the workload at p⌬50 (tlim⌬50) in subject 7.4 Ϯ 4.5% and 48.30).TABLE 3. SV reached its maximal value almost until ˙ O2max (93 Ϯ 6% of V ˙ O2max). This narrowing in a-vO2 diff was correlated with the arterial oxygen desaturation that appeared in tlim⌬50 (SaO2rest Ϫ end of exercise ϭ 15.3 Ϯ 18.8 Ϯ 2. Squares and dashed line represent a-vO2 diff values and its mathe˙ O2max (tlim100). ˙ O2max and p⌬50.05) but not in tlim100 (SaO2rest Ϫ end of exercise ϭ 11. Billat et al.9 Ϯ 2.8%. V In a pilot study. In spite of similar maximal values of oxygen uptake and heart rate. value of Q ˙ -V ˙ O2 responses during two severe exercises Q ˙ O2max.3 Ϯ 3.8 13. at 40 – 60% of V This continuous increase in SV until exhaustion could be explained by a greater left ventricular filling in well-trained males (16.6* 13.2 11.4 Ϯ 3. i.3 Ϯ 0. Also..3 Ϯ 3.4% of ˙ O2max. the heart rate increase ˙ O2max was responsible of the until the attainment of pV ˙ max at the end of the incremental exercise test. DISCUSSION The focus of this study was to examine whether the ˙ O2max) was reached with the maximal oxygen uptake (V same central and peripheral factors in exhaustive constant ˙ O2max and p⌬50 compared load exercises performed at pV FIGURE 5—Example of arterial-venous difference kinetic (a-vO2 diff) ˙ O2max (tlim100) and at p⌬50 (tlim⌬50) in subject during exercise at pV 7. The SV increase with time in constant supra-threshold exercise was not observed in the present study. and oxygen uptake (V ˙ O2) responses volume (SV).8 Ϯ 4.1 Ϯ 27. A longer exercise Medicine & Science in Sports & Exerciseா 1361 . circles matical model during time to exhaustion at pV and solid line represent a-vO2 diff values and its mathematical model during time to exhaustion at p⌬50 (tlim⌬50).4 163.8 Ϯ 2. who observed an increase in muscle oxygenation ˙ O2peak. Despite the fact than tlim⌬50 elicited eliciting V ˙ O2max (6. This is probably due to the fact that the work rate was not sufficient because the intensity that elicited SVmax in the increment test was higher than p⌬50 (89. both SV and V reaching the maximal value measured in an incremental test.5% of ˙ O2max. § P Ͻ 0.1 13. empty lozenges represent Q full triangles represent SV kinetics during tlim100. level of significance between incremental and constant work rate exercises.14).9 tlim100 4545 Ϯ 500 173 Ϯ 14 153 Ϯ 27 25.6 Ϯ 35. ˙ O2MAX-Q ˙ DISSOCIATION DURING HEAVY EXERCISE V with the reference values of a classic incremental test (with 3-min stages). Indeed. The main finding from this study was that ˙ O2max was attained with a lower value of cardiac output V due a lower SV in tlim⌬50 than in the incremental test.3 8. This “Q ˙ –V ˙ O2 disassociV ation” has been attributed to the lower stroke volume in an incremental test lasting 12 min versus 6 min (21).05. Maximal values of the peripheral and central fac˙ O2max during the incremental exercise. Maximal values during incremental exercise and constant workload at ˙ O2max (tlim100).05. (17).2 Ϯ 5. 43. (9) have reported that during a ˙ O2max (11 min 42 s Ϯ constant load exercise at 90% of pV ˙ O2 increased until exhaustion 4 min 7 s). The maximal arterial-venous O2 difference was not significantly different according the exercise intensity but decreased more slowly in the tlim⌬50 compared with tlim100 test. stroke ˙ ). 5).7 15. P Ͻ 0.4 Ϯ 26. the maximal stroke volume was not reached.8%) or in the incremental test (SaO2 ϭ 8.1 Ϯ 2. In the present study.8 * P Ͻ 0. we are going to discuss the value of power output at which the stroke volume reaches its maximum.05).9 161. V ˙ O2max was reached with the maximal V ˙ and a-vO2 diff during the incremental test.9 Ϯ 4.3 vs 88.74.8 tlim⌬50 4363 Ϯ 453 175 Ϯ 13 143 Ϯ 27* 24. attainment Q In agreement with a previous investigation by Grassi et al.01). Therefore. p⌬50 (tlim⌬50) and pV Subjects (N ‫ ؍‬9) ˙ O2max (mL⅐minϪ1) V HRmax (beat⅐minϪ1) SVmax (mL⅐beatϪ1) ˙ max (L⅐minϪ1) Q a-vO2 diff (mL) ˙ Emax (L⅐minϪ1) V ⌬SaO2 (%) Incremental Test 4463 Ϯ 452 171 Ϯ 14 179 Ϯ 34 28. our results also ([O2Hb Ϫ HHb]) until 60 – 65% of V showed an increase in a-vO2 diff until 63. Circles represent ˙ O2 kinetics during tlim100. maximal stroke volume and maximal cardiac output values were lower in the 12-min than 6-min test.2% of the time limit. but it decreased later in tlim⌬50 compared with tlim100 (6 min 58 s Ϯ 4 min 29 s vs 3 min 6 s Ϯ 1 min 3 s. during tlim100. SV did not plateau V ˙ O2max as reported in nonactive subjects (1).0 Ϯ 1. In tors of V agreement with recent studies performed with trained subjects (9.0 Ϯ 22.8 Ϯ 26.2 Ϯ 1. level of significance between time to exhaustion at pV FIGURE 4 —Example of modeling kinetics of heart rate (HR). the exercise duration was put pV forward as being a major factor for the achievement of ˙ O2max without Q ˙ max attainment. First. ercises (Table 3 and Fig.05.

This study was supported by grants from Caisse Centrale des Activite ´ s Sociales d’Electricite ´ et de Gaz de France. However. FEASSON. la Fondation ® ´ Gaz de France. the right shift of the during severe exercise below pV oxy-hemoglobin dissociation curve on tissue oxygenation would be responsible of the attainment of maximal value of ˙ O2.. V. On the contrary.5 or 100% of pV ˙ O2max using different be taken into account for training at V ˙ O2max). 19:268 –274. 90% ˙ O2max is an intensity threshold for the attainment of of pV maximal SV both in an incremental test (with 3-min stages) and constant-load exercise. the progressive recruitment of new unit motors associated with respiratory muscles (19. and J. we can define pV ˙ max with maximal as the work rate allowing matching Q value of a-vO2 diff. V.23. N. RUSKO. (21) postulated that the lower stroke volume during 12-min versus the 6-min incremental test could be in part compensated by the increased of arterial-venous O2 difference (a-vO2 diff). Hence. which was also more pronounced during tlim⌬50 than in incremental test. 80:159 –161. 76:260 –263. COSTES. SALTIN. et al. 1999. V same central and peripheral factors in exhaustive exercises ˙ O2max. L. However. BILLAT. Our results two severe exercises eliciting V showed that a-vO2 diff was not significantly different between the three exercises. work rates (90 –100% pV The authors thank Dr. At the onset of dynamic exercise. This difference was sufficient to reach or not reach the maximal stroke volume at the onset of the dynamic exercise. the duration of exercise.44 kgF (at a rate of pedaling equal to 90 rpm). J. as a consequence of a rightward shift of the oxy-hemoglobin dissociation curve determined by the onset of lactic acidosis (17). 1984. Physiol. of a rise of lactic acidosis and a subsequent decrease in pH above lactate threshold (27). which might be higher in tlim100 compared with tlim⌬50. BINSSE. 4. In the present study. Alternatively. the mechanical effects of the muscle pump increased the arterial-venous pressure gradient (12). the pumping action of contracting skeletal muscle appeared to form an important regulator of increasing blood flow. T. 106:38 – 45. Physiol. ASTRAND. BLONDEL. On the other hand. L. muscle de-oxygenation from 60˙ O2peak could be attributed to capillary-venular 65% of V hemoglobin desaturation..duration could induce a vasodilatation and an increased vascular conductance via the muscle pump in skeletal muscle considered as a determinants of sustained exercise hyperemia in skeletal muscle (13). This might performed at 88. 1964. Previously. A new stroke volume equation for thoracic bioimpedance: theory and rationale. High level runners are able to maintain a VO2 steady-state below VO2max in an all-out run over their critical velocity. Crit. both in incremental and constant work ˙ O2max) has as also been reported as rate. Eur. The time course of a-vO2 diff may be the result REFERENCES 1. 