ATS/ACCP statement on cardiopulmonary exercise testing.

One hundred healthy subjects (50 male and 50 female), selected to provide an even distribution of age (15 to 71 yr) and height (165 to 194 cm in males and 152 to 176 cm in females), underwent a progressively incremental (100 kpm/min each min) exercise test to a symptom-limited maximum. Measurements were made of O2 intake and CO2 output, ventilation and breathing pattern, heart rate and blood pressure, and rating of perceived exertion. The ventilatory anaerobic threshold was identified. Predictive data were derived for measurements at maximal and submaximal exercise. Maximal power output (Wmax) and oxygen intake (VO2max) varied with sex (0, male; 1, female), age (yr), and height (Ht, cm): Wmax = 20.4 (Ht) - 8.74 (Age) - 288 (Sex) - 1,909 kpm/min (SEE, 216; r, 0.858); VO2max = 0.046 (Ht) - 0.021 (Age) - 0.62 (Sex) - 4.31 L/min (SEE, 0.458; r, 0.869). The extent of leisure time activity exerted a positive influence on VO2max (r, 0.47; p less than 0.001); VO2max was also related to lean thigh volume (r, 0.79). Maximal heart rate (HR) declined as a function of age: HRmax = 202 - 0.72 (Age) beats/min (SEE, 10.3; r, 0.72). Maximal O2 pulse (O2Pmax) was related to height and was systematically higher in males than in females: O2Pmax = 0.28 (Ht) - 3.3 (Sex) - 26.7 ml/beat (SEE, 2.8; r, 0.86). Ventilation was closely related to CO2 output, and the maximal tidal volume was related to vital capacity. The VO2 increased linearly with power throughout the test; in an individual subject, the intercept of this relationship was positively influenced by weight and height.(ABSTRACT TRUNCATED AT 250 WORDS)

Normal standards for an incremental progressive cycle ergometer test.

1. The relationships between the depth of a breath and the durations of the inspiratory and expiratory phases have been studied in cat and in man during rebreathing, and in cat using artificial inflations of different magnitudes and timings.2. In the cat, the apparent volume threshold for termination of inspiration (Hering-Breuer threshold) decreased with time from the onset of the inspiratory phase.3. Both in rebreathing experiments and with artificially imposed inflations in the cat, the inspiratory duration T(I) was dependent upon tidal volume V(T), and this dependence could be expressed by a hyperbolic relationship of the form (V(T)-V(0)) T(I) = C where V(0) and C are constants.4. The time course of this ;Hering-Breuer' threshold was dependent on intact vagus nerves. After vagotomy the inspiratory duration remained essentially constant with changes in tidal volume produced either by artificial inflation or by the increased respiratory drive due to accumulation of CO(2) during rebreathing.5. In man during rebreathing, the relation between volume and inspiratory duration typically showed two different characteristics. 1, at tidal volumes up to 1.5-2 times eupnoeic values, inspiratory duration did not change as tidal volume increased in response to increased P(CO2). This range of operation has been designated range 1. 2, as tidal volume increased above this range 1 a second range designated range 2 was observed where inspiratory duration was volume dependent in the same manner as in the cat.6. In cat under pentobarbitone anaesthesia, a range 1 operation was not seen except after vagotomy. However, under urethane anaesthesia a range 1 plus a range 2 operation could be seen.7. The differences between cat and man appeared to be largely quantitative rather than qualitative.8. In both cat and man, expiratory duration was dependent on inspiratory duration, usually with a linear relationship.9. The experimental results were assembled in the form of an inspiratory characteristic and a timing relationship that serve as a model of the respiratory mechanisms controlling the depth and rate of breathing. The model predicts that the depth and duration of a breath are related in a definite manner fixed by the system characteristics and that ventilation is adjusted by setting the appropriate operating point on these characteristics. The operating point is determined primarily by how quickly lung volume increases, i.e. the rate of increase of inspiratory motor activity.

https://physoc.onlinelibrary.wiley.com/doi/pdf/10.1113/jphysiol.1972.sp009797

On the regulation of depth and rate of breathing

Mechanical constraints appear to require that locomotion and breathing be synchronized in running mammals. Phase locking of limb and respiratory frequency has now been recorded during treadmill running in jackrabbits and during locomotion on solid ground in dogs, horses, and humans. Quadrupedal species normally synchronize the locomotor and respiratory cycles at a constant ratio of 1:1 (strides per breath) in both the trot and gallop. Human runners differ from quadrupeds in that while running they employ several phase-locked patterns (4:1, 3:1, 2:1, 1:1, 5:2, and 3:2), although a 2:1 coupling ratio appears to be favored. Even though the evolution of bipedal gait has reduced the mechanical constraints on respiration in man, thereby permitting greater flexibility in breathing pattern, it has seemingly not eliminated the need for the synchronization of respiration and body motion during sustained running. Flying birds have independently achieved phase-locked locomotor and respiratory cycles. This hints that strict locomotor-respiratory coupling may be a vital factor in the sustained aerobic exercise of endothermic vertebrates, especially those in which the stresses of locomotion tend to deform the thoracic complex.

https://science.sciencemag.org/content/sci/219/4582/251.full.pdf

Running and breathing in mammals

Clinical correlates and prognostic significance of the ventilatory response to exercise in chronic heart failure

Effects of various respiratory stimuli on the depth and frequency of breathing in man.

Whelan and Young (1953) showed that a continuous intravenous infusion of either adrenaline or noradrenaline in man causes a transient stimulation of respiration accompanied by a reduction of alveolar carbon dioxide pressure (PACO~, mm. Hg). Barcroft et al. (1957) and Cunningham et al. (1958) showed that the effect of noradrenaline infusion on pulmonary ventilation (v, l./min., BTPS) persists when PAW, is prevented from falling. It appeared from the data of Barcroft et al. that in the equation (Lloyd et al., 1958)

B.B. Lloyd

Papers

Effects of various respiratory stimuli on the depth and frequency of breathing in man.

The effect of noradrenaline infusion on the relation between pulmonary ventilation and the alveolar PO2 and PCO2 in man.

The respiratory response of man to hypoxia