Exercise-related changes in serum catecholamines and potassium: Effect of sustained exercise above and below lactate threshold

doi:10.1016/0002-8703(89)90864-8

American Heart Journal

Volume 117, Issue 5, May 1989, Pages 1070-1075

https://doi.org/10.1016/0002-8703(89)90864-8 Get rights and content

Abstract

Plasma potassium and catecholamines exhibit rapid shifts during exercise testing, particularly when exercise intensity exceeds lactate threshold. To assess changes that may occur during sustained exercise, we studied 10 healthy men to determine the effect of 20 minutes of exercise at 25 W above lactate threshold (ALT) and 20 minutes of exercise at 25 W below lactate threshold (BLT). Both conditions showed elevation of catecholamines at end exercise compared to baseline, but catecholamine levels ALT were significantly higher than the levels BLT (2270 ± 190 versus 900 ± 230 pg/ml norepinephrine, p < 0.001; 509 ± 69 versus 150 ± 18 pg/ml epinephrine, p < 0.001). This difference persisted at 2 minutes of recovery (1620 ± 130 versus 590 ± 60 pg/ml norepinephrine, p < 0.001; 216 ± 31 versus 98 ± 16 pg/ml epinephrine, p < 0.001). Both conditions resulted in a significant elevation in potassium at end exercise compared to baseline, but the potassium levels ALT were significantly higher than the levels BLT (1.1 ± 0.1 mEq/L versus 0.5 ± 0.1 mEq/L, p < 0.001. The fall in potassium in the immediate post-exercise period was significantly greater following exercise ALT (−0.8 ± 0.1 mEq/L versus −0.2 ± 0.1 mEq/L, p < 0.001). Thus sustained exercise slightly ALT resulted in a significant potassium flux and very elevated catecholamine levels. Avoiding these metabolic stresses by exercising BLT may decrease chances for exercise-related arrhythmia or other cardiac dysfunction in susceptible patients.

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Cited by (28)