1986. Thus.. J. D. the longer duration of the exercise V would be responsible for a more marked hypoxemia which would counterbalance the Bo ¨ hr effect and would be respon˙ O2max sible for ending the exercise. KORALSZTEIN. The rate of increase in blood flow during exercise is closely coupled to motor unit recruitment with dilation beginning at the first contraction (26).25) could be responsible for the attainment of ˙ O2max without the Q ˙ max during tlim⌬50. and le Conseil Re ´ gional d’Ile de France. 2. a-vO2 diff narrows less quickly in the lower work rate test (tlim⌬50). BILLAT. This threshold intensity to reach the maximal stroke volume attainment could depend on the quadriceps muscle mass involved in the cycling exercise.acsm-msse. and H. B. Cardiac output during submaximal and maximal work. CONCLUSION Despite there being no difference in the maximal value of ˙ O2.. Appl. O. V. Physiol. 1998. In our study. 4. BENOIT. we have one exercise mode (cycling) but two intensities that have a difference of 40 W. This work rate (pV ˙ O2max for the longest duration being the work rate eliciting V in constant load exercise (6). and J. 1362 Official Journal of the American College of Sports Medicine http://www. S. Jean Slawinski for contributions to the presentation of this manuscript. The quicker recruitment of a large muscle mass at the onset of exercise at the higher intensity was responsible to the attainment of maximal value of SV. V Arterial-venous O2 difference responses during ˙ O2max. Occup. It seems that in trained subjects. Appl. The lower SV seems to be the ˙ max during time main contributor of the nonachievement of Q ˙ O2 reached its maximal to exhaustion at p⌬50 whereas V ˙ O2max was not reached with the value in the both cases. BERTHOIN.e. P. Appl.org . 1997.. H. Appl. So. the decrease in a-vO2 diff was associated with a hypoxemia induced by exercise (SaO2rest Ϫ end of exercise).. Reproducibility of aerobic and anaerobic thresholds in 20 –50 years old men. Nassis and Geladas (22) have recently demonstrated that the decline in stroke volume during an exercise at 60% of ˙ O2max was higher in cycling than in running. 3. P. i. STENBERG. Accuracy of pulse oximetry during intense exercise under severe hypoxic conditions. Physiol. even in exercise elic˙ O2max (so-called “heavy exercise. Biochem. the V ˙ O2max reached during the incremental test reV ˙ compared with the constant sulted in a greater maximal Q p⌬50 workload exercise. They pV showed a moderate correlation between the one-leg quadriceps muscle mass and SV decline in cycling. J. 14:904 –909. (14) found a correlation between the vastus lateralis deoxygenation changes with the oxygen uptake changes and the blood lactate increase between the third minute of exercise and the time to fatigue. ˙ O2max. E. Physiol. Eur. 6. P. Physiol. and S. J.” (29)) is not sufiting V ficient to elicit SVmax. BERSTEIN. implying that individuals with high thigh muscle mass would present a smaller SV decline in cycling compared with running (22). Indeed. McCole et al. Demarie et al. CUDDY. 53:260 –266. F.0 Ϯ 1. 5. Therefore. Genopole . the blood lactate level was not different between the three exercises. AUNOLA. Determination of the velocity associated with the longest time to exhaustion at maximal oxygen uptake. L. Eur. Furthermore. Care Med. Arch.

