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Effects of exercise in normobaric hypoxia on hemodynamics during muscle metaboreflex activation in normoxia

Abstract

Purpose

Little is known about the cardiovascular effects of the transition from exercise in hypoxia (EH) to normoxia. This investigation aimed to assess hemodynamics during the metaboreflex elicited in normoxia after EH.

Methods

Ten trained athletes (four females and six males, age 35.6 ± 8.4 years) completed a cardiopulmonary test to determine the workload at anaerobic threshold (AT). On separate days, participants performed three randomly assigned exercise sessions (10 min pedalling at 80% of AT): (1) one in normoxia (EN); (2) one in normobaric hypoxia with FiO2 15.5% (EH15.5%); and (3) one in normobaric hypoxia with FiO2 13.5% (EH13.5%). After each session, the following protocol was randomly assigned: either (1) post-exercise muscle ischemia after cycling for 3 min, to study the metaboreflex, or (2) a control exercise recovery (CER) session, without any metaboreflex stimulation.

Results

The main result were that both EH15.5% and EH13.5% impaired (p < 0.05) the ventricular filling rate response during the metaboreflex (− 18 ± 32 and − 20 ± 27 ml s−1), when compared to EN (+ 29 ± 32 ml s−1), thereby causing a reduction in stroke volume response (− 9.1 ± 3.2, − 10.6 ± 8.7, and + 5 ± 5.7 ml for EH15.5%, EH13.5% and EN test, respectively, p < 0.05). Moreover, systemic vascular resistance was increased after the EH15.5% and the EH13.5% in comparison with the EN test.

Conclusions

These data demonstrate that moderate exercise in hypoxia impairs the capacity to enhance venous return during the metaboreflex stimulated in normoxia. Overall, there is a functional shift from a flow to vasoconstriction-mediated mechanism for maintaining the target blood pressure during the metaboreflex.

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Abbreviations

AT:

Anaerobic threshold

CER:

Control exercise recovery

CO:

Cardiac output

COX:

Cerebral tissue oxygenation

CPX:

Cardiopulmonary test

DBP:

Diastolic blood pressure

DT:

Diastolic time

EH:

Exercise in acute hypoxia

EN:

Exercise in normoxia

HR:

Heart rate

MAP:

Mean blood pressure

NIRS:

Near-infrared spectroscopy

NO:

Nitric oxide

PEMI:

Post-exercise muscle ischemia

PEP:

Pre-ejection period

SBP:

Systolic blood pressure

SNA:

Sympathetic nervous activity

SO2 :

Peripheral blood O2 saturation

SV/VET:

Stroke volume/ventricular ejection time ratio

SV:

Stroke volume

SVR:

Systemic vascular resistance

VER:

Mean ventricular ejection rate

VET:

Left ventricular ejection time

VFR:

Ventricular filling rate

\(\dot{V}{\text{CO}}_{2}\) :

Carbon dioxide production

\(\dot{V}{\text{O}}_{{2\max}}\) :

Maximum oxygen uptake

W max :

Maximum workload

Z0:

Thoracic impedance

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Acknowledgements

This study was supported by the University of Cagliari and the Italian Ministry of Scientific Research.

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Authors

Contributions

GM, AD and AC: conceived and designed research, conducted experiments, analysed data, and wrote the manuscript. GS, SM, SR, GG, MM, and VP: conducted experiments and analysed data. SJW and GPM: conceived and designed research, analysed data, and wrote the manuscript.

Corresponding author

Correspondence to Antonio Crisafulli.

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All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards The study was approved by the ethics committee of the University of Cagliari.

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Mulliri, G., Sainas, G., Magnani, S. et al. Effects of exercise in normobaric hypoxia on hemodynamics during muscle metaboreflex activation in normoxia. Eur J Appl Physiol 119, 1137–1148 (2019). https://doi.org/10.1007/s00421-019-04103-y

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Keywords

  • Cardiac pre-load
  • Venous return
  • Stroke volume
  • Cardiac output
  • Blood pressure