Relationships of Oxygen Consumption, Hemodynamics, and Heart Rate Variability with the Functional Class of Coronary Artery Disease Patients

The functional classes (FCs) established according to the criteria of the New York Heart Association were tested for association with oxygen consumption, the state of central hemodynamics, and heart rate (HR) variability in coronary artery disease (CAD) patients. Oxygen consumption, central hemodynamics, and HR variability at rest and during exercise were assayed in 146 CAD patients and 30 healthy individuals (the control group). It was established that the peak oxygen consumption (VO_2max), anaerobic threshold, pulmonary ventilation, systolic and minute blood volume at the threshold load (TL), and HR variability in a supine position significantly decrease and the total vascular peripheral resistance at rest and during exercise increases with increasing FC in CAD patients. The closest correlation of FC was revealed with physical working capacity, anaerobic threshold, age, and peak oxygen consumption. Moderate correlations were established with the chronotropic function of the heart at the threshold load, HR variability, the high- and low-frequency components of the cardiac rhythm at TL, pulmonary ventilation, stroke volume at rest and at TL, and the carbon dioxide ventilation equivalent at TL. In healthy individuals, the peak oxygen consumption closely correlated with the HR variability, the very low frequency component at TL, and physical capacity. With an increase in FC in CAD patients, peak oxygen consumption became more tightly associated with the chronotropic function and the hemodynamic components at TL than with the HR variability in a supine position or at TL.     

Estimation of Coronary Reserve by Dynamic Electrocardiography

A method of detection of coronary reserve (CR) for the effective estimation of the functional state of patients with coronary heart disease is discussed. To verify CR estimation by loading tests in subjects with pronounced signs of myocardial ischemia in the electrocardiogram, we examined the stationary heart rate (HR) level as a function of the loading power in each subject. These functions contained intervals of linear and nonlinear changes. In patients with stable stenocardia, the minimum daily HR and the threshold HR that characterizes reaching of the anaerobic threshold by myocardium loci were always in the domain of linear changes. A pathophysiologically substantiated index of coronary reserve was advanced. Values of this index of over 60, 60–35, 34–20, and below 20% correspond to functional classes I, II, III, and IV of stenocardia, respectively.     

Prospect of Stress Testing

A new method for analyzing the data of stress electrocardiography, based on physiologically justified approximations of trends in the heart rate (HR) and ST, is discussed. The method makes it possible to determine how the HR and ST of an individual vary with time during graded exercise and how these parameters and the times of their regulation depend on the workload; to reveal general patterns of their behavior; and to derive new physiological characteristics. Analysis of the general patterns of only the load time dependences of HR and ST and of the workload dependence of HR in patients with ischemic heart disease allows us to detect brief episodes of myocardial ischemia; to assess the anaerobic thresholds of locally injured areas of the myocardium and of the whole body; and to propose unified parameters for assessing the coronary reserve, the physical working capacity, and the severity of ischemic injury to the myocardium. The proposed method of analysis of stress electrocardiographic data and the combined use of stress electrocardiography, positron emission tomography, myocardial scintigraphy, and stress echocardiography offer new opportunities for a better understanding of myocardial ischemia.     

Different times of day do not change heart rate variability recovery after light exercise in sedentary subjects: 24 hours Holter monitoring

