Published ahead of print on February 25, 2005, doi:10.1164/rccm.200408-1005OC
Am. J. Respir. Crit. Care Med., Volume 171, Number 10, May 2005, 1109-1115
A more recent version of this article appeared on May 15, 2005
Submitted on August 15, 2004
Accepted on February 15, 2005
Contractile Fatigue, Muscle Morphometry and Blood Lactate in Chronic Obstructive Pulmonary Disease
Didier Saey1, Annie Michaud1, Annabelle Couillard2, Claude H Cote3, M. Jeffery Mador4, Pierre LeBlanc1, Jean Jobin1, and Francois Maltais1*
1 Centre de recherche, Institut Universitaire de Cardiologie et de Pneumologie de l'Universite Laval, Hopital Laval, Quebec, Canada,
2 Laboratoire de Physiologie des Interactions, Hopital Arnaud de Villeneuve, Montpellier, France,
3 Centre de recherche du CHUQ pavillon CHUL, Universite Laval, Quebec, Canada,
4 Department of Pulmonary, Critical Care and Sleep Medicine, State University of New York at Buffalo and the Buffalo VAMC, Buffalo, NY, USA
* To whom correspondence should be addressed. E-mail: medfma{at}hermes.ulaval.ca.
We hypothesized that patients with chronic obstructive pulmonary disease developing contractile fatigue of the quadriceps during cycle exercise may have characteristic metabolic and muscle features that could increase their susceptibility to fatigue thus differentiating them from those who do not develop fatigue. We examined, in thirty-two patients, the fibre-type proportion, enzymatic activities and capillary density in the vastus lateralis and the arterial blood lactate level during constant work-rate cycling exercise. Contractile fatigue was defined as a post-exercise fall in quadriceps twitch force greater than 15% of resting values. Twenty-two patients developed contractile fatigue after exercise. No significant differences were found between fatiguers and non fatiguers for the endurance time, fibre-type proportion, and oxidative enzyme activities. The lactate dehydrogenase activity was significantly higher (p<0.05) and muscle capillarization significantly reduced in fatiguers (p<0.05). Compared to non-fatiguers, the arterial lactate level during exercise was significantly higher in fatiguers (p<0.001). A significant relationship was found between the fall in quadriceps twitch force and lactate dehydrogenase activity, capillary/fibre ratio and blood lactate level. We conclude that changes in muscle enzymatic profile and capillarization with a greater reliance on glycolytic metabolism during exercise are associated with contractile fatigue in patients with chronic obstructive pulmonary disease.
Key words: COPD, muscle, fatigue, exertion
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