Kernizan Daphney, Glass Austin, D'Aloisio Gina, Hossain Jobayer, Tsuda Takeshi
Nemours Cardiac Center, Nemours Children's Hospital, Delaware, 1600 Rockland Road, Wilmington, DE, 19803, USA.
Department of Biomedical Engineering, Saint Louis University, St. Louis, MO, 63103, USA.
Pediatr Cardiol. 2022 Jun;43(5):1122-1130. doi: 10.1007/s00246-022-02832-0. Epub 2022 Feb 2.
Peak exercise parameters are considered the gold standard to quantify cardiac reserve in cardiopulmonary exercise testing (CPET). We studied whether submaximal parameters would add additional values in analyzing sex differences in CPET. We reviewed CPET of age-matched healthy male and female adolescents by cycle ergometer. Besides peak parameters, submaximal CPET parameters, including ventilatory anaerobic threshold (VAT), oxygen uptake efficiency slope (OUES), and submaximal slopes of Δoxygen consumption (ΔVO2)/Δwork rate (ΔWR), Δheart rate (ΔHR)/ΔWR, ΔVO2/ΔHR, and Δminute ventilation (ΔVE)/ΔCO2 production (ΔVCO2), were obtained. We studied 35 male and 40 female healthy adolescents. Peak VO2 (pVO2), peak oxygen pulse (pOP), and VAT were significantly lower in females than males (1.9 ± 0.4 vs. 2.5 ± 0.6 L/min; 10 ± 2.0 vs. 13.2 ± 3.5 ml/beat; 1.23 ± 0.3 vs. 1.52 ± 0.5 L/min, respectively, all p < 0.005). Females showed significantly lower pVO2, VAT, and OUES with the same body weight than males, implying higher skeletal muscle mass in males. When simultaneously examining ΔHR/ΔWR and pOP, females showed higher dependency on increases in HR than in stroke volume. Females demonstrated significantly lower pOP with the same levels of ΔVO2/ΔHR, suggesting more limited exercise persistence than males under an anaerobic condition at peak exercise. Oxygen uptake efficiency in relation to peak VE was significantly higher in males. There was no sex difference in either ΔVO2/ΔWR or ΔVE/ΔVCO2. Combinational assessment of peak and submaximal CPET parameters delineates the multiple mechanisms that contribute to the sex differences in exercise performance.
峰值运动参数被认为是心肺运动试验（CPET）中量化心脏储备的金标准。我们研究了次最大运动参数在分析CPET中的性别差异时是否会增加额外价值。我们通过功率自行车对年龄匹配的健康男性和女性青少年的CPET进行了回顾。除了峰值参数外，还获得了次最大CPET参数，包括通气无氧阈（VAT）、摄氧效率斜率（OUES）以及耗氧量（ΔVO2）/功率（ΔWR）、心率（ΔHR）/功率（ΔWR）、ΔVO2/ΔHR和分钟通气量（ΔVE）/二氧化碳产生量（ΔVCO2）的次最大斜率。我们研究了35名男性和40名女性健康青少年。女性的峰值摄氧量（pVO2）、峰值氧脉搏（pOP）和VAT显著低于男性（分别为1.9±0.4与2.5±0.6升/分钟；10±2.0与13.2±3.5毫升/搏；1.23±0.3与1.52±0.5升/分钟，所有p<0.005）。在体重相同的情况下，女性的pVO2、VAT和OUES显著低于男性，这意味着男性的骨骼肌质量更高。同时检查ΔHR/ΔWR和pOP时，女性对心率增加的依赖性高于对每搏输出量增加的依赖性。在相同的ΔVO2/ΔHR水平下，女性的pOP显著更低，这表明在峰值运动的无氧条件下，女性的运动耐力比男性更有限。男性相对于峰值分钟通气量的摄氧效率显著更高。ΔVO2/ΔWR或ΔVE/ΔVCO2方面没有性别差异。峰值和次最大CPET参数的联合评估描绘了导致运动表现性别差异的多种机制。