Incidence of cardiovascular events follows a circadian rhythm with peak occurrence during morning. Disturbance of autonomic control caused by exercise had raised the question of the safety in morning exercise and its recovery. Furthermore, we sought to investigate whether light aerobic exercise performed at night would increase HR and decrease HRV during sleep. Therefore, the aim of this study was to test the hypothesis that morning exercise would delay HR and HRV recovery after light aerobic exercise, additionally, we tested the impact of late night light aerobic exercise on HR and HRV during sleep in sedentary subjects. Nine sedentary healthy men (age 24 ± 3 yr; height 180 ± 5 cm; weight 79 ± 8 kg; fat 12 ± 3%; mean±SD) performed 35 min of cycling exercise, at an intensity of first anaerobic threshold, at three times of day (7 a.m., 2 p.m. and 11 p.m.). R-R intervals were recorded during exercise and during short-time (60 min) and long-time recovery (24 hours) after cycling exercise. Exercise evoked increase in HR and decrease in HRV, and different times of day did not change the magnitude (p < 0.05 for time). Morning exercise did not delay exercise recovery, HR was similar to rest after 15 minutes recovery and HRV was similar to rest after 30 minutes recovery at morning, afternoon, and night. Low frequency power (LF) in normalized unites (n.u.) decreased during recovery when compared to exercise, but was still above resting values after 60 minutes of recovery. High frequency power (HF-n.u.) increased after exercise cessation (p < 0.05 for time) and was still below resting values after 60 minutes of recovery. The LF/HF ratio decreased after exercise cessation (p < 0.05 for time), but was still different to baseline levels after 60 minutes of recovery. In conclusion, morning exercise did not delay HR and HRV recovery after light aerobic cycling exercise in sedentary subjects. Additionally, exercise performed in the night did change autonomic control during the sleep. So, it seems that sedentary subjects can engage physical activity at any time of day without higher risk.     

Effect of inspiratory resistive loading on control of ventilation during progressive exercise

Eight healthy volunteers performed gradational tests to exhaustion on a mechanically braked cycle ergometer, with and without the addition of an inspiratory resistive load. Mean slopes for linear ventilatory responses during loaded and unloaded exercise [change in minute ventilation per change in CO2 output (delta VE/delta VCO2)] measured below the anaerobic threshold were 24.1 +/- 1.3 (SE) = l/l of CO2 and 26.2 +/- 1.0 l/l of CO2, respectively (P greater than 0.10). During loaded exercise, decrements in VE, tidal volume, respiratory frequency, arterial O2 saturation, and increases in end-tidal CO2 tension were observed only when work loads exceeded 65% of the unloaded maximum. There was a significant correlation between the resting ventilatory response to hypercapnia delta VE/delta PCO2 and the ventilatory response to VCO2 during exercise (delta VE/delta VCO2; r = 0.88; P less than 0.05). The maximal inspiratory pressure generated during loading correlated with CO2 sensitivity at rest (r = 0.91; P less than 0.05) and with exercise ventilation (delta VE/delta VCO2; r = 0.83; P less than 0.05). Although resistive loading did not alter O2 uptake (VO2) or heart rate (HR) as a function of work load, maximal VO2, HR, and exercise tolerance were decreased to 90% of control values. We conclude that a modest inspiratory resistive load reduces maximum exercise capacity and that CO2 responsiveness may play a role in the control of breathing during exercise when airway resistance is artificially increased.     

Physiological Criteria in Defining the Standards for Training and Competition Loads in Elite Sports

Adaptation to training loads can be quantitatively described by a dose-effect dependence, with the gain in the training function over a certain period regarded as the effect and the dose expressed as a product of the energy spent during exercise and the stimulus duration. The duration combines the periods of exercises, pauses, and recovery needed to compensate for the fast fraction of the oxygen debt. In addition to direct measurements of the energy spent, quantitative assessment of the load intensity can be based on the total pulse cost of exercise, which accurately reflects the changes in the oxygen demand and the energy cost of the physical load. To quantitate and standardize training and competition loads, we suggest the use of correlations found between the pulse and energy costs of exercises and their relative power determined in critical modes of muscle activity: at the anaerobic threshold; the critical power, associated with the maximum oxygen consumption; the alactic anaerobic threshold; the power of exhaustion, when blood lactic acid reaches its maximum; or at maximum aerobic power, when the muscle reserves of ATP and creatine phosphate are the most depleted.     

