Radiographic evidence of pulmonary edema during high-intensity interval training in women

Zavorsky, Gerald S.; Saul, Lloyd; Decker, Adriana; Ruiz, Pedro

doi:10.1016/j.resp.2005.10.009

Cited by 29 publications

(52 citation statements)

References 25 publications

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“…More recently, a 9% increase in EVLW was measured with magnetic resonance imaging (MRI) following 45-min cycling at 76% of maximal oxygen uptake _ VO 2max À Á with a 3-min maximal sprint at the end of exercise (McKenzie et al 2005). Zavorsky and colleagues also recently demonstrated increased oedema scores as measured by radiographic analysis in female cyclists following an intense interval workout (Zavorsky et al 2006a). Alternatively, protocols of 2 h of treadmill running at 75% of _ VO 2max (Manier et al 1999), 1 h cycling at 60-65% _ VO 2max (Hodges et al, unpublished data) and an incremental exercise test to maximum (Gallagher et al 1988) were all insufficient to induce a change in lung density, as measured by CT, MRI and radiography, respectively.…”

Section: Introductionmentioning

confidence: 99%

Intense hypoxic cycle exercise does not alter lung density in competitive male cyclists

et al. 2007

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We tested the hypothesis that intense short duration hypoxic exercise would result in an increase in extravascular lung water (EVLW), as evidenced by an increase in lung density. Using computed tomography (CT), baseline lung density was obtained in eight highly trained male cyclists (mean +/- SD: age = 28 +/- 8 years; height = 180 +/- 9 cm; mass = 71.6 +/- 8.2 kg; VO2max= 65.0 +/- 5.2 ml kg min(-1)). Subjects then completed an intense hypoxic exercise challenge on a cycle ergometer and metabolic data, HR and %S(p)O2 were recorded throughout. While breathing 15% O2, subjects performed five 3 km cycling intervals (mean power, 286 +/- 20 W; HR = 91 +/- 4% HRmax) separated by 5 min of recovery. From a resting hypoxic S(p)O2 of 92 +/- 4%, subjects further desaturated during exercise to 76 +/- 3%. CT scans were repeated 76 +/- 10 min (range 63-88 min) following the completion of exercise. There was no change in lung density from pre (0.18 +/- 0.02 g ml(-1)) to post-exercise (0.18 +/- 0.04 g ml(-1)). The substantial reduction in S(p)O2 may be explained by a number of potential mechanisms, including decreased pulmonary diffusion capacity, alveolar hypoventilation, reduced red cell transit time, ventilation/perfusion inequality or a temperature and pH induced rightward-shift in the oxyhaemoglobin dissociation curve. Alternatively, the integrity of the blood gas barrier may have been disrupted without any measurable increase in lung density.

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Section: Introductionmentioning

confidence: 99%

Intense hypoxic cycle exercise does not alter lung density in competitive male cyclists

et al. 2007

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“…While radiological evidence of increased interstitial pulmonary edema has been demonstrated following sustained, heavy exercise in some studies (McKechnie et al 1979;Caillaud et al 1995;Anholm et al 1999;McKenzie et al 2005;Zavorsky et al 2006a), other studies have not confirmed this relationship (Gallagher et al 1988;Manier et al 1999;Macnutt et al 2007). Zavorsky reviewed the literature on pulmonary edema following exercise and demonstrated that pulmonary edema was more likely to occur following an exhaustive sustained maximal exercise effort rather than a prolonged effort (Zavorsky 2007).…”

Section: Ventilation Heterogeneity and Eiahmentioning

confidence: 99%

“…Nevertheless, potential causes for this include subtle anatomical factors that limit the capacity of airways or pulmonary vessels to cope with increased flow, changes in airway or vascular tone, airway secretions, and/or mild interstitial pulmonary edema (Podolsky et al 1996;Dempsey and Wagner 1999;McKenzie et al 2005;Hopkins 2006;Zavorsky et al 2006a;Burnham et al 2009). These postulated mechanisms may give rise to changes in ventilation and/or perfusion heterogeneity (Wagner 1992).…”

Section: Introductionmentioning

confidence: 99%

Maximal Exercise Does Not Increase Ventilation Heterogeneity In Healthy, Trained Adults

