Impaired oxygen uptake kinetics in the first high-level athlete with Hb Hope: a case study.

Hemoglobin (Hb) Hope is a beta-globin chain variant with reduced oxygen (O2) affinity, known to induce anemia. This usually leads to limitations in O2uptake (VO2) and exercise tolerance. We studied the case of a high-level female athlete with Hb Hope. She had been selected for cross-country races from 13 yrs onward, then was a national junior champion in 400-m race, and finally failed to win any cross-country races as an adult. Hematological analysis revealed normal red blood cell indices and Hb level (12.3 g.dL⁻¹). Incremental exercise showed peak work rate (WR), VO(2max) and gas exchange threshold (GET) within normal ranges for healthy females. Constant WR testing at 90% of GET showed that kinetics of pulmonary VO2included the presence of a slow component. This was in disagreement with the data on VO2kinetics response to exercise intensities below GET. Phase 2 parameters, time constant (τ2, 31 s), time delay (TD2, 39 s), amplitude (A2, 780 ml.min⁻¹), and gain in VO2(ΔVO2 .ΔWR-1, 9.2 ml.min-1.W⁻¹) were within normal ranges. Phase 3 showed a slow component similar to that reported in severe exercise. The absence of anemia and the normality of phase 2 suggested normal O2delivery and oxidative metabolism in exercising muscles. In contrast, phase 3 suggested poor aerobic capacity and limited exercise tolerance. However, the lack of symptoms during testing also suggested that the slow component was due to the specific recruitment of fast-twitch fibers in this former champion athlete with Hb Hope in races requiring mainly anaerobic metabolism.

The performance and efficiency of cycling with a carbon fiber eccentric chainring during incremental exercise.

AIM: The aim of this study was to compare cycling performance and efficiency of a carbon fiber eccentric chainring (EC) versus a metallic standard chainring (SC) during an incremental exercise. The main feature of EC was that crank-arm length changed as a function of the crank angle, being maximal during the pushing phase and minimal during the recovery one. Because of its design, cycling with EC was expected to develop higher torque during the downstroke, and lower torque during the upstroke, thus increasing mechanical efficiency and requiring lower cardioventilatory solicitation at submaximal exercise intensities. METHODS: Eleven male subjects performed two incremental cycle tests in a randomized order using EC and SC successively. Cardioventilatory data were recorded every minute using an automated breath-by-breath system. Blood samples were taken at rest, exhaustion, 5 and 15 minutes of recovery to access lactate concentrations, [LA], mmol . L(-1) . RESULTS: The subjects reached significantly lower maximal speed at volitional exhaustion with EC compared with SC (39.4+/-2.5 versus 41.5+/-2.9 km . h(-1), respectively; P<0.05). Analysis of variance revealed significantly higher values for oxygen uptake and carbon dioxide production during incremental exercise with EC (P<0.05). Lastly, [LA] at exhaustion were similar with the two chainrings. CONCLUSIONS: The carbon fiber EC tested in this study failed to enhance cycling performance and efficiency throughout an incremental exercise. This indicated that carbon fibers did not exhibited its expected mechanical advantage.

Ventilatory responses during experimental cycle-run transition in triathletes.

PURPOSE AND METHODS: To determine the effects of cycling on a subsequent triathlon run, nine male triathletes underwent four successive laboratory trials: 1) an incremental treadmill test, 2) an incremental cycle test, 3) 30 min of cycling followed by 5 km of running (C-R), and 4) 30 min of running followed by 5 km of running (R-R). Before and 10 min after the third and fourth trials, the triathletes underwent pulmonary function testing including spirometry and diffusing capacity testing for carbon monoxide (DL(CO)). During the C-R and R-R trials, arterialized blood samples were obtained to measure arterial oxygen pressure (PaO2). During all trials, ventilatory data were collected every minute using an automated breath-by-breath system. RESULTS: The results showed that 1) the oxygen uptake (VO2) observed during subsequent running was similar for the C-R and R-R trials; 2) the ventilatory response (VE) during the first 8 min of subsequent running was significantly greater in the C-R than in R-R trial (P < 0.05); 3) only the C-R trial induced a significant increase (P < 0.05) in residual volume (RV), functional residual capacity (FRC), and the ratio of residual volume to total lung capacity (RV/TLC); and 4) although a significant decrease (P < 0.05) in DL(CO) was noted after C-R, no difference between the two exercise trials was found for the maximal drop in PaO2. CONCLUSIONS: We concluded that 1) the C-R trial induced specific alterations in pulmonary function that may be associated with respiratory muscle fatigue and/or exercise-induced hypoxemia, and 2) the greater VE observed during the first minute of running after cycling was due to the specificity of cycling. This reinforces the necessity for triathletes to practice multi-trial training to stimulate the physiological responses experienced during the swim-cycle and the cycle-run transitions.

