Lung function, arterial saturation and oxygen uptake in elite cross country skiers: influence of exercise mode.

Arterial desaturation during exercise is common in endurance-trained athletes, a phenomenon often more pronounced when the muscle mass engaged in the exercise is large. With this background, the present study monitored seven international-level cross country skiers performing on a treadmill while running (RUN), double poling (DP; upper body exercise) and diagonal skiing (DIA; arm and leg exercise). Static and dynamic lung function tests were performed and oxygen uptake was measured during submaximal and maximal exercise. Lung function variables (including the diffusion capacity) were only 5-20% higher than reported in sedentary men. Vital capacity was considerably lower than expected from the skiers' maximal oxygen uptake (VO(2max)), but the maximal ventilation followed a linear relationship with VO(2max). None or only a mild desaturation was observed in DP, RUN and DIA. Blood lactate concentration was slightly higher in DIA than in DP but not different from RUN. In DIA, VO(2max) was 6.23 +/- 0.47 L/min (mean +/- SD), which was 3.8% and 13.9% higher than in RUN and DP, respectively, with similar peak heart rates for the three exercise modes. No relationships were present either between the degree of desaturation and pulmonary functions tests, or with peak oxygen uptakes. The low blood lactate accumulation during the exhaustive efforts contributed to the arterial oxygen saturation being mild in spite of the very high oxygen uptake observed in these skiers.

Physical training in Syndrome X: physical training counteracts deconditioning and pain in Syndrome X.

OBJECTIVES: The aim of this study was to evaluate the effects of exercise training and body-awareness training in female patients with Syndrome X. BACKGROUND: Patients with Syndrome X, defined as effort-induced angina pectoris, a positive exercise test and a normal coronary angiogram, suffer from a chronic pain disorder. We hypothesized that this disorder results in physical deconditioning with decreased exertional pain threshold. METHODS: Twenty-six patients were randomly assigned to two training groups (A, B) and a control group (C). Group A (n = 8) started, after baseline measurements, with eight weeks of body-awareness training followed by eight weeks of exercise training on a bicycle ergometer three times a week for 30 min at an intensity of 50% of peak work rate. Group B (n = 8) performed only eight weeks of exercise training. Group C (n = 10) acted as controls without any intervention whatsoever. The effects on exercise performance, hormonal secretion, vascular function, adenosine sensitivity and quality of life were evaluated. RESULTS: Body-awareness training did not change the pain response. The two training groups did not differ in effects of exercise training. Exercise capacity before training was below the gender- and age-matched reference range and improved by 34% with training to a level not different from the reference range. Onset of pain was delayed by 100% from 3 +/- 2 to 6 +/- 3 min (p < 0.05) while maximum pain did not change. Thus the pain-response-to-exercise curve was shifted to the right. Syndrome X patients showed a hypersensitivity to low-dose adenosine infusion compared to healthy age- and gender-matched controls (p < 0.0001) that did not change with exercise training. Endothelium-dependent blood flow increase was at baseline within reference range and tended to increase (p < 0.06) following training. In Group A the concentration of cortisol in urine decreased by 53% after body-awareness training (p < 0.05), and this change from baseline remained after physical exercise training (p < 0.05). A similar decrease occurred with only exercise training (Group B). CONCLUSIONS: Physical deconditioning with lower exertional threshold for pain is a prominent feature in Syndrome X. Physical training in Syndrome X results in an increased exercise capacity with lesser anginal pain. We suggest physical training as an effective treatment in Syndrome X.

Beat-to-beat QRS amplitude variability in elite endurance athletes.

Results from variance electrocardiography, displaying the wide-band, phase-locked electrical micro-variability during the depolarization phase, was analysed versus clinical data, echocardiographic structural and functional variables and myocardial scintigraphic findings in 174 elite orienteers compared with 37 age-matched elite endurance athletes and 50 age-matched, healthy medical students. PCA analysis identified a subgroup of five orienteers deviating from the rest of the study group and both control groups with regard to their QRS amplitude variability. No correlations were found between pathology by medical history or any of the echocardiographic and scintigraphic variables or by the variance electrocardiographic aberrations in any of the groups studied.

