Ventilatory & chronotropic incompetence during incremental & constant load exercise in end-stage renal disease, 2020, McGuire et al

Andy · Aug 4, 2020

Full title: Ventilatory and chronotropic incompetence during incremental and constant load exercise in end-stage renal disease: a comparative physiology study

Background: Aerobic capacity is impaired in end-stage renal disease (ESRD), reducing quality of life and longevity. Whilst determinants of maximal exercise intolerance are well defined, little is known of limitation during submaximal exercise. By comparing ESRD and healthy controls, the aim of this study was to characterise mechanisms of exercise intolerance in ESRD by assessing cardiopulmonary physiology at rest and during exercise.

Methods: Resting spirometry and echocardiography were performed in 20 ESRD participants and 20 healthy age and gender matched controls. Exercise tolerance was assessed with ventilatory gas exchange and central hemodynamics during a maximal cardiopulmonary exercise test (CPEX) and 30 minutes of submaximal constant load exercise (CLEX).

Results: Left ventricular mass (292 ± 102 vs. 185 ± 83 g; p = 0.01) and filling pressure (E/e': 6.48 ± 3.57 vs. 12.09 ± 6.50 m/s; p = 0.02) were higher in ESRD; forced vital capacity (3.44 ± 1 vs. 4.29 ± 0.95 L/min; p = 0.03) and peak VO2 (13.3 ± 2.7 vs. 24.6 ± 7.3 ml.kg-1.min-1; p < 0.001) were lower. During CLEX, the relative increase in (a-v) O2 difference (13 ± 18 vs. 74 ± 18%) and heart rate (32 ± 18 vs. 75 ± 29%) were less in ESRD despite exercise being performed at a higher percentage of maximum VE (48 ± 3 vs 39 ± 3%) and HR (82 ± 2 vs. 64 ± 2%).

Conclusion: Ventilatory and chronotropic incompetence contribute to exercise intolerance in ESRD. Both are potential targets for medical and lifestyle interventions.
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Paywall, https://journals.physiology.org/doi/abs/10.1152/ajprenal.00258.2020
Sci hub, no access at time of posting.

alktipping · Aug 5, 2020

honestly if i had end stage renal disease i would not be volunteering for this how will it help the patients .

obeat · Aug 5, 2020

ESRD causes metabolomic changes so are the cardiorespiratory changes compensatory? I've no idea!

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Ventilatory & chronotropic incompetence during incremental & constant load exercise in end-stage renal disease, 2020, McGuire et al

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Ventilatory & chronotropic incompetence during incremental & constant load exercise in end-stage renal disease, 2020, McGuire et al

Andy Committee Member

alktipping Senior Member (Voting Rights)

obeat Senior Member (Voting Rights)

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