Cardiorespiratory and metabolic responses to exercise in HbSC sickle cell patients.

PURPOSE: Relative to healthy control individuals with normal hemoglobin (Hb), patients carrying the double heterozygous form of sickle cell disease (HbSC) display an impaired oxygen transport capacity. The present study was undertaken to determine the influence of the decreased oxygen availability associated with the presence of HbSC on the cardiorespiratory and metabolic responses to endurance exercise. METHODS: Eleven black men affected by the double heterozygous form of the sickle cell disease (HbSC group) and seven healthy subjects with normal Hb (HbAA group) of the same ethnic origin submitted successively to an incremental exercise test to exhaustion on a cycle ergometer for the determination of their maximal tolerated power and to a 20-min endurance exercise. RESULTS: The HbSC had a significantly lower exercise tolerance than the HbAA. During the endurance exercise, they exhibited furthermore significantly lower VO2, VCO2, and minute ventilation V(E) than the HbAA. Despite the fact that the HbSC exercised at a significantly lower mean absolute work rate than the HbAA, except for the ventilatory equivalent for CO2 (V(E)/VCO2), which was higher (P < 0.001) in the HbSC group, the other parameters recorded during the 20-min endurance exercise (heart rate, arterial PaO2, PaCO2, pH, lactate, and VE/VO2, the ventilatory equivalent for O2) and during the subsequent recovery (blood lactate) were similar for both groups. CONCLUSION: The study underscores the importance of considering relative work rate as well as absolute work rate to arrive at a correct interpretation of exercise and recovery data. The results give evidence that the modifications of homeostasis brought into play by exercise were shifted toward distinctly lower absolute work rates in HbSC patients.

Catecholamine, blood lactate and ventilatory responses to multi-cycle-run blocks.

PURPOSE AND METHODS: This study was designed to determine whether the physiological responses elicited during the run part of repeated bouts of cycle-run exercise are similar to those required during the run segment of a cycle-run succession. Thirteen male triathletes underwent four successive laboratory trials: 1) an incremental treadmill test, 2) an incremental cycle test, 3) 30 min of cycling followed by 20 min of running (C-R), and 4) five repeated bouts of 6 min of cycling and 4 min of running (X-CR). During the C-R and X-CR trials, venous blood samples were obtained to measure lactate, epinephrine and norepinephrine concentrations. During all trials, ventilatory data were collected every min using an automated breath-by-breath system. RESULTS: The results showed that 1) the cardiorespiratory responses observed during running were similar in the X-CR and C-R trials, 2) the lactate concentration was similar in both trials, 3) the epinephrine concentration was greater (277.9 +/- 11.9 vs 169.8 +/- 86.7 pg x mL(-1), P < 0.025) in X-CR than in C-R, and 4) the norepinephrine concentration was similar in both trials, except at the first cycle-run succession (T1) of X-CR. CONCLUSION: We concluded that 1) multi-block training is a good method to stimulate the specific adaptations required for the cycle-run succession, and particularly for the cycle-run transition, and 2) multi-block training seems to induce a greater catecholaminergic response, which may be due to a combination of an inherent effect of this type of training and the triathletes' relative lack of experience with it. In any case, the efficacy of the multi-block model needs to be more thoroughly evaluated over the course of a longer-term training program.

Blood lactate concentrations during incremental exercise in subjects with sickle cell trait.