Effect of anaerobiosis on the kinetics of O2 uptake during exercise

The anaerobic threshold is an O2-related threshold of metabolic acidemia of which the chief metabolic acid is lactic acid. As such, it is a crucial parameter of aerobic function. For power outputs that are below the anaerobic threshold, the dynamics of O2 uptake (VO2) is well characterized as a linear first-order exponential process. The system time constant for leg exercise in humans has been shown to be congruent to 25-35 s with a "delay" of 15-20 s. Steady states are therefore normally achieved within 3 min at this work intensity. Above the anaerobic threshold a second, slower component of VO2 becomes evident that delays the steady state (if attainable). Consequently, the difference in VO2 between the third and the sixth minute of exercise is zero if the work rate is subthreshold and becomes progressively greater, the higher the increment above this parameter; this also correlates highly with the increment of arterial blood lactate, [L-]. This slow phase of the VO2 kinetics results in "excess" VO2, in that the VO2 rises to values above those attained by fitter subjects. This excess VO2 correlates highly with the increased [L-] (and possibly other factors), although its magnitude increases even more rapidly at work rates for which the increase in [L-] exceeds 4-5 meq/liter.     

Parasympathetic reactivation after repeated sprint exercise

The purpose of this study was to examine the effects of muscular power engagement, anaerobic participation, aerobic power level, and energy expenditure on postexercise parasympathetic reactivation. We compared the response of heart rate (HR) after repeated sprinting with that of exercise sessions of comparable net energy expenditure and anaerobic energy contribution. Fifteen moderately trained athletes performed 1) 18 maximal all-out 15-m sprints interspersed with 17 s of passive recovery (RS), 2) a moderate isocaloric continuous exercise session (MC) at a level of mean oxygen uptake similar to that of the RS trial, and 3) a high-intensity intermittent exercise session (HI) conducted at a level of anaerobic energy expenditure similar to that of the RS trial. Subjects were immediately seated after the exercise trials, and beat-to-beat HR was recorded for 10 min. Parasympathetic reactivation was evaluated through 1) immediate postexercise HR recovery, 2) the time course of the root mean square for the successive R-R interval difference between successive 30-s segments (RMSSD(30s)) and 3) HR variability vagal-related indexes calculated for the last 5-min stationary period of recovery. RMSSD(30s) increased during the 10-min period after the MC trial, whereas RMSSD(30s) remained depressed after both the RS and HI trials. Parasympathetic reactivation indexes were similar for the RS and HI trials but lower than for the MC trial (P < 0.001). When data of the three exercise trials were considered together, only anaerobic contribution was related to HR trial-derived indexes. Parasympathetic reactivation is highly impaired after RS exercise and appears to be mainly related to anaerobic process participation.     

Determination of the anaerobic threshold by the rate of ventilation and cardio interval variability

The aim of this work is to develop methods for determining the anaerobic threshold according to the rate of ventilation and cardio interval variability during the test with stepwise increases load on the cycle ergometer and treadmill. In the first phase developed the method for determining the anaerobic threshold for lung ventilation. 49 highly skilled skiers took part in the experiment. They performed a treadmill ski-walking test with sticks with gradually increasing slope from 0 to 25 degrees, the slope increased by one degree every minute. In the second phase we developed a method for determining the anaerobic threshold according dynamics ofcardio interval variability during the test. The study included 86 athletes of different sports specialties who performed pedaling on the cycle ergometer "Monarch" in advance. Initial output was 25 W, power increased by 25 W every 2 min. The pace was steady--75 rev/min. Measurement of pulmonary ventilation and oxygen and carbon dioxide content was performed using gas analyzer COSMED K4. Sampling of arterial blood was carried from the ear lobe or finger, blood lactate concentration was determined using an "Akusport" instrument. RR-intervals registration was performed using heart rate monitor Polar s810i. As a result, it was shown that the graphical method for determining the onset of anaerobic threshold ventilation (VAnP) coincides with the accumulation of blood lactate 3.8 +/- 0.1 mmol/l when testing on a treadmill and 4.1 +/- 0.6 mmol/1 on the cycle ergometer. The connection between the measure of oxygen consumption at VAnP and the dispersion of cardio intervals (SD1), derived regression equation: VO2AnT = 0.35 + 0.01SD1W + 0.0016SD1HR + + 0.106SD1(ms), l/min; (R = 0.98, error evaluation function 0.26 L/min, p < 0.001), where W (W)--Power, HR--heart rate (beats/min), SD1--cardio intervals dispersion (ms) at the moment of registration of cardio interval threshold.     