Analgesic effects of adenosine in syndrome X are counteracted by theophylline: a double-blind placebo-controlled study.

It has been proposed that adenosine mediates ischaemic pain in humans. Patients with cardiac Syndrome X are hypersensitive to potential pain stimuli, including adenosine. On the other hand, recent findings suggest that low-dose adenosine infusion may have analgesic effects. Our aim was to test two hypotheses: (1) that the analgesic effect of adenosine is peripheral in origin, and (2) that part of the hypersensitivity to pain of patients with cardiac Syndrome X results from a disturbed mechanism of adenosine analgesia. A total of 12 female Syndrome X patients and eight healthy age-matched female controls were studied in a randomized, double-blind and placebo-controlled study. Adenosine (70 microg/min) or placebo was infused into the forearm via an intra-arterial catheter. After 15 min of infusion, a tourniquet on the upper arm was inflated to 225 mmHg to ensure arterial occlusion. The patient then carried out dynamic handgrip work at 60 Hz. Pain or discomfort in the forearm was estimated continuously according to the Borg CR-10 scale. After the first test, theophylline was infused for 10 min intravenously at a dose of 5 mg/kg body weight. The ischaemic forearm test was then repeated. On a second occasion, the procedure was repeated with the opposite treatment (adenosine/placebo). Only six of 12 Syndrome X patients completed the protocol because of pain during the catheterization procedure or an inability to establish an intra-arterial line. The time to onset of pain in the working, ischaemic forearm was greater for subjects treated with adenosine than for those treated with placebo, both in those Syndrome X patients who tolerated catheterization (49+/-27 s compared with 32+/-18 s; P<0.03) and in healthy controls (40+/-19 s compared with 16+/-8 s; P<0.02). The time to maximum pain, limiting ischaemic work, was also greater with adenosine pretreatment both in Syndrome X patients (137+/-28 s compared with 106+/-28 s; P<0.03) and in healthy controls (109+/-31 compared with 82+/-18 s; P<0.01). After infusion of theophylline there was no difference between adenosine and placebo in either group. Intra-arterially infused adenosine had similar peripheral analgesic effects on experimentally induced muscular ischaemia in those female Syndrome X patients who tolerated intra-arterial catheterization and in healthy controls. Thus adenosine analgesia is counteracted by theophylline, suggesting that the effect is mediated by membrane-bound peripheral adenosine receptors.

Enhanced left ventricular endocardial border delineation with an intravenous injection of SonoVue, a new echocardiographic contrast agent: A European multicenter study.

The safety and efficacy of SonoVue (also referred to as BR1), a new contrast agent for delineating endocardial border of the left ventricle after intravenous administration, was assessed. Two hundred and eighteen patients with suspected coronary artery disease undergoing fundamental echocardiography for the assessment of left ventricle were enrolled in a prospective multicenter, single blind, cross-over study with random sequence allocation of four different doses of SonoVue. Endocardial border definition in the apical and parasternal views was scored as 0 = not visible, 1 = barely visible, and 2 = well visualized before and after contrast enhancement. Analysis was performed by two pairs of off-site observers. Safety of SonoVue was also assessed. Results of our study indicated that the mean improvements in the endocardial border visualization score were as follows: 3.1 +/- 7.8 (95% CI, 2.5 and 3.7) for 0.5 ml, 3.4 +/- 8.0 (95% CI, 2.8 and 4.0) for 1 ml, 3.4 +/- 7.9 (95% CI, 2.8 and 4.0) for 2 ml, and 3.7 +/- 8.0 (95% CI, 3.1 and 4.3) for 4 ml (P < 0.05 for all doses from baseline). Changes from baseline in endocardial visualization scores were also seen in the apical views (P < 0.05) and they were dose-dependent (P < 0.001). Similar enhancements of endocardial visualization scores were observed in the apical views in patients with suboptimal baseline echocardiographic images. Diagnostic confidence for assigning a score and image quality also were significantly better following contrast enhancement. No significant changes in the laboratory parameters and vital signs were noted following contrast enhancement, and the side effects were minimal. It was concluded that SonoVue is safe and effective in delineating endocardial border, including in patients with suboptimal baseline images.