The aim of the present study was to assess blood lactate concentrations ([LA], mmol x L(-1)) and oxygen uptake (VO2, L x min(-1), mL x kg(-1) x min(-1)) during incremental exercise in subjects with sickle cell trait (SCT) only, i.e., sedentary subjects with SCT without anemia and/or associated alpha thalassemia. Anemia was ruled out using hemoglobin (Hb) level, and alphathalassemia was ruled out using hemoglobin S (HbS) percentage and concomitant Hb level and mean corpuscular volume (MCV). Comparison was made with control subjects with normal Hb, matched for physical fitness, anthropometric data, and hematological parameters. All subjects underwent an incremental exercise test (IET) using an electromagnetic cycle ergometer. Ventilatory data, i.e., minute ventilation (VE, L x min(-1)), oxygen uptake (VO2, mL x min(-1), mL x Kg(-1) x min(-1)) carbon dioxide production (VO2, mL x min(-1)), ventilatory equivalent for O2(VE x VO2(-1))and for CO2 (VE x VO2(-1)), and respiratory exchange ratio (RER, VO2 x VO2(-1)), were collected every minute during IET and the recovery period using a breath-by-breath automated system. Heart rate (HR, beats x min(-1)) was measured every minute using an EKG. Blood sampling was done every minute during IET and the first 5 min of the recovery period, and then every 5 min until the 20th minute of recovery. [LA] were determined by an enzymatic method with a spectrophotometer. Comparisons of all mean cardioventilatory variables showed no significant differences in subjects with SCT versus controls during IET and recovery. In contrast, analysis of variance revealed significantly lower time courses of [LA] during IET (P < 0.05) and recovery (P < 0.05), whereas time courses of VO2 were similar (P > 0.05). We conclude that the lower [LA] exhibited by subjects with SCT during incremental exercise and the subsequent recovery was not associated with concomitant oxygen uptake impairment.

Exercise-induced death in sickle cell trait: role of aging, training, and deconditioning.

The pathophysiological process of exercise-induced death in subjects with sickle cell trait (SCT) remains unclear. Concerning the cause of death, authors have suggested stressful environmental conditions such as altitude, heat and humidity, or abnormal patient conditions such as deconditioning, fatigue, and disease. These conditions are thought to lead to hypoxemia, hyperlactatemia, acidosis, dehydration, hyperthermia, or exercise-induced rhabdomyolysis, all of which may initiate sickle cell crisis, disseminated intravascular coagulation, myoglobinuria, and renal failure. We report the case of a 41-yr-old, healthy, and apparently well-conditioned subject with SCT who died during a cross-country race under normal environmental conditions in good weather (in terms of temperature and humidity). The medical and athletic history of the subject were unremarkable. We refer to an epidemiological study that reported a relation between age and exercise-induced sudden death in subjects with SCT. We then review the pathophysiological effects of aging in association with deconditioning and high-level training reported in the literature, particularly the decrease in aerobic metabolism in deconditioned subjects, and the exercise-induced hypoxemia in highly trained subjects. We discuss the consequences of deconditioning and high-level training in subjects with SCT during exercise, and conclude that these factors may be involved in the age-dependent risk of exercise-related sudden death in subjects with SCT.

The effect of exercise modality on respiratory muscle performance in triathletes.

PURPOSE: The aim of this study was to examine the effects of the cycle-run and run-cycle successions of the triathlon and duathlon, respectively, on respiratory muscle strength and endurance. METHODS: Respiratory muscle strength was assessed by measuring maximal inspiratory (P(Imax)) and expiratory (P(Emax)) pressures. Respiratory muscle endurance was assessed by measuring the time limit (T(lim)). Twelve triathletes participated in a three-trial protocol. The first trial consisted of an incremental cycle test to assess the maximal oxygen uptake (.VO(2max)) of triathletes. Trial 2 consisted of 20 min of cycling followed by 20 min of running (C-R), and trial 3 consisted of 20 min of running followed by 20 min of cycling (R-C). Trials 2 and 3 were performed at the same metabolic intensity (%.VO(2max)). P(Imax) and P(Emax) were measured before and 10 min after C-R and R-C, and 1 min after the post-C-R and post-R-C T(lim) measurements (P(Imax) 1'). T(lim) was measured 1 d before and 30 min after C-R and R-C. RESULTS: The results showed a significant decrease in P(Imax) after C-R (126.7 +/- 4.3 cmH(2)O, P < 0.05) and R-C (123.7 +/- 4.9 cmH(2)O, P < 0.05) compared with the baseline values (130 +/- 3.8 and 129.6 +/- 4.3 cmH(2)O, respectively). P(Imax) 1' showed a significantly greater decrease after R-C versus C-R (111.2 +/- 5.5 cmH(2)O vs 121.2 +/- 3.9 cmH(2O), respectively, P < 0.001). Tlim after C-R (3.3 +/- 0.3 min) and R-C (2.1 +/- 0.3 min) decreased significantly compared with baseline values (4.19 +/- 0.3 min and 4.02 +/- 0.3 min, respectively). However, the Tlim decrease after R-C was significantly greater than after C-R (P < 0.001). CONCLUSION: We concluded that respiratory muscle strength and endurance were less decreased after the cycle-run succession and that cycling induced a greater decrease in respiratory muscle endurance than running.