D. 2001. Po HARA. D. 2001. P. DAVIS. Med.. Pflu ¨ gers Arch. Sci. LAFITTE. Sports Med. G. 22. P. Physiol. M. A. 12. Appl. 33:S96. 18. using a new impedance cardiograph device. Med. J. D. D. M. 15. FRENCH. Appl. 2001. 1987. G. K. W. 33:1265–1269. HAENNEL. 29. Sci. R. A. Adaptation of blood flow during the rest to work transition in humans. DELP. CASABURI. M. S. L. PINOTEAU. Appl. FUEGER. J. LONSDORFER-WOLF. Med.. V. J. K. 2000. Lactic acidosis as a facilitator of oxyhemoglobin dissociation during exercise. 2001. MARCONI. Endurance athlete’s stroke volume does not plateau: major advantage is diastolic function. RICHARD. D.. J. M. 87:1997–2006. K. Sci. Cardiovasc. 2000. Appl. SCHEUERMANN. E. Sports Exerc. 31:1019 –1026. 20:102–111. 26. LONDSORFER. ˙ O2MAX-Q ˙ DISSOCIATION DURING HEAVY EXERCISE V Medicine & Science in Sports & Exerciseா 1363 . L. ˜ RSZASZ. and J. D. 1996. R. PETIT. F. 1987. CONLEE. Physiol. and P. R. Physiol. R. K. 14. 1999. BILLAT. 76:VI18 –VI28. FISCHER. HETHERINGTON. DELP. Physiol. S. Sports Exerc. BILLAT. NOBLE. and V. J. J. LAUGHLIN. Sports Exerc. and D. A. Respir. 33:1849 –1854. BOLSTER. FERRARI. WAGNER.. and P. 21. Eur. and P. 1999. 19:737–743. et al. C. Neurobiol. 445:398 – 404. Cardiac output measured by impedance cardiography during maximal exercise tests. 28. and N. P. SHOEMAKER. Oxygen-pulse steady state allows estimation of VO2 by heart rate monitoring in a severe submaximal run. HARMARD. A new impedance cardiograph device for non-invasive evaluation of cardiac output at rest and during exercise: comparison with the “direct” Fick method. L. Regulation of skeletal muscle perfusion during exercise. and J. 1999. R.. Scand. T. Is there disassociation of maximal oxygen consumption and maximal cardiac output? Med. J.. STRINGER. Stroke volume does not plateau during graded exercise in elite male distance runners. Sci. J. RICHARD. A. V. B. and T. Biology of Sport 17:255–264. 2002. WASSERMAN. Res. V. Cardiac output decline in prolonged dynamic exercise is affected by the exercise mode. J. M. Acta Physiol. GELADAS. W. 1985. MAE27. J. C. 20. Significance of the velocity at VO2max and time to exhaustion at this velocity. and J. 253:H993– H1004. VO2 slow component correlates with vastus lateralis de-oxygenation and blood lactate accumulation in running. Fitness 41:448 – 455. 162:411– 419. K. D. G. Appl. WHIPP. W. HUGHSON. N. and M. Sports Exerc. LONDSDORFER-WOLF.. PERREY. 2001. J. DEMARIE. BOUCKAERT. 80:1011–1018. J. B. D. Sci. BILLAT. RENOUX. The effect of submaximal exercise on gas exchange kinetics and ventilation during heavy exercise in humans. L. 1999. V... QUARESIMA. 531:245–256.. FERRARI. D. and R. Physiol. J. B. A. Physiol. J. H. and A. and A. Noninvasive cardiac output evaluation during a maximal progressive exercise test. FELLINGHAM. 32:1080 –1087. K. Appl. 2002. A. and R. LONDSORFER. Eur. COX. Am. Sports Exerc. 1994. C. JONES. Dynamics of pulmonary gas exchange.. D.. Can. J. KOPPO. 16. 87:348 –355. KORALSZTEIN. 24.7. J.. and T. M. L. CANDAU. ROUILLON. Cardiovascular responses during prolonged exercise at ventilatory threshold in boys and men.. 2001. 1995. Physiol. The slow component of O(2) uptake is not accompanied by changes in muscle EMG during repeated bouts of heavy exercise in humans. KAPPAGODA. M. GEORGE. 2000. GLEDHILL.. D. Sports Med. D. Stroke volume increases in an all-out severe cycling exercise in moderate trained subjects. RICHARD. 9. 23. Sci. Skeletal muscle blood flow capacity: role of muscle pump in exercise hyperemia. MAHON. 82:313–320. L. 11. R. J. Sci. Sports Exerc. H. 19. 89:587–593. ¨ LTING. K.. CHARLOUX. HOE BARSTOW. V. J.. 22:90 –108. V. P. Physiol. J. JAMNIK. J. 17. B. KORALSZTEIN. QUARESIMA. 2003. M. Oxygen kinetics during high-intensity arm and leg exercise. Med. 1994. Physiol. CERRETELLI. 10. Sports Exerc. Med. C. TEO. Eur. Physiol... E. Hypoxemia and exhaustion time to maximal aerobic speed in long-distance runners. Blood lactate accumulation and muscle de-oxygenation during incremental exercise. JENSEN. 26:1116 –1121. KORALSZTEIN. ZHOU. FAINA. G. S. 30. BROWN. 13. Exercise-induced arterial hypoxemia. E. GRASSI. Med. R.. J. 8. DEMPSEY. R. NASSIS. HUGHSON.. L. and M. J. ROSSALL. R. E. B. Phys. BILLAT. M. DEMARLE. L. GREENWOOD. and R. BILLAT. Circulation. R. P. SARDELLA. LAUGHLIN. CHARLOUX. V. 133:241–250. 85:202–207. B. 1998. Control of skeletal muscle perfusion at the onset of dynamic exercise. and W. Appl. 25. 76:1462– 1467. et al. MCCOLE. CHEATHAM.