The Maze operation for treatment of atrial fibrillation. Early clinical experience in a Scandinavian institution.

The Maze operation is a potentially curative surgical option in patients with disabling atrial fibrillation (AF) refractory to conventional treatment. The aim of this study was to evaluate the initial 4-year Maze experience in our institution. The study included 26 patients (19 males, mean age 55 years) who had undergone the Maze (III) operation between 1994 and 1998. Nine patients had surgery for concomitant heart disease. Follow-up was 3-55 (median 18) months. No deaths or neurological complications occurred; 22 patients are at present in regular sinus-, or junctional rhythm, 2 patients have permanent atrial pacing for symptomatic sinus node dysfunction, and 2 patients have had persistent AF, post surgery. Sinus node dysfunctions were detected in five patients, though not requiring pacemakers. Out of the total 26 patients, 23 are free of anti-arrhythmic drugs. Echocardiographic signs of left atrial contraction were recorded in 50% of the patients. The Maze operation offers a safe alternative to conventional therapy, with attractive results justifying expansion in the use of this treatment for AF.

Short-term intermittent normobaric hypoxia--haematological, physiological and mental effects.

Effects on erythropoiesis and blood pressure as well as physical performance and mental effects were studied in 15 healthy subjects during intermittent exposure to normobaric hypoxia corresponding to either 2000 m (6 persons) or 2700 m (9 persons) above sea level; another group (5 persons) also served as controls at normoxia. The concept "live high-train low" was used for 10 d consecutively and the exposure to hypoxia was 12 h/d. Blood pO2 and oxygen saturation were significantly decreased during the 10 d at hypoxia. [Hb] and Hct decreased significantly after 2 d in hypoxia and then returned to pre-study levels. Erythropoietin was significantly elevated in both hypoxia groups during the initial 3-5 d. Reticulocytes were significantly increased during 7 d of hypoxia. Submaximal and maximal oxygen uptake, blood pressure at rest and during exercise and the profile of mood states (POMS test) did not change during the study. In conclusion, intermittent normobaric hypoxia for 10 d resulted in a significant stimulation of erythropoiesis. Staying at normobaric hypoxia may serve as a complement to an ordinary altitude level sojourn.

[A new surgical technique in atrial fibrillation. The maze procedure restores sinus rhythm]. / Ny hjärtkirurgisk metod vid förmaksflimmer. Maze-operation återställer sinusrytm.

Atrial fibrillation (AF) is a common arrhythmia associated with significant morbidity and increased mortality, partly due to the increased risk of stroke. The maze procedure, introduced by James Cox of the USA, is an internationally established surgical alternative in cases of unsuccessful medical or catheterised treatment of paroxysmal or chronic AF. It is an open heart procedure, involving multiple transmural incisions and continuous suture lines in both atria. By creating a maze of atrial tissue, the re-entrant circuits causing the AF are interrupted, hence re-establishing regular sinus rhythm and atrioventricular synchronization. The article reviews the initial 3-year experience of the procedure in 10 patients with AF, either paroxysmal (n = 5) or chronic (n = 5). The indications for surgery were disabling symptoms in all 10 cases, medical treatment failure in nine cases, previous AF-associated stroke in three cases, and a significant atrial septal defect in one case. All patients underwent extensive investigation both pre- and post-operatively. Postoperatively, nine of the 10 patients manifested regular sinus or atrial rhythm and freedom from or amelioration of preoperative symptoms associated with AF. There were no deaths, neurological complications or long-term recurrence of arrhythmia. One patient had an early recurrence of AF that was not amenable to medical treatment, and was subsequently treated with His' bundle ablation. Of the remaining nine patients, seven manifested signs of some postoperative atrial contraction at echocardiography, the occurrence of which needs to be borne in mind with a view to reducing the risk of future thromboembolic events. We recommend the maze procedure as an attractive surgical option in cases of unsuccessful medical treatment of paroxysmal or chronic AF.