[The Flack test: a test exploring the sinus function in athletes. Apropos of 351 tests]. / Le test de Flack: test d'exploration de la fonction sinusale chez les sportifs. A propos de 351 tests.

A standardized Flack's test with continuous electrocardiographic recording was performed in 351 moderately trained athletes (317 men and 34 women; mean age 23.7 years). The test gave normal results in 310 subjects (88.3%). Tachycardia in excess of 100 beats/min was observed in 12 subjects (3.4%), and 56 abnormalities which were not present on previous ECG recordings at rest were noted in 29 subjects (8.3%); 27 of these abnormalities appeared immediately after a previous one. Out of these 56 abnormalities, 26 (44.6%) were associated with sinus dysfunction: sinus bradycardia in 8 cases, second degree sinoatrial block in 2 cases, third degree sinoatrial block in 3 cases and sinus arrest in 13 cases. In 16 cases of third degree sinoatrial block or sinus arrest escape rhythms were observed, including coronary sinus rhythm (3), junctional rhythm (12) and accelerated idioventricular rhythm (1). Five of the 56 abnormalities (8.9%) were disorders of conduction, i.e. first or second degree atrioventricular block, atrioventricular dissociation and blocked P waves. These disorders are known to be frequently associated with sinus dysfunction. In 9 out of 56 abnormalities (16.1%) disorders of excitability were present as atrial, junctional and ventricular extrasystoles. In 8 subjects the Flack's test resulted in the disappearance of disorders of conduction or excitability of the "athlete" type present at rest, as the Ruffier-Dickinson test, or the cycloergometric exercise test.(ABSTRACT TRUNCATED AT 250 WORDS)

Pulmonary function during cycling and running in triathletes.

AIM: Running performance has become key to the triathlete's overall performance. We still know relatively little about the factors that define the ability to perform a good run after cycling, however, and the perception of discomfort during the first minutes of this post-cycling running has yet to be satisfactorily explained. Pulmonary volumes (i.e., residual volume, RV, and functional residual capacity, FRC) have been demonstrated to be impaired after a cycle-run succession in triathletes but not after a run-run succession that is matched in terms of intensity and duration. Cycling in itself and/or the succession of two different exercises (i.e., cycling and running) may explain this phenomenon, but the exact mechanism has not yet been determined. METHODS: Thirteen young male triathletes participated in three different exercise trials: 30 min of cycling followed by 20 min of running (C-R), 30 min of control cycling (C) and 20 min of control running (R). Pulmonary volumes and flows were measured 10 min before and 10 min after each trial. During all trials, ventilatory data were collected every minute using an automated breath-by-breath system. RESULTS: The results showed that 1) C induced significant increases in RV, FRC and RV/TLC (2.31+/-0.18 vs 2.01+/-0.17 L, 4.35+/-0.24 vs 4.01+/-0.25 L, and 27.21+/-1.62 vs 23.98+/-1.55, respectively, after versus before C) and 2) there were no significant pulmonary volume or flow changes after C-R or R. CONCLUSION: We concluded that 1) cycling exercise in itself seems to increase the post-exercise pulmonary volume changes which could lead to respiratory muscle alterations and 2) one likely explanation for this finding appears to be the crouched position of cycling.

Effect of sleep deprivation on shuttle run score in middle-aged amateur athletes. Influence of initial score.

AIM: The aim of the present study was to investigate the effect of sleep deprivation on shuttle run score (corresponding to an estimated VO2 peak) in middle-aged amateur athletes. METHODS: Twenty-two athletes, training 9.2 hours a week (+/-4), performed a Leger and Gadoury shuttle test daily in a 4-day series that included a pre-test in day 0, 28 hours without sleep before test 1 (and 10 another hours after the test and before bedtime for a sleep deprivation of 38 hours), and then 10 hours of sleep before each of days 2 and 3. RESULTS: Shuttle run score showed no significant difference over the 4 days; however, the change in shuttle run score on day 2 was significantly correlated with the initial score. CONCLUSIONS: This result suggests that effect of sleep deprivation on shuttle run score is dependent on initial score and may encourage high level aerobic athletes to avoid sleep deprivation 2 days before a competition.

