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Artan Yüke Karşı Egzersiz Testi Sırasında Solunum Etkinliğinin Antrenmanlı ve Sedanter Erkek Deneklerde Karşılaştırılmalı İncelenmesi

Yıl 2018, Cilt: 28 Sayı: 2, 57 - 62, 01.03.2018

Çağrı Oğuz Özcelik Çağrı Özdenk

Öz

Amaç: Artan yüke karşı yapılan egzersiz sırasında solunum ve CO2 atılımı VE/VCO2 oranı ile tanımlanmakta olan solunumun etkinliği aerobik fitnes seviyesinin belirlenmesinde kullanılmaktadır. Egzersiz sırasında en düşük VE/VCO2 oranının 34’ün üzerinde olduğu durumlar artan ölüm riskini göstermektedir. Bu çalışmadaki amacımız solunumun etkinliğini antrenmanlı ve sedanter deneklerde karşılaştırmalı olarak incelenmesi ve düşük VE/VCO2 oranının fitnes değerlendirilmesinde kullanılıp kullanılamayacağını araştırmaktır. Gereç ve Yöntem: On antrenmanlı yaş 20.1±0.4 yıl ve 10 sedanter yaş:19.8±0.7 yıl erkek denek artan yüke karşı yapılan egzersiz testine katıldılar 15 W/min . Akciğer gaz değişim parametreleri metabolik gaz analizörü ile solunumdan solunuma ölçüldü. Anaerobik eşik AE ve solunum kompansasyon noktası SKN gaz değişim parametreleri ile hesaplandı.Bulgular: İş gücü antrenmanlı ve sedanter deneklerde AE de 143±8 W ile 123±5 W , SKN de 170±9 W ile 148±6 W ve testin sonunda 222±9 W ile 204±7 W olarak sırası ile bulundular. VE/VCO2 oranı antrenmanlı ve sedanter deneklerde testin başında 32±0.6 ile 32±1.6, AE de 26.5±0.7 ile 26±1, SKN de 27.5±0.7 ile 26±0.9 ve testin sonunda 30±1.1 ile 30±1.3 olarak bulundular.Sonuç: AE ve SKN de elde edilen ve solunum etkinliğini gösteren en düşük VE/VCO2 oranı her iki grupta istatistiksel olarak farklılık göstermedi. Böylece artan VE/VCO2 oranı, zayıflayan aerobik fitnes göstergesi olarak kullanılmasına rağmen, bu kriterin artan fitnes seviyesi göstergesi olarak kullanılamayacağı belirlenmiştir