Increased left ventricular muscle mass after long-term altitude training in athletes.

The effects of long-term altitude training on altitude and sea-level physiological characteristics in elite endurance athletes were investigated. Seven Swedish elite cross-country skiers (five men, two women; mean age 27 years) spent 1 month training at 1900 m above sea level in Italy. Rollerski treadmill tests were performed before and 5 and 11 days after the altitude sojourn; three tests were also performed at altitude. Before and 1, 11 and 35 days after the altitude camp, echocardiographic and blood volume measurements were performed. The heart rates at both maximal (P < 0.05) and submaximal (P < 0.01) work loads were decreased by 5-9 beats min-1 at altitude. The haemoglobin concentration and haematocrit increased quickly at altitude with a corresponding decrease on return to sea level. The blood volume (7%) and total haemoglobin (3%) tended to be higher day 11 post-altitude (NS). There were no significant changes in diastolic internal diameter or wall thickness of the left ventricle, but the calculated cardiac left ventricular muscle mass was increased post-altitude (9-10%, P < 0.01). The maximal oxygen uptake increased in six of the seven skiers after the altitude training (day 11, mean 3%, NS). In conclusion, training at moderate altitude may cause a reduction in heart rates during exercise. Moreover, after long-term training at altitude, there may be an increase in the cardiac left ventricular muscle mass.

Beat-to-beat QRS amplitude variability after acute myocardial infarction and coronary artery bypass grafting.

Ischemic myocardial injury has been demonstrated to be associated with increased beat-to-beat electrical variability of the depolarization phase. This can be quantified by electrocardiographic (ECG) signal variance analysis, a technique that has proven its diagnostic value in the detection of coronary artery disease (CAD). This study evaluates QRS amplitude variability during a 6-month follow-up period in 73 patients with acute myocardial infarction (AMI) and in 56 patients subjected to coronary artery bypass grafting (CABG). The beat-to-beat QRS amplitude variability was quantified with variance electrocardiography. The equipment allows computerized time domain analysis of high-fidelity ECG signals from 24 leads, and the detected electrical heterogeneity is then expressed as a nondimensional index ranging from 0 to 150, with values >90 being indicative of ischemic myocardial involvement. One week after AMI 55% of the patients presented with an abnormal QRS variability index >90. A significant (p <0.01) increase in the index values occurred during the follow-up period, but only in the patients with an initial index <70. In the CABG group 44% of the patients had a preoperative QRS variability index >90. The values increased (p <0.05) in all patients after surgery; the increase was transient in patients with an initial index <70 (p <0.01). The results demonstrate that the myocardial injury in patients with CAD is often associated with increased electrical variability of myocardial depolarization. The QRS amplitude variability index can be used as a marker of such an injury, and analysis of its changes in the course of ischemic cardiac events may provide new insights into the dynamics of ischemic heart disease and the myocardial healing process.

Beat-to-beat QRS amplitude variability during dobutamine infusion in patients with coronary artery disease.