Perceived exertion and gas exchange after calcium and beta-blockade in atrial fibrillation

Nine male patients (mean age 65 yr) with chronic atrial fibrillation underwent maximal exercise testing during placebo, beta-adrenergic (celiprolol, 600 mg), or calcium (diltiazem, 30 or 60 mg four times daily) channel blockade. The results were analyzed to determine which factors most closely related to ratings of perceived exertion (RPE) during exercise. Heart rate (HR), blood pressure (BP), oxygen uptake (VO2), minute ventilation (VE), and carbon dioxide production (VCO2) were evaluated at rest, 3.0 mph/0% grade, the gas exchange anaerobic threshold (ATge), 80% of placebo maximal O2 uptake, and maximal exercise. Both beta-adrenergic and calcium channel blockade significantly reduced heart rate and systolic blood pressure relative to placebo; these effects were more profound during beta-adrenergic blockade and as exercise progressed. Correlation coefficients and estimates of slope were derived for changes in RPE during exercise vs. changes in HR, VO2, VE, and VCO2 during the three treatments (r = 0.76 to 0.92, P less than 0.001). Although RPE was significantly correlated with HR during placebo and diltiazem therapy (r = 0.45, P less than 0.01), this was not the case during beta-adrenergic blockade (r = 0.31, NS). Slope of the regression lines between RPE and VO2, VE, and VCO2 did not differ between the three treatments. Slope of the regression lines between RPE and HR differed only during calcium channel blockade. Because the presence of atrial fibrillation and beta-adrenergic blockade altered the associations between RPE, VO2, and HR, these results suggest that VE is more closely related to RPE than the other parameters.     

Analysis and Evaluation of the Functional State of the Cardiovascular System in Cosmonauts during Long-term Spaceflights

Forty-four cosmonauts participating in 28 main long-term (73–438 days) missions on the Mirorbital station performed functional tests with graded physical exercise using a bicycle ergometer. There were two types of this functional load. The cosmonauts that participated in the first eight main missions performed a two-step exercise with a total load power of 1150 W. In the remaining cosmonauts, the exercise was three-step, with a total power of 1350 W. The results obtained during the flight were compared with the results of the same tests performed before the flight, which served as control values for each cosmonaut. To estimate the load tolerance, the heart rate (HR), systolic blood pressure, stroke volume (SV), cardiac output (CO), and cardiac index were analyzed. The data were grouped according to the load, taking into account the type of blood circulation for each group before and during the flight. The ratio between different types of blood circulation was found to change during the flight. The responses to both types of exercises before the flight were less favorable in the cases of the hyperkinetic type of circulation. In these cases, the dominance of the chronotropic function of the heart determined the increase in CO. In the cases of the hypo- and eukinetic types of circulation, the response to the exercise was close to normotonic. In microgravity, irrespective of the circulation type and the exercise, the mechanism of the CO formation changed: the effect of HR was dominant, and there was no increase in SV. Insufficient venous return to the chambers of the heart is the main cause of the decreased response of SV to exercises during spaceflight.     

Analysis of heart rate deflection points to predict the anaerobic threshold by a computerized method