DLCO response to experimental cycle-run succession in triathletes.

BACKGROUND: We still know relatively little about the factors that define the ability to perform a good run after cycling in triathlon, however, and the perception of discomfort during the first minutes of this post-cycling running has yet to be satisfactorily explained. The pulmonary diffusion capacity for carbon monoxide (DLCO) has been demonstrated to be impaired after the cycle-run succession. Numerous causes have been suggested to explain this phenomenon, but the exact mechanism has not yet been determined. METHODS: Thirteen young male triathletes participated in four different exercise trials: 30 min of cycling followed by 20 min of running (C-R, 1 min rest between C and R), 30 min of running followed by 20 min of running (R-R, 1 min rest between R and R), 30 min of cycling (C), and 30 min of running (R). DLCO and alveolar volume were simultaneously measured during 9 sec of breath-holding before and 10 min after exercise. The transfer coefficient (KCO=DLCO/VA) was then calculated. During all trials, ventilatory data were collected every minute using an automated breath-by-breath system. RESULTS: The results showed that 1) C-R and C induced significant and identical decreases in DLCO and KCO in post-trial compared with pre-trial measurement (40.41+/-2.24 vs 43.49+/-2.36 ml x min(-1) x mm Hg(-1), p<0.01, and 39.37+/-2.16 vs 42.99+/-2.38 ml x min(-1) x mm Hg(-1), p<0.02, for C-R and C, respectively) and 2) there were no DLCO decreases in post-trial compared with pre-trial measurement in R-R and R. CONCLUSIONS: We concluded that cycling exercise in itself seems to increase the immediate post-exercise DLCO impairment.

The effect of multi-cycle-run blocks on pulmonary function in triathletes.

BACKGROUND: This study was designed to determined the pulmonary responses elicited by multi-cycle-run exercise in triathletes and to compare them to those elicited during a simple cycle-run succession. METHODS: Twelve male triathletes underwent three successive laboratory trials: 1) an incremental cycle test, 2) 30 min of cycling followed by 20 min of running (C-R), and 3) five repeated bouts of 6 min of cycling and 4 min of running (X-CR). Before and 10 minutes after the third and fourth trials, the triathletes underwent lung function testing, especially spirometry and diffusing capacity testing for carbon monoxide (DL(CO)). During all trials, ventilatory data were collected every minute using an automated breath-by-breath system. RESULTS: The results showed that: 1) the cardiorespiratory responses observed during running were greater in the X-CR trial for VE/VCO2 and HR, 2) DL(CO) and DL(CO)/VA were significantly reduced after both trials, and 3) there were no significant changes in pulmonary volumes. CONCLUSIONS: We concluded that 1) the multi-block trial elicited greater cardioventilatory responses than simple the cycle-run succession and 2) multi-block seems a good method to stimulate the specific adaptations required for the cycle-run succession, and particularly for the cycle-run transition. In any case, the efficacy of the multi-block model needs to be more thoroughly evaluated over the course of a longer-term training programme.

Effects of successive running and cycling on the release of atrial natriuretic factor in highly trained triathletes.

AIM: To evaluate the influence of successive running and cycling on both exercise-induced arterial hypoxemia (EIAH) and atrial natriuretic factor (ANF) release, 5 triathletes performed 2 separate exercise trials. METHODS: One trial consisted of a 20-min+20-min successive cycle-run exercise (C(1)-R(2)) and the other consisted of a 20-min+20-min successive run-cycle exercise (R(1)-C(2)). Arterial oxygenation (PaO(2)) and ANF were determined at pre-exercise, at the end of each 20-min segment of exercise and after 10 min of recovery. RESULTS: EIAH was noted during C(1)-R(2) and R(1)-C(2) trials. A higher EIAH was observed during running compared with cycling performed in the 1(st) position (R(1) vs C(1)) in the succession. In contrast, no difference was observed between successive running and successive cycling (R(2) vs C(2)), (-10.6+/-7.0 vs -15.6+/-4.0 mmHg for C(1)-R(2) and -20.9+/-6.0 vs -16.2+/-2.4 mmHg for R(1)-C(2)). ANF showed no difference between cycling and running performed in first position, whereas a significantly lower ANF was observed during successive cycling compared with successive running (C(2) vs R(2)) (19.9+/-3.72 vs 36.2+/-6.4 pmol.L(-1)). During recovery, neither PaO(2) nor ANF plasma returned to baseline level after either trial. CONCLUSION: This study provides new information on some of the physiological modifications that occur during multi-sports. Specifically, the impact of the modality of the successive exercise on ANF release and body fluid regulation was observed. Cycling as the successive exercise seems to cause lower ANF release than does running.

