Unexplained exertional intolerance associated with impaired systemic oxygen extraction

Purpose 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). Method...

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Bibliographic Details
Published in:European journal of applied physiology 2019-10, Vol.119 (10), p.2375-2389
Main Authors: Melamed, Kathryn H., Santos, Mário, Oliveira, Rudolf K. F., Urbina, Mariana Faria, Felsenstein, Donna, Opotowsky, Alexander R., Waxman, Aaron B., Systrom, David M.
Format: Article
Language:English
Subjects:
Adult
Aged
Anaerobic Threshold
Biomedical and Life Sciences
Biomedicine
Carbon dioxide
Cardiorespiratory Fitness
Exercise - physiology
Exercise Tolerance
Female
Heart
Heart Rate
Human Physiology
Humans
Hyperventilation
Intolerance
Male
Middle Aged
Occupational Medicine/Industrial Medicine
Original Article
Oxygen
Pulmonary Gas Exchange
Pulmonary Ventilation
Skeletal muscle
Sports Medicine
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Summary:Purpose 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). Methods 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 2 )/[Hb] ≤ 0.8 and V O 2max   0.8, V O 2max  ≥ 80%, and no cardiac or pulmonary limit were considered otherwise normal. The otherwise normal group was divided into hyperventilators (HV) and normals (NL). Hyperventilation was defined as peak PaCO 2  
ISSN:1439-6319
1439-6327
DOI:10.1007/s00421-019-04222-6