Anahtar Kelimeler

Egzersiz solunum etkinliği akciğer gaz değişimi aerobik fitnes anaerobik eşik

Kaynakça

  • Wasserman K, Hansen JE, Sue DY, et al. Principles of Exer- cise Testing and Interpretation: Including Pathophysiolgy and Clinical Applications, Lippincott Williams & Wilkins, Philadelphia, PA, USA, 5th edition, 2012.
  • Palange P, Ward SA, Carlsen KH, et al. Recommendations on the use of exercise testing in clinical practice. Eur Respir J 2007;29 (1): 185-209.
  • Ozcelik O, Aslan M, Ayar A, Kelestimur H. Effects of body mass index on maximal work production capacity and ae- robic fitness during incremental exercise test. Physiol Res 2004;53:165–70.
  • Whipp BJ. Physiological mechanisms dissociating pulmo- nary CO2 and O2 exchange dynamics during exercise in humans. Exp Physiol 2007;92:347-55.
  • Algul S, Ugur FA, Ayar A, Ozcelik O. Comparative determi- nation of ventilator efficiency from constant load and inc- remental exercise testing. Cell Mol Biol (Noisy-le-grand) 2017;15;63(7):26-30.
  • Sin PY, Webber MR, Galletly DC, Tzeng YC. Relationship between cardioventilatory coupling and pulmonary gas ex- change. Clin Physiol Funct Imaging 2012;32:476-80.
  • Sun XG, Hansen JE, Garatachea N, Storer TW, Wasserman K. Ventilatory efficiency during exercise in healthy subjects. Am J Respir Crit Care Med 2002;166:1443-8.
  • Ward SA. Ventilatory control in humans: constraints and limitations. Exp Physiol 2007;92:357-66.
  • Whipp, BJ, Davis, JA, Wasserman, K. Ventilatory control of the ‘isocapnic buffering’ region in rapidly-incremental exercise. Respir Physiol 1989;76:357-67.
  • Stringer W, Casaburi R, Wasserman K. Acid-base regulati- on during exercise and recovery in humans. J Appl Physiol 1992;72:954–61.
  • Ingle L, Goode K, Carroll S, et al. Prognostic value of the VE/VCO2 slope calculated from different time inter- vals in patients with suspected heart failure. Int J Cardiol 2007;118:350-5.
  • Myers J, Arena R, Oliveira RB, et al. The lowest VE/VCO2 ratio during exercise as a predictor of outcomes in patients with heart failure. J Card Fail 2009;15:756-62.
  • Murphy RM, Weiner RB, Hough SS, et al. Determinants of VE/VCO2 slope in normal individuals – entilator efficien- cy is modifiable with endurance training. J Am Coll Cardiol 2012;59:13-5.
  • Kaya H, Özçelik O. Tıp öğrencilerinin bir yılda vücut kom- pozisyonlarında meydana gelen değişimlerin belirlenmesi Fırat Tıp Dergisi 2005;10(4):164-8.
  • Whipp BJ, Davis JA, Torres F, Wasserman K. A test to deter- mine parameters of aerobic function during exercise. J Appl Physiol 1981;50:217-21.
  • Ozcelik O, Ward SA, Whipp BJ. Effect of altered body CO2 stores on pulmonary gas exchange dynamics during incre- mental exercise in humans. Exp Physiol 1999;84:999–1011.
  • aver WL, Lamarra N, Wasserman K. Breath-by-breath mea- surement of true alveolar gas exchange. J Appl Physiol Res- pir Environ Exerc Physiol 1981;51(6):1662-75.
  • Beaver WL, Wasserman K, Whipp BJ. A new method for detecting anaerobic threshold by gas exchange. J Appl Phy- siol 1986;60: 2020-7.
  • Whipp, BJ, Ward, SA, Wasserman, K. Respiratory markers of the anaerobic threshold. Adv Cardiol 1986;35:47-64.
  • Hansen JE, Wasserman K. Pathophysiology of activity li- mitation in patients with interstitial lung disease. Chest 1996;109:1566–76.
  • Gitt AK, Wasserman K, Kilkowski C, et al. Exercise ana- erobic threshold and ventilatory efficiency identify heart failure patients for high risk of early death. Circulation 2002;106:3079-84.
  • Guazzi M. Abnormalities in cardiopulmonary exercise testing ventilatory parameters in heart failure: pathop- hysiology and clinical usefulness. Curr Heart Fail Rep 2014;11:80–7.
  • Reindl I, Wernecke KD, Opitz C, et al. Impaired ventilator efficiency in chronic heart failure: possible role of pulmo- nary vasoconstriction. Am Heart J 1998;136(5):778-85.
  • Poggio R, Arazi HC, Giorgi M, Miriuka SG. Prediction of severe cardiovascular events by VE/VCO2 slope versus peak VO2 in systolic heart failure: a meta-analysis of the published literature. Am Heart J 2010; 160:1004-14.
  • Prado DM, Rocco EA, Silva AG, et al. Effect of exercise tra- ining on ventilatory efficiency in patients with heart disea- se: a review. Braz J Med Biol Res 2016; 20;49(7).
  • Alba AC, Adamson MW, MacIsaac J, et al. The added value of exercise variables in heart failure prognosis. J Card Fail 2016;22(7):492-7.
  • Elbehairy AF, Ciavaglia CE, Webb KA, et al. Pulmonary gas exchange abnormalities in mild chronic obstructive pul- monary disease. Implications for dyspnea and exercise into- lerance. Am J Respir Crit Care Med 2015;191(12):1384-94.
  • Parazzi PL, Marson FA, Ribeiro MA, Schivinski CI, Ribei- ro JD. Ventilatory efficiency in children and adolescents: A systematic review. Dis Markers 2015; 2015:546891.
  • Davis JA, Sorrentino KM, Soriano AC, Pham PH, Dorado S. Is ventilator efficiency dependent on the speed of the exercise test protocol in healthy men and women? Cli Phy- siol Funct Imaging 2006;26:67-71.
  • Hoshimoto-Iwamoto M, Koike A, Nagayama O, et al. .Determination of the VE/VCO2 slope from a constant work-rate exercise test in cardiac patients. J Physiol Sci 2008;58(4):291-5.
  • Arena R, Myers J, Aslam SS, Varughese EB, Peberdy MA. Peak VO2 and VE/VCO2 slope in patients with heart failu- re: a prognostic comparison. Am Heart J 2004;147(2):354- 60.
  • Ozcelik O, Kelestimur H. Effects of acute hypoxia on the estimation of lactate threshold from ventilatory gas exchan- ge indices during an incremental exercise test. Physiol Res 2004;53;653–9.

