Oxidative capacity of the skeletal muscle and lactic acid kinetics during exercise in normal subjects and in patients with COPD.

Maltais, François; Simard, A A; Simard, C; Jobin, Jean; Desgagnés, P; Leblanc, Pierre

doi:10.1164/ajrccm.153.1.8542131

Cited by 496 publications

(360 citation statements)

References 25 publications

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“…The alternative would be that the ventilatory load progressively increases during exhaustive PPV-assisted exercise. This model would be consistent with progressive carbon dioxide production (and retention) consequent on the loss of oxidative capacity [30], which is a recognized feature of the peripheral myopathy associated with COPD. In this context, it is of interest that the two subjects whose performance showed the greatest improvement with PPV were the two making the greatest use of the (possibly redundant) abdominal muscles during the free walk.…”

Section: Significance Of the Findingssupporting

confidence: 68%

Respiratory muscle activity in patients with COPD walking to exhaustion with and without pressure support

Kyroussis¹,

Polkey²,

Hamnegärd³

et al. 2000

Eur Respir J

117

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The function of the diaphragm and other respiratory muscles during exercise in chronic obstructive pulmonary disease (COPD) remains controversial and few data exist regarding respiratory muscle pressure generation in this situation.The inspiratory pressure/time products of the oesophageal and transdiaphragmatic pressure, and the expiratory gastric pressure/time product during exhaustive treadmill walking in 12 patients with severe COPD are reported. The effect of noninvasive positive pressure ventilation during treadmill exercise was also examined in a subgroup of patients (n=6).During free walking, the inspiratory pressure/time products rose early in the walk and then remained level until the patients were forced to stop because of intolerable dyspnoea. In contrast, the expiratory gastric pressure/time product increased progressively throughout the walk. When patients walked the same distance assisted by noninvasive positive pressure ventilation, a substantial reduction was observed in the inspiratory and expiratory pressure/time products throughout the walk. When patients walked with positive pressure ventilation for as long as they could, the pressure/time products observed at exercise cessation were lower than those observed during exercise cessation after free walking.It is concluded that, in severe chronic obstructive pulmonary disease, inspiratory muscle pressure generation does not increase to meet the demands imposed by exhaustive exercise, whereas expiratory muscle pressure generation rises progressively. Inspiratory pressure support was shown to substantially unload all components of the respiratory muscle pump. Eur Respir J 2000; 15: 649±655.

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Section: Significance Of the Findingssupporting

confidence: 68%

Respiratory muscle activity in patients with COPD walking to exhaustion with and without pressure support

Kyroussis¹,

Polkey²,

Hamnegärd³

et al. 2000

Eur Respir J

117

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“…These findings are in accordance with GEA et al [27], who did not find abnormalities in enzyme capacities in deltoid muscle. However, in studies examining quadriceps femoris muscle, a decreased oxidative capacity as measured by CS [3,6] and HAD [6] and an increased glycolytic capacity as measured by PFK [6] were found. With comparable patient characteristics, other factors seem to be more important in causing the discrepancies between the studies.…”

Section: Discussionmentioning

confidence: 95%

“…JAKOBSSON et al [6] found a decreased oxidative capacity and an increased glycolytic capacity in quadriceps femoris muscle. MALTAIS et al [3] reported a decreased oxidative capacity in quadriceps femoris muscle. In another recent study [4], in tibialis anterior muscle, indications for an imbalance in adenosine triphosphate (ATP) utilization and resynthesis were found, as suggested by increased inosine monophosphate (IMP) levels, which were negatively related with ATP/adenosine diphosphate (ADP) ratios.…”

mentioning

confidence: 95%

Muscle metabolic status in patients with severe COPD with and without long-term prednisolone