[Cardiac hypertrophy, dilatation and performance in top athletes]. / Hypertrophie, dilatation et performance cardiaque chez 34 sportifs de haut niveau.

The authors have studied three groups of patients: 12 reference patients (REF) leading a sedentary life; 22 athletes of international fame, practising an endurance sport (END), including 10 long distance and middle-distance runners, 12 cyclists and 12 top (RES) athletes practising a resistance sport i.e. 12 sprinters. There is no age difference between the two groups. The RES have a larger body area than the REF and END. The cardiac frequency is lowered in the athletes without any difference between RES and END. There is no difference as far as the athletes' blood pressure is concerned. On the EKG, the Sokoloff index is significantly higher in END than in REF and RES. Sonographic data were especially analyzed. END present a hypertrophic myocardium and ventricular dilatation. The hypertrophy, more assymmetrical than that of RES, is more marked at the level of the septum. There is a non-significant tendency toward an excentric hypertrophy. RES present a marked hypertrophy with little or no dilatation. This hypertrophy is more symmetrical and concentric than in END patients. As far as the pump function is concerned (FR, FE, VES): it is not altered in RES (this fact is found in the literature). On the contrary, in END patients, the pump function (FR, FE) is diminished (this fact is debated in the literature), in spite of an increased systolic ejection volume. The total contraction function is not altered in RES nor in END patients. An increased septal contraction rate is noted, which is significant in RES patients and non-significant in END patients.(ABSTRACT TRUNCATED AT 250 WORDS)

High plasmatic angiotensin-converting enzyme (ACE) activity is not correlated with training-induced left ventricular growth in ACE congenic rats.

AIM: The aim of this study was to determine the influence of angiotensin-converting enzyme (ACE) genotype on left ventricular growth after endurance training, in ACE congenic rats with plasma ACE activity twice as high as the donor strain (LOU), thus mimicking the ACE I/D polymorphism observed in humans. METHODS: LOU and congenic rats (n = 12) were submitted to an endurance training on a treadmill for 7 weeks, while similar LOU and congenic rats (n = 10) constituted the control groups. Blood pressure, skeletal muscle citrate synthase activity, plasma and left ventricular ACE activity were assessed, and echocardiography was performed before and after the training. RESULTS: Angiotensin-converting enzyme plasmatic activity of congenic rats (188.2 +/- 26.6 in controls and 187.1 +/- 22.6 IU in trained rats respectively) was twofold that of the LOU strain (91.9 +/- 23.3 in controls, and 88.3 +/- 18.1 IU in trained rats respectively). After training, congenic and LOU rats showed a similar significant increase in citrate synthase activity (P < 0.05), and in the left ventricular mass/body mass ratio x 10(3): 3.7 +/- 0.3 and 3.6 +/- 0.6 in the trained congenic and LOU groups, respectively, vs. 3.0 +/- 0.1 and 2.9 +/- 0.2 in the control congenic and LOU groups respectively (P < 0.05). There was no significant correlation between ACE plasma activity and left ventricular mass in trained or untrained congenic rats. CONCLUSION: We conclude that training-induced left ventricular growth is not associated with plasma ACE activity in congenic rats.

Non-linear analyses of heart rate variability during heavy exercise and recovery in cyclists.

