Physiological mechanisms of dyspnea during exercise with external thoracic restriction: Role of increased neural respiratory drive

呼吸系统 医学 体育锻炼 呼吸控制 物理医学与康复 呼吸生理学 麻醉 心脏病学 神经科学 内科学 生物
作者
Cassandra T. Mendonca,Michele R. Schaeffer,Patrick Riley,Dennis Jensen
出处
期刊:Journal of Applied Physiology [American Physiological Society]
卷期号:116 (5): 570-581 被引量:43
标识
DOI:10.1152/japplphysiol.00950.2013
摘要

We tested the hypothesis that neuromechanical uncoupling of the respiratory system forms the mechanistic basis of dyspnea during exercise in the setting of “abnormal” restrictive constraints on ventilation (V E ). To this end, we examined the effect of chest wall strapping (CWS) sufficient to mimic a “mild” restrictive lung deficit on the interrelationships between V E , breathing pattern, dynamic operating lung volumes, esophageal electrode-balloon catheter-derived measures of the diaphragm electromyogram (EMGdi) and the transdiaphragmatic pressure time product (PTPdi), and sensory intensity and unpleasantness ratings of dyspnea during exercise. Twenty healthy men aged 25.7 ± 1.1 years (means ± SE) completed symptom-limited incremental cycle exercise tests under two randomized conditions: unrestricted control and CWS to reduce vital capacity (VC) by 21.6 ± 0.5%. Compared with control, exercise with CWS was associated with 1) an exaggerated EMGdi and PTPdi response; 2) no change in the relationship between EMGdi and each of tidal volume (expressed as a percentage of VC), inspiratory reserve volume, and PTPdi, thus indicating relative preservation of neuromechanical coupling; 3) increased sensory intensity and unpleasantness ratings of dyspnea; and 4) no change in the relationship between increasing EMGdi and each of the intensity and unpleasantness of dyspnea. In conclusion, the increased intensity and unpleasantness of dyspnea during exercise with CWS could not be readily explained by increased neuromechanical uncoupling but likely reflected the awareness of increased neural respiratory drive (EMGdi) needed to achieve any given V E during exercise in the setting of “abnormal” restrictive constraints on tidal volume expansion.
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