Many studies have used the heart rate deflection points (HRDPs) during incremental exercise tests, because of their strong correlation with the anaerobic threshold. The aim of this study was to evaluate the profile of the HRDPs identified by a computerized method and compare them with ventilatory and lactate thresholds. Twenty-four professional soccer players (age, 22 ± 5 years; body mass, 74 ± 7 kg; height 177 ± 7 cm) volunteered for the study. The subjects completed a Bruce-protocol incremental treadmill exercise test to volitional fatigue. Heart rate (HR) and alveolar gas exchange were recorded continuously at ≥1 Hz during exercise testing. Subsequently, the time course of the HR was fit by a computer algorithm, and a set of lines yielding the lowest pooled residual sum of squares was chosen as the best fit. This procedure defined 2 HRDPs (HRDP1 and HRDP2). The HR break points averaged 43.9 ± 5.9 and 89.7 ± 7.5% of the VO2peak. The HRDP1 showed a poor correlation with ventilatory threshold (VT; r = 0.50), but HRDP2 was highly correlated to the respiratory compensation (RC) point (r = 0.98). Neither HRDP1 nor HRDP2 was correlated with LT1 (at VO2 = 2.26 ± 0.72 L·min(-1); r = 0.26) or LT2 (2.79 ± 0.59 L·min(-1); r = 0.49), respectively. LT1 and LT2 also were not well correlated with VT (2.93 ± 0.68 L·min(-1); r = 0.20) or RC (3.82 ± 0.60 L·min(-1); r = 0.58), respectively. Although the HR deflection points were not correlated to LT, HRDP2 could be identified in all the subjects and was strongly correlated with RC, consistent with a relationship to cardiorespiratory fatigue and endurance performance.     

New Indices for Evaluating the Functional State in Patients with Angina Pectoris

Traditional indices used to evaluate the functional state in patients with ischemic heart disease (IHD) by testing under conditions of exercise take into account changes in the heart rate (HR), arterial pressure, and the ST segment only during exercise and, for the most part, take into account do not information about the recovery period. The authors show on the basis of the analyses of the regression of ST and HR in patients with angina pectoris that the traditional indices are more effective during exercise. They suggest new standardized nondimensional indices to evaluate the state of patients with myocardial ischemia, i.e., the standardized duration and amplitude of fast recovery (SDFR and SAFR) of ST depression. Most likely, SAFR reflects the share of cardiomyocytes in the metastable state in the total number of the cells affected by short-term ischemia, and SDFR may be an index of the time of the change in the metastable state. Comparative study of the standardized indices of myocardial ischemia showed that the rate–pressure product, SDFR, and SAFR are independent values and may be recommended for evaluating the functional state in patients with IHD.     

Anaerobic threshold and maximal steady-state blood lactate in prepubertal boys

To elucidate further the special nature of anaerobic threshold in children, 11 boys, mean age 12.1 years (range 11.4-12.5 years), were investigated during treadmill running. Oxygen uptake, including maximal oxygen uptake (VO2max), ventilation and the "ventilatory anaerobic threshold" were determined during incremental exercise, with determination of maximal blood lactate following exercise. Within 2 weeks following this test four runs of 16-min duration were performed at a constant speed, starting with a speed corresponding to about 75% of VO2max and increasing it during the next run by 0.5 or 1.0 km.h-1 according to the blood lactate concentrations in the previous run, in order to determine maximal steady-state blood lactate concentration. Blood lactate was determined at the end of every 4-min period. "Anaerobic threshold" was calculated from the increase in concentration of blood lactate obtained at the end of the runs at constant speed. The mean maximal steady-state blood lactate concentration was 5.0 mmol.l-1 corresponding to 88% of the aerobic power, whereas the mean value of the conventional "anaerobic threshold" was only 2.6 mmol.l-1, which corresponded to 78% of the VO2max. The correlations between the parameters of "anaerobic threshold", "ventilatory anaerobic threshold" and maximal steady-state blood lactate were only poor. Our results demonstrated that, in the children tested, the point at which a steeper increase in lactate concentrations during progressive work occurred did not correspond to the true anaerobic threshold, i.e. the exercise intensity above which a continuous increase in lactate concentration occurs at a constant exercise intensity.     