We investigated the time course of RR interval variability during exercise and subsequent 50 minutes of recovery in seven well-trained male cyclists who performed an exercise with 3 successive 8 min stages at 40 %, 70 % and 90 % of their maximal oxygen uptake. The goal of the study was to check whether the decrease in the amplitude of heart rate variability during heavy exercise was accompanied by changes in the chaotic structure of the fluctuations. Heart rate variability was analysed in the temporal and frequency domain using traditional tools and using non-linear methods (Largest Lyapunov Exponent, Detrended Fluctuation Analysis, Minimum Embedding Dimension). When compared to rest, variability at the heaviest exercise intensity was significantly lower (RR: 0.94 +/- 0.22 vs. 0.34 +/- 0.01 ms; SDRR: 0.11 +/- 0.04 vs. 0.01 +/- 0.00 ms) due to a decrease in both LF (2101 +/- 1450 vs. 0.14 +/- 0.09 ms (2) . Hz (-1)) and HF spectral energy (1148 +/- 1126 vs. 7.88 +/- 9.24 ms (2) . Hz (-1)). Non-linear analyses showed that heart rate variability remained chaotic whatever the exercise intensity (the largest Lyapunov exponent was positive at 90 % of the maximal oxygen uptake), with a fractal organisation that tended towards white noise (DFA value close to 0.5) during heavy exercise. During recovery, temporal and spectral variables came back to their rest values within about 30 minutes following an exponential pattern. Non-linear analyses revealed that heartbeat dynamics were disorganised at the beginning of recovery, and involved more regulating systems than at rest, even after 50 minutes of recovery. We concluded that, during heavy exercise, heart rate variability was mainly influenced by other factors than autonomous nervous system, and suggest that mechanical or neurological couplings between the cardiac, locomotor and respiratory systems could play an important part in the observed changes.

High versus low training frequency in cardiac rehabilitation using a systems model of training.

No study has reported the long term effects of cardiac rehabilitation, concerning the duration of beneficial effects of training program. The present study analyzed the influence of training session frequency on long-term beneficial effects in patients with coronary artery disease (CAD) undergoing phase 2 cardiac rehabilitation. Four patients with CAD completed 20 training sessions. Two patients were assigned to low training frequency (LTF) and two to high training frequency (HTF): three and five sessions per week(-1), respectively. The method was based on the systems model of training and required training quantification and the assessment of real exercise tolerance. Convolution of training quantity with real exercise tolerance provided the model exercise tolerance for every patient. The model parameters, the magnitude factor (k), and the time constant of decay (tau), were fitted from real and model exercise tolerances by the least squares method. LTF and HTF resulted in similar increases in exercise tolerance (12-14%). A model with one-component (fitness) allowed fitting exercise tolerance in all patients with r (2) = 0.77, 0.79, 0.84, and 0.91, respectively (p < 0.05). The addition of a second component did not improve the fit in any patient (p > 0.05). The k value was about twice as high with LTF (0.13 and 0.16 AU) than with HTF (0.05 AU for the two patients), whereas the tau value was about twice as low with LTF (37 and 41 days) than with HTF (72 and 89 days). The long term beneficial effects estimated by 4tau, were twice as long with HTF (288 and 356 days) than with LTF (148 and 164 days). We concluded that exercise tolerance was similarly increased with HTF and LTF but HTF training induced beneficial effects which were sustained twice as long.

Salivary IgA response of triathletes participating in the French Iron Tour.

Athletes are susceptible to upper respiratory tract infections (URTI) during intense training and after major competitions. Secretory IgA, which is the predominant antibody of the mucosal immune system, is the major effector of host-resistance to many microorganisms causing URTI. Previous studies have shown that salivary IgA-mediated immunity decreases after a single short distance triathlon, but the effect of repeated triathlon competitions on secretory IgA levels remains unknown. The purpose of this study was to examine the salivary IgA response of elite triathletes in repeated triathlon races during the 2001 French Iron Tour (FIT). Eight triathletes participated in this study. Saliva samples were collected daily after waking up (fasting basal state), before (pre-race) and after (post-race) each day's competition. Salivary IgA, total protein, and flow rate were measured. Salivary IgA concentrations were measured by an enzyme-linked immunosorbent assay. The salivary flow rate was significantly decreased after each race compared with the fasting basal state (p < 0.01). The salivary IgA concentration of the fasting basal state decreased over the FIT and was even lower than that of the post-race values (p < 0.05). The salivary IgA secretion rate of the fasting basal state decreased by 51.9% over the FIT (p < 0.05). Our data suggest that intense exercise repeated daily has a cumulative negative effect on basal levels of salivary IgA.