Faull Olivia K, Cox Pete J, Pattinson Kyle T S
FMRIB Centre and Nuffield Division of Anesthetics, Nuffield Department of Clinical Neurosciences, University of OxfordOxford, UK; Department of Physiology, Anatomy and Genetics, University of OxfordOxford, UK.
Department of Physiology, Anatomy and Genetics, University of Oxford Oxford, UK.
Front Physiol. 2016 Jun 16;7:231. doi: 10.3389/fphys.2016.00231. eCollection 2016.
Breathlessness is a complex set of symptoms that are comprised of both sensory and affective (emotional) dimensions. While ventilation is now understood to be a potential limiter to performance in highly-trained individuals, the contribution of breathlessness-anxiety in those nearing maximal ventilation during intense exercise has not yet been considered as a limiter to performance.
In this study, we compared the physiology and psychology of breathlessness in 20 endurance athletes with 20 untrained age- and sex-matched sedentary controls. Subjects completed baseline spirometry and anxiety questionnaires, an incremental exercise test to exhaustion and a steady-state hypercapnic ventilatory response test, with concurrent measures of breathlessness intensity and breathlessness-anxiety.
Compared with sedentary subjects, athletes reported equivalent breathlessness intensity but greater breathlessness-anxiety at maximal exercise (athletes vs. sedentary (mean ± SD): breathlessness intensity (0-100%) 80.7 (22.7) vs. 72.5 (17.2), p = 0.21; breathlessness-anxiety (0-100%), 45.3 (36.3) vs. 22.3 (20.0), p = 0.02). Athletes operated at higher proportions of their maximal ventilatory capacity (MVV) (athletes vs. sedentary (mean ventilation ± SD; % MVV): 101.6 (27.2) vs. 73.7 (30.1), p = 0.003). In the athletes there was a positive linear correlation between ventilation and breathlessness score during the hypercapnic challenge that was not observed in the sedentary controls.
The results of this study indicate that whilst operating at high proportions of maximal ventilation, breathlessness-anxiety becomes increasingly prominent in athletes. Our results suggest that ventilatory perception pathways may be a target for improved athletic performance in some individuals.
呼吸急促是一组复杂的症状，包括感觉和情感（情绪）两个维度。虽然目前已了解通气是训练有素的个体运动表现的一个潜在限制因素，但在剧烈运动接近最大通气量时，呼吸急促焦虑对运动表现的影响尚未被视为一个限制因素。
在本研究中，我们比较了20名耐力运动员与20名年龄和性别匹配的未经训练的久坐对照者的呼吸急促的生理和心理情况。受试者完成基线肺活量测定和焦虑问卷、递增运动至力竭测试以及稳态高碳酸血症通气反应测试，同时测量呼吸急促强度和呼吸急促焦虑。
与久坐受试者相比，运动员在最大运动时报告的呼吸急促强度相当，但呼吸急促焦虑程度更高（运动员与久坐者（均值±标准差）：呼吸急促强度（0 - 100%）80.7（22.7）对72.5（17.2），p = 0.21；呼吸急促焦虑（0 - 100%），45.3（36.3）对22.3（20.0），p = 0.02）。运动员在其最大通气量（MVV）的更高比例下进行运动（运动员与久坐者（平均通气量±标准差；% MVV）：101.6（27.2）对73.7（30.1），p = 0.003）。在运动员中，高碳酸血症激发试验期间通气与呼吸急促评分之间存在正线性相关性，而在久坐对照者中未观察到这种相关性。
本研究结果表明，虽然运动员在最大通气量的高比例下运动，但呼吸急促焦虑在运动员中变得越来越突出。我们的结果表明，通气感知途径可能是提高某些个体运动表现的一个靶点。
