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Exercise oscillatory ventilation during autonomic blockade in young athletes and healthy controls

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European Journal of Applied Physiology Aims and scope Submit manuscript

Abstract

Purpose

Exercise oscillatory ventilation (EOV) is a form of periodic breathing that is associated with a poor prognosis in heart failure patients, but little is known about EOV in other populations. We sought to provide insights into the phenomenon of EOV after it was observed in young healthy subjects, including athletes, after the administration of dual autonomic blockade (DAB).

Methods

From 29 participants who completed cardiopulmonary exercise testing (CPET) with and without DAB (0.04 mg/kg atropine and 0.2 mg/kg metoprolol), 5 subjects developed EOV (age = 29 ± 5 years; 3/5 were athletes) according to American Heart Association criteria. For each case, we identified 2 non-EOV healthy controls (age = 34.2 ± 8.3; 7/10 were athletes) that were subsequently age- and sex-matched.

Results

No participants had EOV during exercise without DAB. The 5 participants (4 male, 1 female) who demonstrated EOV with DAB had lower mean tidal volume (1.7 ± 0.5 L/min vs. 1.8 ± 0.5 L/min; p = 0.04) compared to participants in the non-EOV group and a decrease in peak tidal volume (2.9 ± 0.6 L/min to 2.2 ± 0.7 L/min; p = 0.004) with DAB. There were few other differences in CPET measures between EOV and non-EOV participants, although the PETCO2 tended to be higher in the EOV group (p = 0.07).

Conclusion

EOV can be elucidated in young healthy subjects, including athletes, during cardiopulmonary exercise testing, suggesting that it may not be an ominous sign in all populations.

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Funding

This study funded by a project grant from the National Health and Medical Research Council (NHMRC) of Australia (APP1130353: Atrial remodelling and risk of arrhythmias in endurance athletes). ALG is supported by a Future Leader Fellowship from the National Heart Foundation of Australia (102021—Utility of novel exercise imaging to identify sub-clinical cardiovascular disease).

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Authors and Affiliations

  1. School of Medicine, Monash University, Melbourne, VIC, Australia

    Andrew T. Jeklin

  2. Sports Cardiology, Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia

    Fergus Sully, Darragh Flannery & André La Gerche

  3. Department of Medicine, University of Melbourne, Parkville, Australia

    Darragh Flannery & André La Gerche

  4. Respiratory Department, The Alfred Hospital, Melbourne, Australia

    Matthew T. Naughton, Kris Nilsen & Matthew J. Ellis

  5. Human Autonomic Neurophysiology Lab, Baker Heart and Diabetes Institute, Melbourne, Australia

    Vaughan G. Macefield

  6. National Centre for Sports Cardiology, St Vincent’s Hospital Melbourne, Fitzroy, Australia

    André La Gerche

Authors
  1. Andrew T. Jeklin
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  2. Fergus Sully
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  3. Darragh Flannery
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  4. Matthew T. Naughton
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  5. Vaughan G. Macefield
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  6. Kris Nilsen
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  7. Matthew J. Ellis
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  8. André La Gerche
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Contributions

ALG contributed to the conception and design of the research. ALG and FS contributed to the acquisition of data. Analysis and interpretation of the data was done by AJ, FS, MN, KN, ME, and ALG. Drafting of the manuscript was done by AJ and critically revised by FS, MN, KN, ME, VM and ALG.

Corresponding author

Correspondence to André La Gerche.

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The authors declare that no conflict of interest exists.

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Communicated by Susan Hopkins.

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Jeklin, A.T., Sully, F., Flannery, D. et al. Exercise oscillatory ventilation during autonomic blockade in young athletes and healthy controls. Eur J Appl Physiol 121, 2499–2507 (2021). https://doi.org/10.1007/s00421-021-04720-6

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  • DOI: https://doi.org/10.1007/s00421-021-04720-6

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