Pulmonary diffusion and aerobic capacity: is there a relation? Does obesity matter?

Zavorsky, Gerald S.; Wilson, Bonnie; Harris, Joshua; Kim, D. J.; Carli, Franco; Mayo, Nancy E.

doi:10.1111/j.1748-1716.2009.02059.x

Cited by 18 publications

(20 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Lung diffusing capacity has been shown to predict aerobic exercise capacity in patients with chronic heart failure (1,35) or with lung diseases (43), but less constantly in healthy subjects with the exception of smokers (41). In healthy subjects, aerobic exercise capacity is generally better predicted by DL NO than DL CO , indicating a predominant effect on the membrane component of lung diffusion (51). The same was shown in a study on patients with heart failure (35), although not clearly confirmed (1).…”

Section: Discussionmentioning

confidence: 65%

“…Recent studies have shown that NO has actually a finite value (6). However, it has been estimated that, for clinical applications in humans, measurements of the diffusing capacity for NO (DL NO ) need adjustment only when the hemoglobin concentration is below 8 g/dl (51). The NO/CO transfer method has been applied to high-altitude residents, confirming a markedly increased lung diffusing capacity compared with recently acclimatized sojourners (12).…”

mentioning

confidence: 95%

See 1 more Smart Citation

Improvement in lung diffusion by endothelin A receptor blockade at high altitude

Bisschop

Martinot

Leurquin‐Sterk³

et al. 2012

Journal of Applied Physiology

View full text Add to dashboard Cite

de Bisschop C, Martinot J, Leurquin-Sterk G, Faoro V, Guénard H, Naeije R. Improvement in lung diffusion by endothelin A receptor blockade at high altitude. J Appl Physiol 112: 20 -25, 2012. First published October 6, 2011 doi:10.1152/japplphysiol.00670.2011.-Lung diffusing capacity has been reported variably in high-altitude newcomers and may be in relation to different pulmonary vascular resistance (PVR). Twenty-two healthy volunteers were investigated at sea level and at 5,050 m before and after random double-blind intake of the endothelin A receptor blocker sitaxsentan (100 mg/day) vs. a placebo during 1 wk. PVR was estimated by Doppler echocardiography, and exercise capacity by maximal oxygen uptake (V O2 max). The diffusing capacities for nitric oxide (DLNO) and carbon monoxide (DLCO) were measured using a single-breath method before and 30 min after maximal exercise. The membrane component of DLCO (Dm) and capillary volume (Vc) was calculated with corrections for hemoglobin, alveolar volume, and barometric pressure. Altitude exposure was associated with unchanged DLCO, DLNO, and Dm but a slight decrease in Vc. Exercise at altitude decreased DLNO and Dm. Sitaxsentan intake improved V O2 max together with an increase in resting and postexercise DLNO and Dm. Sitaxsentan-induced decrease in PVR was inversely correlated to DLNO. Both DLCO and DLNO were correlated to V O2 max at sea level (r ϭ 0.41-0.42, P Ͻ 0.1) and more so at altitude (r ϭ 0.56 -0.59, P Ͻ 0.05). Pharmacological pulmonary vasodilation improves the membrane component of lung diffusion in high-altitude newcomers, which may contribute to exercise capacity. altitude; hypoxia; lung diffusion; gas exchange; exercise capacity; pulmonary vascular resistance; pulmonary capillary pressure; pulmonary hypertension BOTH THE MEMBRANE AND THE capillary components of lung diffusing capacity have been shown to be increased in highaltitude residents (10,13,15,25). Increased lung diffusing capacity at high altitude allows for the preservation of gas exchange in the presence of a decreased ventilatory response at exercise (15). High-altitude newcomers do not benefit from this adaptation (10,15,25) and, accordingly, depend on increased ventilation to maintain pulmonary gas exchange (15,45).Previous studies on lung diffusing capacity at high altitudes calculated the membrane and capillary components of alveolocapillary transfer of carbon monoxide (CO) using measurements at ambient air and increased inspired PO 2 (10,13,15,25). This approach rests on the PO 2 dependence of , the blood's specific transfer conductance of CO, in the Roughton and Forster equation, which states that 1/DL CO ϭ 1/Dm ϩ 1/ Vc where DL CO is the diffusing capacity of the lung for CO, Dm its membrane component, and Vc the capillary blood volume (37). Thus changing as by increasing or decreasing inspired PO 2 allows for the calculation of Dm and Vc from a simple system of two equations with two unknowns. However, changing inspired PO 2 might also change pulmonary vascular tone, cardiac output, ...

show abstract

Section: Discussionmentioning

confidence: 65%

mentioning

confidence: 95%

Improvement in lung diffusion by endothelin A receptor blockade at high altitude

Bisschop

Martinot

Leurquin‐Sterk³

et al. 2012

Journal of Applied Physiology

View full text Add to dashboard Cite

show abstract

“…Recently, alveolar-membrane diffusing capacity (measured at rest) has been shown to be very closely related to O 2max in fit and obese individuals [21], [22] and to longevity in heart disease patients [23]. Specifically, when measured at rest, pulmonary diffusing capacity for nitric oxide (DLNO, mL NO.min −1 .mmHg −1 ) – a surrogate for alveolar-membrane diffusing capacity for carbon monoxide (DmCO) [24], [25] – has been shown to be related to aerobic capacity in fit men and women, such that for every 1 unit increase in DLNO, O 2max increases by 0.3 mL O 2 .…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, alveolar membrane conductance is the main pulmonary diffusing capacity component representative of fitness, with the exception of pulmonary capillary blood volume (V C ) and the blood transfer conductance (Θ) for CO (ΘCO). There are mixed data as to whether DLCO or DLNO is a more valid predictor of aerobic capacity, but overall diffusion capacity does appear to be significantly correlated with aerobic capacity in fit subjects [21], [22]. Nitric oxide (NO) has been shown to bind more strongly than CO to hemoglobin [26], leading to a higher value for membrane conductance and a diffusion measurement more reflective of total membrane diffusion.…”