Metabolic and ventilatory responses to steady state exercise relative to lactate thresholds

The metabolic and ventilatory responses to steady state submaximal exercise on the cycle ergometer were compared at four intensities in 8 healthy subjects. The trials were performed so that, after a 10 min adaptation period, power output was adjusted to maintain steady state VO2 for 30 min at values equivalent to: (1) the aerobic threshold (AeT); (2) between the aerobic and the anaerobic threshold (AeTAnT); (3) the anaerobic threshold (AnT); and (4) between the anaerobic threshold and VO2max (AnTmax). Blood lactate concentration and ventilatory equivalents for O2 and CO2 demonstrated steady state values during the last 20 min of exercise at the AeT, AeAnT and AnT intensities, but increased progressively until fatigue in the AnTmax trial (mean time = 16 min). Serum glycerol levels were significantly higher at 40 min of exercise on the AeAnT and the AnT when compared to AeT, while the respiratory exchange ratios were not significantly different from each other. Thus, metabolic and ventilatory steady state can be maintained during prolonged exercise at intensities up to and including the AnT, and fat continues to be a major fuel source when exercise intensities are increased from the AeT to the AnT in steady state conditions. The blood lactate response to exercise suggests that, for the organism as a whole, anaerobic glycolysis plays a minor role in the energy release system at exercise intensities upt to and including the AnT during steady state conditions.     

Muscle metabolism, blood lactate and oxygen uptake in steady state exercise at aerobic and anaerobic thresholds

Muscle metabolites and blood lactate concentration were studied in five male subjects during five constant-load cycling exercises. The power outputs were below, equal to and above aerobic (AerT) and anaerobic (AnT) threshold as determined during an incremental leg cycling test. At AerT, muscle lactate had increased significantly (p less than 0.05) from the rest value of 2.31 to 5.56 mmol X kg-1 wet wt. This was accompanied by a significant reduction in CP by 28% (p less than 0.05), whereas only a minor change (9%) was observed for ATP. At AnT muscle lactate had further increased and CP decreased although not significantly as compared with values at AerT. At the highest power outputs (greater than AnT) muscle lactate had increased (p less than 0.01) and CP decreased (p less than 0.01) significantly from the values observed at AnT. Furthermore, a significant reduction (p less than 0.05) in ATP over resting values was recorded. Blood lactate decreased significantly (p less than 0.01) during the last half of the lowest 5 min exercise, remained unchanged at AerT and increased significantly (p less than 0.05-0.01) at power outputs greater than or equal to AnT. It is concluded that anaerobic muscle metabolism is increased above resting values at AerT: at low power outputs (less than or equal to AerT) this could be related to the transient oxygen deficit during the onset of exercise or the increase in power output. At high power outputs (greater than AnT) anaerobic energy production is accelerated and it is suggested that AnT represents the upper limit of power output where lactate production and removal may attain equilibrium during constant load exercise.     

代谢、血液碱化和纯氧影响呼吸调控的人体实验研究I:运动试验*

目的: 在整体整合生理学医学理论的指导下,通过分析正常人运动期间心肺代谢等多系统功能整体整合的连续动态变化,探讨正常环境运动状态下呼吸反应模式的调控机理。方法: 选正常志愿者5名,在美国洛杉矶加州大学Harbor-UCLA医学中心分别进行动脉置管,在常温室内空气状态下完成症状限制性最大极限心肺运动试验(CPET)。在运动过程中,连续测定肺通气指标及每分钟动脉取样的血气分析指标的变化,对CPET期间呼吸气体交换和血气指标的动态变化进行统计分析。结果: 在CPET期间,随着运动功率逐步递增,分钟摄氧量(每呼吸摄氧量×呼吸频率=每搏摄氧量×心率）和分钟通气量(潮气量×呼吸频率)均呈现近于线性渐进性递增(与静息状态比较,P<0.05~0.001);在运动超过无氧阈和呼吸代偿点后,分钟通气量的上升反应更加显著。结论: 人体在运动过程中,为了克服自行车功率计的阻力而发生代谢率改变,呼吸随代谢改变而变化,高强度运动时酸性代谢产物堆积更加加剧呼吸反应。     