Pouw¹,

Lang²,

Gosker³

et al. 2000

Eur Respir J

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Both abnormalities in high energy phosphate metabolism and a decreased oxidative enzyme capacity have been reported in skeletal muscle of stable chronic obstructive pulmonary disease (COPD) patients. The first aim of this study was to investigate whether these findings are present in anterior tibialis muscle and whether or not they are associated. Abnormalities in mitochondrial structure and function as well as signs of myopathy have been found during corticosteroid treatment. The second aim of this study, therefore, was to investigate whether in COPD patients prolonged use of low dose prednisolone has effects on muscle energy metabolism and qualitative morphology.In a cross-sectional study 15 COPD patients (forced expiratory volume in one second (FEV1) 33 9 (mean SD) % predicted) who were steroid-naive (CORT-) were compared with 10 healthy control subjects (HC) and with 14 COPD patients (FEV1 30 11 % pred), who had been using oral prednisolone for at least 1 yr (CORT+).It was found that adenosine triphosphate (ATP)/adenosine diphosphate was lower in CORT-compared to HC (5.7 versus 6.2, p=0.03). Inosine monophosphate was detected in 13 of 15 CORT-compared to 3 of 10 HC (p=0.004). However, although indications were found for an imbalance in production and utilization of ATP, comparing CORT-and HC, no differences in oxidative (citrate synthase and 3-hydroxy-acylcoenzyme A dehydrogenase) and glycolytic (hexokinase, lactate dehydrogenase and phosphofructokinase) enzyme capacities were found.When, comparing steroid-treated and steroid-naive patient subgroups, no differences in the above mentioned parameters of muscle energy metabolism and of muscle qualitative morphology were found. Eur Respir J 2000; 16: 247±252. Supported by a scholarship from ASTRA BV, the Netherlands.Exercise intolerance and dyspnoea are the most frequently occurring complaints in patients with severe chronic obstructive pulmonary disease (COPD). Weakness of both skeletal and respiratory muscles contributes significantly to these complaints [1]. Recently it has been shown that muscle weakness in COPD patients can predominantly be explained by muscle atrophy [2]. However, several studies suggested that exercise tolerance might also be impaired by alterations in muscle energy metabolism [3±5].Experimental evidence is accumulating that in COPD patients muscle energy metabolism is already disturbed at rest. JAKOBSSON et al. [6] found a decreased oxidative capacity and an increased glycolytic capacity in quadriceps femoris muscle. MALTAIS et al.[3] reported a decreased oxidative capacity in quadriceps femoris muscle. In another recent study [4], in tibialis anterior muscle, indications for an imbalance in adenosine triphosphate (ATP) utilization and resynthesis were found, as suggested by increased inosine monophosphate (IMP) levels, which were negatively related with ATP/adenosine diphosphate (ADP) ratios. However, in that study oxidative and glycolytic enzyme capacities were not investigated.In view of the above mentioned findings in skel...

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“…Physiologic abnormalities in the structure and metabolism of the skeletal muscles have also been shown (Maltais et al, 1996;Casaburi, 2000). Rehabilitation programmes, including physiotherapy (mobility training, breathing exercises and physical exercise), nutritional support, psychotherapy and education, are recommended in international treatment guidelines for COPD patients (Siafakas et al, 1995;Ries et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Energy expenditure in underweight chronic obstructive pulmonary disease patients before and during a physiotherapy programme

et al. 2006

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Objective: To investigate how total daily energy expenditure (TEE) changes when underweight patients with chronic obstructive pulmonary disease (COPD) enters a physiotherapy programme. Design: Prospective intervention study. Setting: Sahlgrenska University Hospital, Göteborg, Sweden. Subjects: Fifteen patients with severe COPD and BMIo21 kg/m 2 were recruited consecutively at the outpatient COPD unit at the Department of Respiratory Medicine. Fourteen patients completed the whole study. Intervention: TEE was assessed by the doubly labelled water method in a 2-week control period and during 2 weeks of physiotherapy. Energy intake was assessed using 7-day dietary record during control and physiotherapy period. Results: Mean TEE during physiotherapy period was 500 kJ (6%) lower than during control period but the difference was not statistically significant. Ten of the 14 patients had lower and four had higher TEE. Mean energy intake during the physiotherapy period did not change from the control period (7700 vs 7600 kJ/day). Conclusions: Since underweight patients with COPD may show variable TEE during physiotherapy compared to a control period, an assessment of individual energy requirements is recommended.

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Oxidative capacity of the skeletal muscle and lactic acid kinetics during exercise in normal subjects and in patients with COPD.

Cited by 496 publications

References 25 publications

Respiratory muscle activity in patients with COPD walking to exhaustion with and without pressure support

Respiratory muscle activity in patients with COPD walking to exhaustion with and without pressure support

Muscle metabolic status in patients with severe COPD with and without long-term prednisolone

Energy expenditure in underweight chronic obstructive pulmonary disease patients before and during a physiotherapy programme

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