The aim of this study was to investigate if provoked myocardial ischemia induces increased beat-to-beat QRS amplitude variability in patients with angiographically verified coronary artery disease. 15 patients (median age 62 years, range 46-73 years) and 10 healthy controls (median age 25 years, range 22-42 years) were studied. Dobutamine was infused intravenously at a low and at a high dose. The mean low dose of the drug was 10.0 micrograms/kg/min for both patients and controls, whereas the mean maximum dose was 31 +/- 2 for patients and 38 +/- 1 microgram/kg/min for controls. The total QRS amplitude beat-to-beat variance from 12 leads as well as individual variance scores in each single lead were evaluated. Before infusion, the total QRS variance did not differ between patients and controls, nor did the individual variance in 9 of the 12 ECG leads. Dobutamine elicited an increase (p < 0.01) in the total QRS variance, with significantly higher (p < 0.001) total variance in patients than in controls. At the high dose of the drug, the patients displayed significantly higher individual variance values in each ECG lead as well. During dobutamine infusion, 7 of 15 patients developed ST depressions (> or = 0.1 mV in > or = 2 leads) in 12-lead ECG readings. Eleven of 15 patients developed chest pain (grade > or = 3 at the Borg's CR-10 scale). In conclusion, in patients with ischemic heart disease, dobutamine-provoked stress gives rise to increased QRS amplitude beat-to-beat variability, as a sign of electrical instability of the myocardium.

The validity of isokinetic knee extensor endurance measurements with reference to treadmill running capacities.

The validity of isokinetic knee extensor endurance measurements with reference to treadmill running capacities was investigated. Nine male elite middle-distance runners completed a test consisting of 100 repetitive maximal eccentric and 100 concentric knee extensor actions where peak torque (Nm) and work (J) were measured. On a different day, submaximal and maximal treadmill tests were performed. Stepwise regression analysis was applied to determine the isokinetic variables with the greatest influence on the selected treadmill running capacities, including submaximal oxygen uptake (VO(2)) and maximal blood lactate. Eccentric total work was significantly and negatively related to submaximal VO(2) at all three running velocities investigated (12, 14, and 15 km.h(-1)). The R(2) values ranged from 0.48-0.59 for V0(2) ml.kg(-0.75).min(-1), indicating that 48-59 % of the variability in VO(2) ml.kg(-0.75).min(-1) could be accounted for by eccentric total work. The corresponding R(2) values for VO in ml.kg(-1).min(-1) were 0.50-0.58. Concentric relative endurance was significantly and negatively related to maximal blood lactate (R(2) = 0.73). This study has shown that isokinetic knee extensor endurance measurements of eccentric total work and concentric relative endurance are substantially related to measures of treadmill running capacity, as expressed by submaximal V02 and maximal blood lactate. It is suggested that these isokinetic measures may be used to evaluate specified running capacities in male elite middle-distance runners.

Maximal and submaximal oxygen uptake during running: how should body mass be accounted for?

Oxygen uptake during running, i.e., the running economy, is an important factor in determining running performance in endurance events. The relation to performance is particularly strong when the aerobic running capacity is calculated, i.e., when running economy is related to the maximal oxygen uptake. There is considerable interindividual variation in running economy, and the reason for this is only partly understood. To some extent, this may be due to the way in which the oxygen uptake during running is usually expressed. This may especially be true when subjects with different or changing body masses are compared. Several lines of evidence, including earlier animal studies as well as more recent human studies, favor the expression of submaximal and maximal oxygen uptake during running in terms of ml.kg-0.75.min-1 rather than as ml.kg-1.min-1.

Morphology, enzyme activities and buffer capacity in leg muscles of Kenyan and Scandinavian runners.

The study comprises data on 12 Scandinavian runners who had either trained for two weeks in Kenya (n = 6; approximately 2000 meters above sea level (m.a.s.l.)) or in Portugal (n = 6; sea level (s.l.)) and on 13 Kenyan runners (9 junior and 4 senior) living and training at approximately 2000 m.a.s.l. Muscle biopsies were taken before and after the training camps in the Scandinavian runners and once on the Kenyan runners from the vastus lateralis (v.l.) and the gastrocnemius muscles. Muscle fiber size and composition were similar in the various groups (4.6-5.1 X 10(3) microns2; ST approximately 60-70%; FTa 30-40%; FTb < 6.0%) with a tendency for some more (approximately 5%) FTa fibers in the gastrocnemius muscle. Mean number of capillaries in v.l. varies between 405-493 cap.(mm2)-1, 2.0-2.7 cap.fiber-1, and 4.4-6.2 cap around the various fiber types, with the Kenyan seniors having the highest and the Kenyan juniors the lowest values. All runners had 10-20% more capillaries in their gastrocnemius muscle. Similar levels for citrate synthase (CS) activity were found in the v.l. of the Kenyan seniors and Scandinavian runners, whereas the Kenyan juniors were 10-15% lower. The 3- hydroxyacyl-CoA-dehydrogenase (HAD) activity was 20% higher in the Kenyan than in the Scandinavian runners. In the gastrocnemius muscle, both enzyme activities were 20-50% higher in Scandinavian and Kenyan runners. The ratio for lactate dehydrogenase (LDH) isoform1-2 and isoform4-5 was increased when training at altitude due to a lowering of LDH4-5 and became close to what was observed in the Kenyan runners.