On the kinetics of anaerobic power

ABSTRACT: BACKGROUND: This study investigated two different mathematical models for the kinetics of anaerobic power. Model 1 assumes that the work power is linear with the work rate, while model 2 assumes a linear relationship between the alactic anaerobic power and the rate of change of the aerobic power. In order to test these models, a cross country skier ran with poles on a treadmill at different exercise intensities. The aerobic power, based on the measured oxygen uptake, was used as input to the models, whereas the simulated blood lactate concentration was compared with experimental results. Thereafter, the metabolic rate from phosphocreatine break down was calculated theoretically. Finally, the models were used to compare phosphocreatine break down during continuous and interval exercises. RESULTS: Good similarity was found between experimental and simulated blood lactate concentration during steady state exercise intensities. The measured blood lactate concentrations were lower than simulated for intensities above the lactate threshold, but higher than simulated during recovery after high intensity exercise when the simulated lactate concentration was averaged over the whole lactate space. This fit was improved when the simulated lactate concentration was separated into two compartments; muscles + internal organs and blood. Model 2 gave a better behavior of alactic energy than Model 1 when compared against invasive measurements presented in the literature. During continuous exercise, model 2 showed that the alactic energy storage decreased with time, whereas model 1 showed a minimum value when steady state aerobic conditions were achieved. During interval exercise the two models showed similar patterns of alactic energy. CONCLUSIONS: The current study provides useful insight on the kinetics of anaerobic power. Overall, our data indicates that blood lactate levels can be accurately modeled during steady state, and suggests a linear relationship between the alactic anaerobic power and the rate of change of the aerobic power.     

Effects of short-term training using powercranks on cardiovascular fitness and cycling efficiency

Powercranks use a specially designed clutch to promote independent pedal work by each leg during cycling. We examined the effects of 6 wk of training on cyclists using Powercranks (n=6) or normal cranks (n=6) on maximal oxygen consumption (VO2max) and anaerobic threshold (AT) during a graded exercise test (GXT), and heart rate (HR), oxygen consumption (VO2), respiratory exchange ration (RER), and gross efficiency (GE) during a 1-hour submaximal ride at a constant load. Subjects trained at 70% of VO2max for 1 h.d(-1), 3 d.wk(-1), for 6 weeks. The GXT and 1-hour submaximal ride were performed using normal cranks pretraining and posttraining. The 1-hour submaximal ride was performed at an intensity equal to approximately 69% of pretraining VO2max with VO2, RER, GE, and HR determined at 15-minute intervals during the ride. No differences were observed between or within groups for VO2max or AT during the GXT. The Powercranks group had significantly higher GE values than the normal cranks group (23.6 +/- 1.3% versus 21.3 +/- 1.7%, and 23.9 +/- 1.4% versus 21.0 +/- 1.9% at 45 and 60 min, respectively), and significantly lower HR at 30, 45, and 60 minutes and VO2 at 45 and 60 minutes during the 1-hour submaximal ride posttraining. It appears that 6 weeks of training with Powercranks induced physiological adaptations that reduced energy expenditure during a 1-hour submaximal ride.     

Response of left ventricular diastolic filling to graded exercise relative to the lactate threshold

During incremental exercise, the left ventricular ejection fraction increases up to the intensity of the anaerobic threshold and tends to level off at higher exercise intensities. Since there is a correlation between the response of peak filling rate and ejection fraction to exercise, this study was conducted to determine whether the response of left ventricular diastolic function is similar to the response of systolic function relative to lactate threshold. Twelve healthy men performed two exercise tests on a cycle ergometer. In the first test, lactate threshold and maximal power output were determined. In the second exercise test, gated radionuclide ventriculography was performed at rest, at the lactate threshold intensity, and at peak exercise to measure ejection fraction and peak filling rate. Ejection fraction increased significantly from rest [mean (SD): 62 (5)%] to lactate threshold [76 (7) %] and did not change significantly from lactate threshold to peak exercise [77 (7)%]. Likewise, peak filling rate (normalized for stroke counts) increased from resting [6.1 (0.9)V _s · s^–1] to lactate threshold [9.4 (1.8)V _s · s^–1] and did not change significantly from lactate threshold to peak exercise [9.6 (2.9)V _s · s^–1]. There was no correlation between the change in peak filling rate and the change in ejection fraction from rest to lactate threshold. Thus, during incremental exercise, left ventricular diastolic function responds qualitatively similar to systolic function.