Section: Introductionmentioning

confidence: 99%

Alveolar-Membrane Diffusing Capacity Limits Performance in Boston Marathon Qualifiers

et al. 2012

View full text Add to dashboard Cite

Purpose(1) to examine the relation between pulmonary diffusing capacity and marathon finishing time, and (2), to evaluate the accuracy of pulmonary diffusing capacity for nitric oxide (DLNO) in predicting marathon finishing time relative to that of pulmonary diffusing capacity for carbon monoxide (DLCO).Methods28 runners [18 males, age = 37 (SD 9) years, body mass = 70 (13) kg, height = 173 (9) cm, percent body fat = 17 (7) %] completed a test battery consisting of measurement of DLNO and DLCO at rest, and a graded exercise test to determine running economy and aerobic capacity prior to the 2011 Steamtown Marathon (Scranton, PA). One to three weeks later, all runners completed the marathon (range: 2∶22:38 to 4∶48:55). Linear regressions determined the relation between finishing time and a variety of anthropometric characteristics, resting lung function variables, and exercise parameters.ResultsIn runners meeting Boston Marathon qualification standards, 74% of the variance in marathon finishing time was accounted for by differences in DLNO relative to body surface area (BSA) (SEE = 11.8 min, p<0.01); however, the relation between DLNO or DLCO to finishing time was non-significant in the non-qualifiers (p = 0.14 to 0.46). Whereas both DLCO and DLNO were predictive of finishing time for all finishers, DLNO showed a stronger relation (r2 = 0.30, SEE = 33.4 min, p<0.01) compared to DLCO when considering BSA.ConclusionDLNO is a performance-limiting factor in only Boston qualifiers. This suggests that alveolar-capillary membrane conductance is a limitation to performance in faster marathoners. Additionally, DLNO/BSA predicts marathon finishing time and aerobic capacity more accurately than DLCO.

show abstract

“…Because hemoglobin concentration is a determinant of pulmonary diffusing capacity, measurement of pulmonary diffusion may also relate to maternal and fetal outcomes, a possibility that has not yet been tested. Pulmonary diffusing capacity for carbon monoxide (DL CO ) and nitric oxide (DL NO ) at rest is also related to aerobic capacity (Zavorsky et al, 2009), a strong independent predictor of death in women (Gulati et al, 2003) and men (Myers et al, 2002). Thus, a measurement of pulmonary diffusion could be a prognostic marker for mortality in pregnancy.…”

Section: Introductionmentioning

confidence: 99%

CO and NO pulmonary diffusing capacity during pregnancy: Safety and diagnostic potential

Zavorsky

Blood

Power

et al. 2010

Respiratory Physiology & Neurobiology

View full text Add to dashboard Cite

This paper reviews the scientific evidence for the safety of carbon monoxide (CO) and nitric oxide (NO) inhalation to measure pulmonary diffusing capacity (DLCO and DLNO) in pregnant women and their fetuses. In eight earlier studies, 650 pregnant women had DLCO measurements performed at various times during pregnancy, with a minimum of two to four tests per session. Both pregnant subjects that were healthy and those with medical complications were tested. No study reported adverse maternal, fetal, or neonatal outcomes from the CO inhalation in association with measuring DLCO. Eleven pregnant women, chiefly with pulmonary hypertension, and 1105 pre-term neonates, mostly with respiratory failure, were administered various dosages of NO (5–80 ppm for 4 weeks continuously in pregnant women, and 1–20 ppm for 15 min to 3 weeks for the neonates). NO treatment was found to be an effective therapy for pregnant women with pulmonary hypertension. In neonates with respiratory failure and pulmonary hypertension, NO therapy improved oxygenation and survival and has been associated with only minor, transient adverse effects. In conclusion, maternal carboxyhemoglobin ([HbCO]) levels can safely increase to 5% per testing session when the dose-exposure limit is 0.3% CO inhalation for ≤3 min, and for NO, 80 ppm for ≤ 3 min. The risk of late fetal or neonatal death from increased HbCO from diffusion testing is considerably less than the risk of death from all causes reported by the Centers for Disease Control, and is therefore considered “minimal risk”.

show abstract

Pulmonary diffusion and aerobic capacity: is there a relation? Does obesity matter?

Cited by 18 publications

References 32 publications

Improvement in lung diffusion by endothelin A receptor blockade at high altitude

Improvement in lung diffusion by endothelin A receptor blockade at high altitude

Alveolar-Membrane Diffusing Capacity Limits Performance in Boston Marathon Qualifiers

CO and NO pulmonary diffusing capacity during pregnancy: Safety and diagnostic potential

Contact Info

Product

Resources

About