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Exercise Training in Chronic Obstructive Pulmonary Disease: Muscle O2 Transport Plasticity

Ryan M. Broxterman, Peter D. Wagner, Russell S. Richardson
European Respiratory Journal 2021; DOI: 10.1183/13993003.04146-2020
Ryan M. Broxterman
1Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
2Geriatric Research, Education, and Clinical Center, VA Medical Center, Salt Lake City, Utah, USA
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  • For correspondence: ryan.broxterman@utah.edu
Peter D. Wagner
4Department of Medicine, University of California, San Diego, La Jolla, California, USA
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Russell S. Richardson
1Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
2Geriatric Research, Education, and Clinical Center, VA Medical Center, Salt Lake City, Utah, USA
3Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, USA
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Abstract

Both convective O2 transport to, and diffusive transport within, skeletal muscle are markedly diminished in patients with chronic obstructive pulmonary disease (COPD). However, it is unknown how these determinants of peak muscle O2 uptake (V̇MO2peak) respond to exercise training in patients with COPD. Therefore, the purpose of this study was to assess the plasticity of skeletal muscle O2 transport determinants of V̇MO2peak in patients with COPD.

Adaptations to 8 weeks of single-leg knee-extensor exercise training were measured in 8 patients with severe COPD (forced expiratory volume in 1 s (FEV1)±sem=0.9±0.1 l) and 8 healthy, well-matched controls. Femoral arterial and venous blood samples, and thermodilution-assessed leg blood flow were used to determine muscle O2 transport and utilisation at maximal exercise pre- and post-training.

Training increased V̇MO2peak in both COPD (by ∼26% from 271±29 to 342±35 mL·min−1) and controls (by ∼32% from 418±37 to 553±41 mL·min−1), restoring V̇MO2peak in COPD to only ∼80% of pre-training control V̇MO2peak. Muscle diffusive O2 transport increased similarly in both COPD (by ∼38% from 6.6±0.9 to 9.1±0.9 mL·min·mmHg−1) and controls (by ∼36% from 10.4±0.7 to 14.1±0.8 mL·min·mmHg−1), with the patients reaching ∼90% of pre-training control values. In contrast, muscle convective O2 transport increased significantly only in controls (by ∼26% from 688±57 to 865±69 mL·min−1), leaving patients with COPD (438±45 versus 491±51 mL·min−1) at ∼70% of pre-training control values.

While muscle diffusive O2 transport in COPD was largely restored by exercise training, V̇MO2peak remained constrained by limited plasticity in muscle convective O2 transport.

Footnotes

This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Broxterman reports grants from National Heart, Lung, and Blood Insitute, grants from U.S. Department of Veterans Affairs, during the conduct of the study;.

Conflict of interest: Dr. Wagner reports grants from National Heart, Lung, and Blood Insitute, grants from U.S. Department of Veterans Affairs, during the conduct of the study;.

Conflict of interest: Dr. Richardson reports grants from National Heart, Lung, and Blood Insitute, grants from U.S. Department of Veterans Affairs, during the conduct of the study;.

  • Received November 10, 2020.
  • Accepted January 5, 2021.
  • ©The authors 2021. For reproduction rights and permissions contact permissions{at}ersnet.org
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Exercise Training in Chronic Obstructive Pulmonary Disease: Muscle O2 Transport Plasticity
Ryan M. Broxterman, Peter D. Wagner, Russell S. Richardson
European Respiratory Journal Jan 2021, 2004146; DOI: 10.1183/13993003.04146-2020

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Exercise Training in Chronic Obstructive Pulmonary Disease: Muscle O2 Transport Plasticity
Ryan M. Broxterman, Peter D. Wagner, Russell S. Richardson
European Respiratory Journal Jan 2021, 2004146; DOI: 10.1183/13993003.04146-2020
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