Stride-to-stride variability and fluctuations at intensities around lactate threshold in distance runners
2023, Heliyon
Stride-to-stride variability and fluctuations in running have been widely investigated in relation to fatigue, injury, and other factors. However, no studies have examined the relationship of stride-to-stride variability and fluctuations with lactate threshold (LT), a well-known performance indicator for distance runners that represents the threshold at which fast-twitch muscle fibers are activated and the glycolytic system is hyperactivated. In this study, we examined a relationship between LT and stride-to-stride variability and fluctuations in trained middle- and long-distance runners (n = 33). All runners were asked to perform multistage graded exercise tests while wearing accelerometers on the upper surface of their shoes. The LT was determined by measuring blood lactate concentrations after each stage. Three gait parameters for each step were calculated based on the acceleration data: stride time (ST), ground contact time (CT), and peak acceleration (PA). The coefficient of variation (CV) and the long-range correlations (α) for each parameter were also calculated. The effects of the runner's group and the relative intensity for CV and α on gait parameters were evaluated using a two-way repeated measures analysis of variance. Although no significant effect was observed in the CV and α of ST, significant intensity main effects were observed for the CV and α of CT and PA. The lack of significant changes in ST might be the result of runners' adequate control of ST to minimize energy cost. All the parameters showing significant changes with increasing intensity decreased dramatically when they were close to LT. This might have been caused by an increase in physiological load near LT and be interpreted as a variation in motor control because of alternations in the mobilized muscle fibers and physiological changes around the LT. The α should be useful for non-invasive LT detection.
Cardiopulmonary reserve examined with cardiopulmonary exercise testing in individuals with chronic kidney disease: A systematic review and meta-analysis
2022, Annals of Physical and Rehabilitation Medicine
Citation Excerpt :
Current knowledge suggests that in patients with CKD, deconditioning is part of a vicious cycle leading to exertional fatigue and further physical inactivity resulting to deterioration of exercise tolerance [11]. Exercise above the anaerobic threshold induces a rapid accumulation of lactate and an increase in anaerobic metabolism [52]; thus, low VO2 at the anaerobic threshold may contribute to limited functional capacity, which is perceived as fatigue and inability to perform everyday activities [53]. These findings have been confirmed in other disease populations by lower scores in functional status as assessed by health-related quality-of-life questionnaires [53, 54].
Patients with chronic kidney disease (CKD) often present reduced physical activity and exercise tolerance due to factors relevant to co-existing disturbances of the cardiac, nervous and muscular systems. Cardiopulmonary exercise testing (CPET) is used for clinical evaluation of exercise limitation and related symptoms (i.e., dyspnea, fatigue) in several medical fields.
This is a systematic review and meta-analysis of studies using CPET technology to examine cardiopulmonary reserve in individuals with versus without CKD.
Literature search involved PubMed, Web of Science and Scopus databases; manual search of article references and of gray literature was also performed. Observational studies and randomized trials that used CPET for patients with CKD stage 1–5 versus controls were eligible. The primary outcome was peak oxygen uptake (VO₂peak). The Newcastle-Ottawa Scale was used to evaluate the quality of retrieved studies.
From an initial 4944 literature records, we identified 29 studies fulfilling the inclusion criteria; of these, 25 studies (2,213 participants) with complete data were included in the final meta-analysis. VO₂peak was significantly lower in CKD patients than controls without CKD [standardized mean difference (SMD) -1.40, 95% confidence interval (CI) -1.68; -1.13)]. Values were lower for CKD than non-CKD individuals for oxygen consumption at anaerobic threshold (SMD -1.06, 95% CI -1.34; -0.79) and maximum workload [weighted mean difference (WMD) -58.26, 95% CI 74.14; -42.38]. In 3 studies, CKD patients had higher VO₂peak than controls with heart failure without CKD (WMD 6.60, 95% CI 3.02; 10.18). Sensitivity analyses confirmed the robustness of these findings.
VO₂peak and other commonly analyzed CPET variables were lower in patients with CKD than controls, which indicates reduced functional cardiopulmonary reserve in CKD. In contrast, patients with CKD performed better than controls with heart failure without CKD. Overall, rehabilitation programs should be more widely applied to individuals with CKD.
: CRD42021227805
The neuroendocrine effects of the TASER X26<sup>®</sup>: A brief report
2009, Forensic Science International
Citation Excerpt :
/(L min) [25]. Coplan et al. found that potassium shifts were more exaggerated with exercise above the lactate threshold than below the lactate threshold [26]. Hypokalemia can lead to cardiac dysrhythmias as well as respiratory arrest independent from cardiac arrest.
Law enforcement officers use conducted electrical weapons (CEW) such as the TASER X26^® to control violently resistive subjects. There are no studies in the medical literature examining the effects of these weapons on the human stress response. This is the first study to compare the human stress response to conducted electrical weapons, oleoresin capsicum (O.C.), a cold-water tank immersion, and a defensive tactics drill.
Subjects were randomized to one of the four interventions studied. Subjects received either a 5-s exposure from the TASER X26 CEW with the probes fired into the back from 7 ft, a 5-s spray of O.C., a skin and mucous membrane irritant, to the eyes, a 45-s exposure of the hand and forearm in a 0 °C cold water tank, or a 1-min defensive tactics drill.
Alpha-amylase had the greatest increase from baseline at 10–15 min with the defensive tactics drill. Cortisol had the greatest increase at 15–20 min with O.C. Cortisol remained most elevated at 40–60 min in the defensive tactics drill group.
Our preliminary data suggests that physical exertion during custodial arrest may be most activating of the human stress response, particularly the sympathetic–adrenal–medulla axis. This may suggest that techniques to limit the duration of this exertion may be the safest means to apprehend subjects, particularly those at high-risk for in-custody death. Conducted electrical weapons were not more activating of the human stress response than other uses of force.
Aerobic capacity in adult dermatomyositis/polymyositis patients and healthy controls
2000, Archives of Physical Medicine and Rehabilitation
Citation Excerpt :
The anaerobic threshold is defined as the maximum exercise intensity at which exercise can be maintained without increasing the accumulation of lactate.30 Exercise above the anaerobic threshold induces a rapid accumulation of lactate and an increase in anaerobic metabolism and increases the secretion of catecholamines and adrenocorticotropic hormone.32 This low V̇O2 at anaerobic threshold in patients with DM/PM in comparison to their matched controls could contribute to limited functional capacity in daily activities.