Wrobel

Ellis

Stuart-Andrews

et al. 2012

D79. Exercise, Hypoxia and Altitude

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The effect of exercise on ventilation heterogeneity has not been investigated. We hypothesized that a maximal exercise bout would increase ventilation heterogeneity. We also hypothesized that increased ventilation heterogeneity would be associated with exercise-induced arterial hypoxemia (EIAH). Healthy trained adult males were prospectively assessed for ventilation heterogeneity using lung clearance index (LCI), S cond , and S acin at baseline, postexercise and at recovery, using the multiple breath nitrogen washout technique. The maximal exercise bout consisted of a maximal, incremental cardiopulmonary exercise test at 25 watt increments. Eighteen subjects were recruited with mean AE SD age of 35 AE 9 years. There were no significant changes in LCI, S cond , or S acin following exercise or at recovery. While there was an overall reduction in SpO 2 with exercise (99.3 AE 1 to 93.7 AE 3%, P < 0.0001), the reduction in SpO 2 was not associated with changes in LCI, S cond or S acin . Ventilation heterogeneity is not increased following a maximal exercise bout in healthy trained adults. Furthermore, EIAH is not associated with changes in ventilation heterogeneity in healthy trained adults.

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“…Similar findings were noted in female athletes. 12 Pingitore et al examined 48 athletes before and after completing an iron man triathlon. They used ultrasound to detect lung edema and reported the incidence of ultrasound lung comets.…”

Section: Exercise-induced Pulmonary Hemorrhagementioning

confidence: 99%

Pulmonary Aspects of Exercise and Sports

Bové

2016

Methodist DeBakey Cardiovascular Journal

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Although the lungs are a critical component of exercise performance, their response to exercise and other environmental stresses is often overlooked when evaluating pulmonary performance during high workloads. Exercise can produce capillary leakage, particularly when left atrial pressure increases related to left ventricular (LV) systolic or diastolic failure. Diastolic LV dysfunction that results in elevated left atrial pressure during exercise is particularly likely to result in pulmonary edema and capillary hemorrhage. Data from race horses, endurance athletes, and triathletes support the concept that the lungs can react to exercise and immersion stress with pulmonary edema and pulmonary hemorrhage. Immersion in water by swimmers and divers can also increase stress on pulmonary capillaries and result in pulmonary edema. Swimming-induced pulmonary edema and immersion pulmonary edema in scuba divers are well-documented events caused by the fluid shifts that occur with immersion, elevated pulmonary venous pressure during extreme exercise, and negative alveolar pressure due to inhalation resistance. Prevention strategies include avoiding extreme exercise, avoiding over hydration, and assuring that inspiratory resistance is minimized. Figure 1. Pulmonary capillary wedge pressure (PCWP) measured during increasing exercise intensity, determined by oxygen consumption (VO 2 ), in well-trained (circles) and average-trained (squares) men with a mean age of 29.6. Note that the well-trained subjects preserved normal levels of PCWP until they reached high levels of exercise, while the average-trained men demonstrated increases in PCWP at lower levels of exercise intensity. Adapted from Stickland et al. 4MDCVJ | XII (2) 2016 94 houstonmethodist.org/debakey-journal of interstitial hemorrhage and fluid accumulation following a high workload in one horse that developed EIPH. West et al. 9 suggested that two factors contributed to this problem in horses: (1) They were likely to have a congenital weakness of pulmonary capillaries that resulted in capillary rupture at high pulmonary venous and capillary pressure, and (2) they developed high pulmonary venous pressure due to failure of the left ventricle with subsequent elevation of LV end diastolic pressure during high workloads.Human studies of lung responses to high workloads 10 corroborate the studies of West et al. to some extent. Zavorsksy et al. 11 studied individuals under several different workloads and performed lung imaging to document the presence or absence of lung edema. Radiographic image readers were blinded to the exposures and reported visual evidence of lung fluid. In individuals undergoing a diagnostic graded exercise test, no evidence of lung edema was noted. However, 15% of individuals who ran on a treadmill at 70% of maximum capacity for 2 hours demonstrated evidence of pulmonary edema, as did 65% of those who ran at maximum capacity for 7 minutes. Similar findings were noted in female athletes.12 Pingitore et al. examined 48 athletes before and aft...

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Radiographic evidence of pulmonary edema during high-intensity interval training in women

Cited by 29 publications

References 25 publications

Intense hypoxic cycle exercise does not alter lung density in competitive male cyclists

Intense hypoxic cycle exercise does not alter lung density in competitive male cyclists

Maximal Exercise Does Not Increase Ventilation Heterogeneity In Healthy, Trained Adults

Pulmonary Aspects of Exercise and Sports

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