Aerobic exercise capacity at sea level and at altitude in Kenyan boys, junior and senior runners compared with Scandinavian runners.

The aim of this study was to characterize Kenyan runners in regard to their oxygen uptake and blood and ammonia responses when running. Untrained Kenyan boys (14.2 +/- 0.2 years) and Scandinavian runners were included for comparison. The studies were performed at altitude (approximately 2.000 m.a.s.l.) and, for several Kenyan and Scandinavian runners, at sea level as well. At altitude sedentary adolescent Kenyan boys had a mean maximal oxygen uptake (VO2max) of 47 (44-51) ml.kg-1.min-1, whereas similarly aged boys regularly walking or running but not training for competition reached above 62 (58-71) ml.kg-1.min-1 in VO2max. Kenyan runners in active training had 68 +/- 1.4 ml.kg-1.min-1 at altitude and 79.9 +/- 1.4 ml.kg-1.min-1 at sea level, with individuals reaching 85 ml.kg-1.min-1. The best Scandinavian runners were not significantly different from the Kenyan runners in VO2max both at altitude and at sea level, but none of the Scandinavians reached as high individual values as observed for some Kenyan runners. The running efficiency, determined as the oxygen cost at a given running speed, was less in the Kenyan runners, and the difference became more pronounced when body weight was expressed in ml.kg-0.75 min-1. Blood lactate concentration was in general lower in the Kenyan than in the Scandinavian runners, and the Kenyans also had extremely low ammonia accumulation in the blood even at very high exercise intensities. It is concluded that it is the physical activity during childhood, combined with intense training as teenagers that brings about the high VO2max observed in some Kenyan runners. Their high aerobic capacity, as well as their good running economy, makes them such superior runners. In addition, their low blood lactate and ammonia accumulation in blood when running may also be contributing factors.

Effect of epinephrine infusion on chest pain in syndrome X in the absence of signs of myocardial ischemia.

Eight female patients (aged 51 to 65 years) with New York Heart Association class II angina pectoris, normal coronary angiograms, normal hyperventilation, and abnormal exercise stress tests (chest pain and ST depression), and 5 sex- and age-matched controls participated in this study. Epinephrine was given intravenously to both patients and controls at 5-minute intervals in doses of 0.1, 0.2, 0.3, 0.4, and 0.6 nmol/kg/min. After rest (15 minutes), the alpha-adrenoceptor antagonist phentolamine or placebo was administered intravenously to patients in a double-blind, crossover study on 2 separate occasions in doses of 250 micrograms/min for 5 minutes and 500 micrograms/min for the next 10 minutes; the epinephrine infusion was repeated. Blood pressure, heart rate, and electrocardiogram were monitored continuously and pain was estimated on the Borg CR-10 scale. On a third occasion, chest pain was induced in patients using the same epinephrine protocol during echocardiographic monitoring. In the control group, all patients received the maximal epinephrine dose. No chest discomfort or pain developed. In the patient group, the maximal tolerable epinephrine dose (0.39 +/- 0.19 nmol/kg/min) decreased diastolic pressure (-14 +/- 9 mm Hg, p < 0.01) and increased heart rate (+24 +/- 10 beats/min, p < 0.01), not statistically different from the control group. Pulse pressure increased in the patient group (27 +/- 17 mm Hg, p < 0.01) but not in the controls. Left ventricular ejection fraction at baseline was within reference limits (58% to 75%) and did not change during epinephrine infusion.(ABSTRACT TRUNCATED AT 250 WORDS)

A case of Brucella melitensis endocarditis successfully treated by a combination of surgical resection and antibiotics.