Wiesinger GF, Quittan M, Nuhr M, Volc-Platzer B, Ebenbichler G, Zehetgruber M, Graninger W. Aerobic capacity in adult dermatomyositis/polymyositis patients and healthy controls. Arch Phys Med Rehabil 2000;81:1-5. Objective: Assessment of myositis patients has relied on symptoms, strength testing, and serum muscle enzyme activity. Recently, functional assessments and evaluation of strength by dynamometry and of disease activity by magnetic resonance imaging have also been added. Aerobic testing in selected patients has been considered useful. Design: Case-control study. Setting: University Hospital, Vienna, Austria. Patients: Twenty-two subjects (8 outpatients with chronic dermatomyositis and 3 outpatients with chronic polymyositis, and 11 healthy controls) participated, allowing the identification of 11 case-control pairs matched by age (±3 years) and gender (mean age, 48 ± 14yrs; ratio of women to men, 18/4). Main Outcome Measures: Target parameters were peak oxygen uptake (peak V̇O₂) to estimate aerobic exercise capacity and peak isometric torque for muscle strength. Creatine phosphokinase (CPK) was measured to assess elevation of muscle enzymes. Results: The mean peak V̇O₂ in patients with dermatomyositis/polymyositis was 15.3mL/min/kg (SD = 5.8) and in the healthy controls 28.7mL/min/kg (SD = 7.8). Cardiorespiratory capacity expressed as peak V̇O₂ was thus significantly reduced at 53% (p = .0001) of the control value. Muscle strength expressed as peak isometric torque was significantly lower (p = .01) in patients (mean 148 ± 73Nm) when compared to the control group (mean 261 ± 99Nm). In myositis patients peak V̇O₂ and peak isometric torque correlate well with each other (r = .7631; p = .0001), but not at all with serum CPK levels (r = .056; p = .869). Conclusion: Peak V̇O₂ is significantly diminished in patients with dermatomyositis/polymyositis, compared with age- and sex-matched controls. Serum CPK did not significantly correlate with V̇O₂. Aerobic exercise testing may be a useful assessment parameter in selected patients with dermatomyositis/polymyositis. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation
Enhanced exercise-induced hyperkalemia in patients with syndrome X
1999, Journal of the American College of Cardiology
OBJECTIVES
The purpose of this study was to determine whether patients with syndrome X have altered potassium metabolism.
BACKGROUND
Patients with syndrome X have angina pectoris and exercise induced ST segment depression on the electrocardiogram despite normal coronary angiograms. Increasing evidence suggests that myocardial ischemia is uncommon in these patients. Altered potassium metabolism causing interstitial potassium accumulation in the myocardium may be an alternative mechanism for chest pain and ST segment depression in syndrome X.
METHODS
We compared the magnitude of exercise-induced hyperkalemia in 16 patients with syndrome X (12 female and four male, mean ± SD age 53 ± 6 years) and 15 matched healthy control subjects. The participants underwent a bicycle test at a fixed load of 75 W for 10 min, and blood samples were taken for analysis of potassium, catecholamines and lactate before, during and in the recovery period after exercise. In five patients with syndrome X, the test was repeated during alpha₁adrenoceptor blockade.
RESULTS
Baseline concentrations of serum potassium, plasma catecholamines and plasma lactate were similar in patients and control subjects. The rate of exercise-induced increment of serum potassium was increased in the patients (70 ± 29 vs. 30 ± 21 μmol/liter/min in control subjects, p < 0.001). Six patients, who stopped before 10 min of exercise, showed very rapid increments in serum potassium concentration. Compared to the control subjects, patients also demonstrated larger increments in rate–pressure product, plasma norepinephrine and lactate concentrations during exercise. The rate of serum potassium increment correlated with the rate of plasma norepinephrine increment in the patients (r = 0.63, p < 0.02), but not in the control subjects (r = 0.01, p = 0.97). Blockade of alpha₁adrenoceptors decreased systolic blood pressure at baseline, but did not influence the increment of serum potassium, plasma catecholamines and lactate.
CONCLUSIONS
Patients with syndrome X have enhanced exercise induced hyperkalemia in parallel with augmented increases of circulating norepinephrine and lactate. The prevailing mechanisms behind the abnormal potassium handling comprise sources distinct from alpha₁-adrenoceptor activation.
Effect of physiologic and pharmacologic adrenergic stimulation on heart rate variability
1994, Journal of the American College of Cardiology
Objectives. The aim of this study was to evaluate and compare the effects of physiologic and pharmacologic sympathetic stimulation on time and frequency domain indexes of heart rate variability.
Background. Measurements of heart rate variability have been used as indexes of sympathetic tone. To date, the effects of circulating catecholamines on heart rate variability have not been evaluated.
Methods. Fourteen normal subjects (eight men, six women, mean (± SD) age 28.5 ± 48 years) were evaluated. Five-minute electrocardiographic recordings were obtained in triplicate after physiologic and pharmacologic sympathetic stimulation: during upright tilt, after maximal exercise, during epinephrine and isoproterenol infusions at 50 ng/kg body weight per min, during beta-adrenergic blockade and during combined beta-adrenergic and parasympathetic blockade.
Results. Beta-adrenergic stimulation resulted in a significant decrease in time domain measures of heart rate variability. The frequency domain indexes showed variable responses, depending on the individual stimulus. Tilt caused an increase in low frequency power and in the ratio of low to high frequency power. These changes were not necessarily observed with other conditions of beta-adrenergic stimulation. Double blockade suppressed baseline heart rate variability, but beta-adrenergic blockade had no significant effect. Time domain measures of heart rate variability demonstrated excellent reproducibility over the three recordings, but the frequency domain variables demonstrated fair to excellent reproducibility.
Conclusions. These findings suggest that different modes of beta-adrenergic stimulation may result in divergent heart rate variability responses. Thus, current heart rate variability techniques cannot be used as general indexes of “sympthetic” tone. Studies utilizing heart rate variability to quantify sympathetic tone need to consider this.

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Exercise-related changes in serum catecholamines and potassium: Effect of sustained exercise above and below lactate threshold

Abstract

Am J Cardiol

Lancet

Am J Cardiol

Prog Cardiovasc Dis

Lancet

Am J Cardiol

Am Heart J

Am J Cardiol

Incidence of primary cardiac arrest during vigorous exercise

N Engl J Med

Physical activity and physical demand on the job and risk for cardiovascular disease and death: the Framingham Study

Am Heart J

Physical activity, all-cause mortality, and longevity of college alummi

N Engl J Med

Leisure-time physical activity levels and risk of coronary heart disease and death

JAMA

Plasma catecholamines in trained and untrained volunteers during graduated exercise

Int J Sports Med

Plasma catecholamines and blood lactate accumulation during incremental exhaustive exercise

Int J Sports Med

Hyperkalemia during progressive dynamic exercise

J Cardiopulmonary Rehabilitation

The anaerobic threshold measurement to evaluate exercise performance

Am Rev Respir Dis