Yıl 2018, Cilt: 28 Sayı: 2, 57 - 62, 01.03.2018

Çağrı Oğuz Özcelik Çağrı Özdenk

Öz

Objective: Ventilatory efficiency, which describes the ratio between ventilation to CO2 output VE/VCO2 during an incremental exercise test has been used to evaluate fitness levels of the subjects. During exercise, the lowest VE/VCO2 ratio above 34 shows increased mortality levels. In the present study, we comparatively evaluated ventilatory efficiency in trained and sedentary males that the lowest VE/VCO2 ratio could be related fitness levels of the subjects. Materials and Methods: Ten trained age: 20.1±0.4 yr and 10 sedentary age:19.8±0.7 yr male subjects were performed an incremental exercise 15 W/min test. Ventilatory gas exchange parameters were evaluated breath-by-breath using metabolic gas analyser. Anaerobic threshold AT and respiratory compensation point RCP estimated from the gas exchange values. Results: Work rates for trained and sedentary subjects were found to be 143±8 W vs 123±5 W at the AT, 170±9 W vs 148±6 W at the RCP and 222±9 W vs 204±7 W at the end of the test, respectively. VE/VCO2 ratio for trained and sedentary subjects were found to be 32±0.6 vs 32±1.6 at the beginning of test and 26.5±0.7 vs 26±1 at the AT, 27.5±0.7 vs 26±0.9 at the RCP and 30±1.1 vs 30±1.3 at the end of the test.Conclusion: The lowest VE/VCO2 ratio, reflects optimal ventilatory efficiency obtained at the AT and RPC, was not statistically different in both groups. While increased VE/VCO2 ratio could be a useful criteria to evaluate reduced aerobic fitness levels, it can not be use to indicate increased aerobic fitness levels

Anahtar Kelimeler

Exercise ventilatory efficency pulmonary gas exchange aerobik fitness anaerobik threshold

