Faculty of Health Care Sciences, Himeji Dokkyo University, Himeji, Japan.
Department of Medical Engineering, Kawasaki University of Medical Welfare, Okayama, Japan.
Adv Exp Med Biol. 2018;1065:169-179. doi: 10.1007/978-3-319-77932-4_11.
The differences in hemodynamic and ventilatory responses to graded exercise between men and women have not been well documented. Using wave intensity (WI) analysis, which is useful for analyzing ventriculo-arterial interaction, we aimed to elucidate the sex-specific differences.
We enrolled 48 healthy subjects (24 men and 24 women, age 21.3 ± 1.6 and 20.5 ± 0.9 years, n.s. [not significant]). Using ultrasonic diagnostic equipment, we measured WI, arterial stiffness parameter (β), force-frequency relation (FFR) and other hemodynamic parameters in the carotid artery before and during graded bicycle exercise. We also analyzed expired gas volume (VE) during the exercise. The workload was increased stepwise by 20 W at 1-min intervals up to respiratory compensation (RC) point through the anaerobic threshold (AT). WI is defined as WI = (dP/dt) (dU/dt), where P is blood pressure, U is velocity, and t is time. The peak value of WI (W) increases with left ventricular (LV) peak dP/dt, in other words, an index of cardiac contractility. The FFR was obtained as the linear regression line of W on heart rate. β is defined as β = ln (Ps/Pd)/[(Ds - Dd)/Dd], where D is the arterial diameter, and suffixes s and d indicate systolic and diastolic, respectively.
There was no difference in the body mass index between men and women. Carbon dioxide outputs (VCO) did not differ at rest, but those at AT and RC were greater in men. Oxygen consumptions (VO) in men and women at rest did not differ, but those in men at AT and RC were greater. Workloads per body weight in men and women did not differ at AT, but they were greater in men at RC. Systolic pressures at rest, AT and RC were greater in men than women. Heart rates in men and women did not differ at any stage of the graded exercise. W did not differ at rest and AT, but it was greater in men than women at RC. The slope of the FFR during the period from rest to AT did not differ between men and women. However, the slope of the FFR during the period from AT to RC was greater in men.
The reached values of workload/weight at RC, VCO at AT and RC, VO at AT and RC, W at RC, and the slope of the FFR during the period from AT to RC were greater in men than women.
男女在分级运动时的血流动力学和通气反应差异尚未得到很好的记录。使用波强度（WI）分析，这对于分析心室-动脉相互作用很有用，我们旨在阐明性别特异性差异。
我们招募了 48 名健康受试者（24 名男性和 24 名女性，年龄分别为 21.3±1.6 岁和 20.5±0.9 岁，无统计学差异）。使用超声诊断设备，我们在颈动脉中测量了 WI、动脉僵硬参数（β）、力频率关系（FFR）和其他血流动力学参数，在分级自行车运动前和运动期间进行了测量。我们还分析了运动期间的呼气量（VE）。通过无氧阈（AT），将工作负荷以 20W 的步长，每 1 分钟增加一次，直至达到呼吸补偿（RC）点。WI 定义为 WI=dP/dt·dU/dt，其中 P 是血压，U 是速度，t 是时间。WI 的峰值（W）随着左心室（LV）的峰值 dP/dt 而增加，换句话说，这是心肌收缩力的指标。FFR 是通过 W 对心率的线性回归线获得的。β定义为β=ln（Ps/Pd）/[（Ds-Dd）/Dd]，其中 D 是动脉直径，后缀 s 和 d 分别表示收缩期和舒张期。
男性和女性的体重指数没有差异。在休息时，二氧化碳产量（VCO）没有差异，但在 AT 和 RC 时，男性的 VCO 更大。在休息时，男性和女性的耗氧量（VO）没有差异，但在 AT 和 RC 时，男性的 VO 更大。在 AT 时，男性和女性的单位体重工作量没有差异，但在 RC 时，男性的工作量更大。在休息、AT 和 RC 时，男性的收缩压高于女性。在任何分级运动阶段，男性和女性的心率都没有差异。在休息和 AT 时，W 没有差异，但在 RC 时，男性的 W 大于女性。从休息到 AT 期间，FFR 的斜率在男性和女性之间没有差异。然而，从 AT 到 RC 期间，FFR 的斜率在男性中更大。
RC 时的工作负荷/体重、AT 和 RC 时的 VCO、AT 和 RC 时的 VO、RC 时的 W 以及 AT 到 RC 期间 FFR 的斜率在男性中均大于女性。