Endocarditis is a rare complication of brucellosis, often fatal, and the treatment is controversial. We present a case of Brucella melitensis endocarditis successfully treated by a combination of surgical resection and antibiotics.

Body-mass-modified running economy and step length in elite male middle- and long-distance runners.

To minimize the influence of body mass on oxygen uptake (VO2) during running, submaximal and maximal VO2 should preferentially be expressed as ml.kg-0.75.min-1. In this study, the levels of such body-mass-modified running economy were investigated at different velocities in elite runners and related to step lengths and anthropometric measures. Twenty-six Swedish National Team middle- and long-distance runners performed submaximal (4 velocities) and maximal treadmill tests. In 17 runners repeated (2-4) tests were performed within 6 months. The maximal oxygen uptake (VO2max; 214 vs 202 ml.kg-0.75.min-1) and running velocity at 4 mmol.l-1 blood lactate were higher in the long- (n = 12) than in the middle-distance group (n = 14). The oxygen uptake at 15 km.h-1 (VO2 15) was lower (129 vs 138 ml.kg-0.75.min-1, p < 0.01) and the VO2/velocity slope higher in the long-distance runners, with similar VO2 18 in the two groups. Step lengths at 18 (168 vs 173 cm) and 15 km.h-1 did not differ significantly between the groups, but the increase in step length per km.h-1 velocity raise was greater in the middle-distance runners. Step lengths at these velocities were positively related to body mass and stature, negatively to relative leg length. Stature and leg length were greater in runners displaying low VO2 15, whereas no corresponding difference was seen for VO2 18. The figures for running economy at 15 and 18 km.h-1 were poorly related to the concomitantly determined step lengths at the respective velocities.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of muscle mass on lactate formation during exercise in humans.

To elucidate the mechanisms of lactate formation during submaximal exercise, eight men were studied during one- (1-LE) and two-leg (2-LE) exercise (approximately 11-min cycling) using the catheterization technique and muscle biopsies (quadriceps femoris muscle). The absolute exercise intensity and thus the energy demand for the exercising limb was the same [mean 114 (SEM 7) W] during both 1-LE and 2-LE. At the end of exercise partial pressure of O2 and O2 saturation in femoral venous blood were lower and arterial adrenaline and noradrenaline were higher during 2-LE than during 1-LE. Mean arterial blood lactate concentration increased to 10.8 (SEM 0.8) (2-LE) and 5.2 (SEM 0.4) mmol.l-1 (1-LE) after 10 min of exercise. The intramuscular metabolic response to exercise was attenuated during 1-LE [mean, lactate = 49 (SEM 9); glucose 6-P = 3.3 (SEM 0.3); nicotinamide adenine dinucleotide, reduced = 0.17 (SEM 0.02); adenosine 5'-diphosphate 2.7 (SEM 0.1) mmol.kg dry mass-1] compared to 2-LE [76 (SEM 6); 6.1 (SEM 0.7); 0.21 (SEM 0.02); 3.0 (SEM 0.1) mmol.kg dry mass-1, respectively]. To elucidate whether the lower plasma adrenaline concentration could contribute to the attenuated metabolic response, additional experiments were performed on four of the eight subjects with infusion of adrenaline during 1-LE (1-LEE). Average plasma adrenaline concentration was increased during 1-LEE and reached 2-4 times higher levels than during 2-LE. Post-exercise muscle lactate and glucose 6-P contents were higher during 1-LEE than during 1-LE and were similar to those during 2-LE.(ABSTRACT TRUNCATED AT 250 WORDS)