Unexplained exertional intolerance associated with impaired systemic oxygen extraction.
Cardiopulmonary exercise testing
Chronic fatigue syndrome
Exertional intolerance
Hyperventilation
Poor systemic oxygen extraction
Journal
European journal of applied physiology
ISSN: 1439-6327
Titre abrégé: Eur J Appl Physiol
Pays: Germany
ID NLM: 100954790
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
17
12
2018
accepted:
28
08
2019
pubmed:
8
9
2019
medline:
7
2
2020
entrez:
8
9
2019
Statut:
ppublish
Résumé
The clinical investigation of exertional intolerance generally focuses on cardiopulmonary diseases, while peripheral factors are often overlooked. We hypothesize that a subset of patients exists whose predominant exercise limitation is due to abnormal systemic oxygen extraction (SOE). We reviewed invasive cardiopulmonary exercise test (iCPET) results of 313 consecutive patients presenting with unexplained exertional intolerance. An exercise limit due to poor SOE was defined as peak exercise (Ca-vO Prevalence of impaired SOE as the sole cause of exertional intolerance was 12.5% (32/257). At peak exercise, poor SOE and HV had less acidemic arterial blood compared to NL (pHa = 7.39 ± 0.05 vs. 7.38 ± 0.05 vs. 7.32 ± 0.02, p < 0.001), which was explained by relative hypocapnia (PaCO We identified a cohort of patients whose exercise limitation is due only to systemic oxygen extraction, due to either an intrinsic abnormality of skeletal muscle mitochondrion, limb muscle microcirculatory dysregulation, or hyperventilation and left shift the oxyhemoglobin dissociation curve.
Identifiants
pubmed: 31493035
doi: 10.1007/s00421-019-04222-6
pii: 10.1007/s00421-019-04222-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2375-2389Subventions
Organisme : NIH HHS
ID : U01HL125215-01
Pays : United States
Organisme : NIH HHS
ID : U01HL125215-01
Pays : United States
Références
Am J Physiol. 1999 Nov;277(5):R1274-81
pubmed: 10564197
Ann Neurol. 2000 Aug;48(2):188-93
pubmed: 10939569
Am J Respir Crit Care Med. 2001 Aug 1;164(3):425-32
pubmed: 11500344
J Physiol. 2001 Dec 1;537(Pt 2):641-9
pubmed: 11731594
Ann Neurol. 2002 Jan;51(1):38-44
pubmed: 11782982
J Appl Physiol (1985). 2002 May;92(5):1808-16
pubmed: 11960928
Scand J Clin Lab Invest. 1975 Oct;35(6):539-43
pubmed: 1198057
Circulation. 2002 May 14;105(19):2274-81
pubmed: 12010910
Neurology. 2002 May 28;58(10):1533-8
pubmed: 12034793
Brain. 2003 Feb;126(Pt 2):413-23
pubmed: 12538407
Clin Auton Res. 2002 Dec;12(6):429-39
pubmed: 12598947
Chest. 2003 Aug;124(2):720-7
pubmed: 12907564
Clin Physiol Funct Imaging. 2004 Mar;24(2):109-15
pubmed: 15056184
Eur Heart J. 2005 Mar;26(5):472-80
pubmed: 15618042
J Appl Physiol (1985). 1992 May;72(5):1810-7
pubmed: 1601790
Mitochondrion. 2004 Sep;4(5-6):529-42
pubmed: 16120411
Med Sci Sports Exerc. 2005 Dec;37(12):2086-93
pubmed: 16331134
Muscle Nerve. 2006 Apr;33(4):524-31
pubmed: 16372322
Acta Neurol Belg. 2007 Sep;107(3):78-83
pubmed: 18072335
Med Sci Sports Exerc. 2008 Jan;40(1):3-8
pubmed: 18091026
Circulation. 2008 Nov 18;118(21):2183-9
pubmed: 18981305
J Appl Physiol (1985). 2010 Jun;108(6):1641-50
pubmed: 20339012
Circ Heart Fail. 2010 Sep;3(5):588-95
pubmed: 20543134
J Appl Physiol (1985). 2010 Oct;109(4):966-76
pubmed: 20634355
J Appl Physiol (1985). 2010 Oct;109(4):947-8
pubmed: 20689092
Exp Physiol. 2010 Nov;95(11):1043-8
pubmed: 20696787
Mayo Clin Proc. 2010 Dec;85(12):1095-100
pubmed: 21123636
Braz J Med Biol Res. 2011 Apr;44(4):354-60
pubmed: 21487644
J Am Coll Cardiol. 2011 Jul 12;58(3):265-74
pubmed: 21737017
Am J Physiol Regul Integr Comp Physiol. 2011 Oct;301(4):R873-84
pubmed: 21813873
Eur J Appl Physiol. 2012 May;112(5):1763-71
pubmed: 21898145
Eur J Heart Fail. 2011 Dec;13(12):1296-304
pubmed: 21979991
Eur J Heart Fail. 2013 Jul;15(7):776-85
pubmed: 23426022
Circulation. 2013 Mar 12;127(10):1157-64
pubmed: 23479667
Exp Physiol. 2013 Oct;98(10):1422-31
pubmed: 23733520
Exp Physiol. 2013 Dec;98(12):1668-82
pubmed: 23975901
Eur Respir J. 2014 May;43(5):1316-25
pubmed: 24177003
Exp Physiol. 2014 Apr;99(4):609-15
pubmed: 24293507
Respir Physiol Neurobiol. 2014 Jan 1;190:142-8
pubmed: 24369924
J Appl Physiol (1985). 2014 Apr 1;116(7):736-45
pubmed: 24458750
Front Physiol. 2014 Jun 16;5:220
pubmed: 24982638
Circ Heart Fail. 2015 Mar;8(2):286-94
pubmed: 25344549
J Appl Physiol (1985). 2015 Jan 1;118(1):1-10
pubmed: 25359719
Circ Heart Fail. 2015 Mar;8(2):278-85
pubmed: 25550438
Clin Chest Med. 1989 Jun;10(2):227-37
pubmed: 2661120
Rev Environ Health. 2015;30(4):223-49
pubmed: 26613325
Medicine (Baltimore). 1989 May;68(3):163-72
pubmed: 2716515
J Appl Physiol (1985). 1988 Nov;65(5):2080-9
pubmed: 3145275
Chest. 1988 Mar;93(3 Suppl):97S-99S
pubmed: 3342706
J Appl Physiol (1985). 1987 Aug;63(2):521-30
pubmed: 3654410
Neurology. 1987 Feb;37(2):257-62
pubmed: 3808305
Ann Neurol. 1985 Aug;18(2):189-96
pubmed: 4037759
Ann Intern Med. 1967 Feb;66(2):312-22
pubmed: 6016545
Am Rev Respir Dis. 1984 Feb;129(2 Pt 2):S49-55
pubmed: 6421218
J Neurol Sci. 1994 Dec 20;127(2):198-206
pubmed: 7707079
J Appl Physiol (1985). 1994 Apr;76(4):1462-7
pubmed: 8045820
Med Sci Sports Exerc. 1994 Mar;26(3):319-27
pubmed: 8183096
J Appl Physiol (1985). 1998 Jan;84(1):90-6
pubmed: 9451622
J Appl Physiol (1985). 1998 Feb;84(2):676-82
pubmed: 9475880