Kaynakça

  • Wasserman K, Hansen JE, Sue DY, et al. Principles of Exer- cise Testing and Interpretation: Including Pathophysiolgy and Clinical Applications, Lippincott Williams & Wilkins, Philadelphia, PA, USA, 5th edition, 2012.
  • Palange P, Ward SA, Carlsen KH, et al. Recommendations on the use of exercise testing in clinical practice. Eur Respir J 2007;29 (1): 185-209.
  • Ozcelik O, Aslan M, Ayar A, Kelestimur H. Effects of body mass index on maximal work production capacity and ae- robic fitness during incremental exercise test. Physiol Res 2004;53:165–70.
  • Whipp BJ. Physiological mechanisms dissociating pulmo- nary CO2 and O2 exchange dynamics during exercise in humans. Exp Physiol 2007;92:347-55.
  • Algul S, Ugur FA, Ayar A, Ozcelik O. Comparative determi- nation of ventilator efficiency from constant load and inc- remental exercise testing. Cell Mol Biol (Noisy-le-grand) 2017;15;63(7):26-30.
  • Sin PY, Webber MR, Galletly DC, Tzeng YC. Relationship between cardioventilatory coupling and pulmonary gas ex- change. Clin Physiol Funct Imaging 2012;32:476-80.
  • Sun XG, Hansen JE, Garatachea N, Storer TW, Wasserman K. Ventilatory efficiency during exercise in healthy subjects. Am J Respir Crit Care Med 2002;166:1443-8.
  • Ward SA. Ventilatory control in humans: constraints and limitations. Exp Physiol 2007;92:357-66.
  • Whipp, BJ, Davis, JA, Wasserman, K. Ventilatory control of the ‘isocapnic buffering’ region in rapidly-incremental exercise. Respir Physiol 1989;76:357-67.
  • Stringer W, Casaburi R, Wasserman K. Acid-base regulati- on during exercise and recovery in humans. J Appl Physiol 1992;72:954–61.
  • Ingle L, Goode K, Carroll S, et al. Prognostic value of the VE/VCO2 slope calculated from different time inter- vals in patients with suspected heart failure. Int J Cardiol 2007;118:350-5.
  • Myers J, Arena R, Oliveira RB, et al. The lowest VE/VCO2 ratio during exercise as a predictor of outcomes in patients with heart failure. J Card Fail 2009;15:756-62.
  • Murphy RM, Weiner RB, Hough SS, et al. Determinants of VE/VCO2 slope in normal individuals – entilator efficien- cy is modifiable with endurance training. J Am Coll Cardiol 2012;59:13-5.
  • Kaya H, Özçelik O. Tıp öğrencilerinin bir yılda vücut kom- pozisyonlarında meydana gelen değişimlerin belirlenmesi Fırat Tıp Dergisi 2005;10(4):164-8.
  • Whipp BJ, Davis JA, Torres F, Wasserman K. A test to deter- mine parameters of aerobic function during exercise. J Appl Physiol 1981;50:217-21.
  • Ozcelik O, Ward SA, Whipp BJ. Effect of altered body CO2 stores on pulmonary gas exchange dynamics during incre- mental exercise in humans. Exp Physiol 1999;84:999–1011.
  • aver WL, Lamarra N, Wasserman K. Breath-by-breath mea- surement of true alveolar gas exchange. J Appl Physiol Res- pir Environ Exerc Physiol 1981;51(6):1662-75.
  • Beaver WL, Wasserman K, Whipp BJ. A new method for detecting anaerobic threshold by gas exchange. J Appl Phy- siol 1986;60: 2020-7.
  • Whipp, BJ, Ward, SA, Wasserman, K. Respiratory markers of the anaerobic threshold. Adv Cardiol 1986;35:47-64.
  • Hansen JE, Wasserman K. Pathophysiology of activity li- mitation in patients with interstitial lung disease. Chest 1996;109:1566–76.
  • Gitt AK, Wasserman K, Kilkowski C, et al. Exercise ana- erobic threshold and ventilatory efficiency identify heart failure patients for high risk of early death. Circulation 2002;106:3079-84.
  • Guazzi M. Abnormalities in cardiopulmonary exercise testing ventilatory parameters in heart failure: pathop- hysiology and clinical usefulness. Curr Heart Fail Rep 2014;11:80–7.
  • Reindl I, Wernecke KD, Opitz C, et al. Impaired ventilator efficiency in chronic heart failure: possible role of pulmo- nary vasoconstriction. Am Heart J 1998;136(5):778-85.
  • Poggio R, Arazi HC, Giorgi M, Miriuka SG. Prediction of severe cardiovascular events by VE/VCO2 slope versus peak VO2 in systolic heart failure: a meta-analysis of the published literature. Am Heart J 2010; 160:1004-14.
  • Prado DM, Rocco EA, Silva AG, et al. Effect of exercise tra- ining on ventilatory efficiency in patients with heart disea- se: a review. Braz J Med Biol Res 2016; 20;49(7).
  • Alba AC, Adamson MW, MacIsaac J, et al. The added value of exercise variables in heart failure prognosis. J Card Fail 2016;22(7):492-7.
  • Elbehairy AF, Ciavaglia CE, Webb KA, et al. Pulmonary gas exchange abnormalities in mild chronic obstructive pul- monary disease. Implications for dyspnea and exercise into- lerance. Am J Respir Crit Care Med 2015;191(12):1384-94.
  • Parazzi PL, Marson FA, Ribeiro MA, Schivinski CI, Ribei- ro JD. Ventilatory efficiency in children and adolescents: A systematic review. Dis Markers 2015; 2015:546891.
  • Davis JA, Sorrentino KM, Soriano AC, Pham PH, Dorado S. Is ventilator efficiency dependent on the speed of the exercise test protocol in healthy men and women? Cli Phy- siol Funct Imaging 2006;26:67-71.
  • Hoshimoto-Iwamoto M, Koike A, Nagayama O, et al. .Determination of the VE/VCO2 slope from a constant work-rate exercise test in cardiac patients. J Physiol Sci 2008;58(4):291-5.
  • Arena R, Myers J, Aslam SS, Varughese EB, Peberdy MA. Peak VO2 and VE/VCO2 slope in patients with heart failu- re: a prognostic comparison. Am Heart J 2004;147(2):354- 60.
  • Ozcelik O, Kelestimur H. Effects of acute hypoxia on the estimation of lactate threshold from ventilatory gas exchan- ge indices during an incremental exercise test. Physiol Res 2004;53;653–9.
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Original Article
Yazarlar

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Yayımlanma Tarihi 1 Mart 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 28 Sayı: 2

Kaynak Göster

Vancouver Özcelik ÇO, Özdenk Ç. Artan Yüke Karşı Egzersiz Testi Sırasında Solunum Etkinliğinin Antrenmanlı ve Sedanter Erkek Deneklerde Karşılaştırılmalı İncelenmesi. Genel Tıp Derg. 2018;28(2):57-62.


Genel Tıp Dergisi Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı (CC BY NC) ile lisanslanmıştır.