Int J Sports Med 2002; 23(3): 183-190
DOI: 10.1055/s-2002-23177
Physiology and Biochemistry
© Georg Thieme Verlag Stuttgart · New York

Quantitative Effects of Respiration on Venous Return during Single Knee Extension-Flexion

T.  Osada1 , T.  Katsumura1 , T.  Hamaoka1 , N.  Murase1 , M.  Naka2 , T.  Shimomitsu1
  • 1Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
  • 2Tokyo Metropolitan Health Promotion Center, Tokyo, Japan
Further Information

Publication History

September 3, 2001

Publication Date:
26 March 2002 (online)

Abstract

Respiration and the muscle pump play major roles in increasing venous return. However, the relative contribution of each of these factors remains unclear. The present study investigates the quantitative effects of interaction between respiration and the muscle pump on femoral venous blood flow (FVBF) during a single voluntary knee extension-flexion (KEF) using duplex-Doppler ultrasound. During various respiration modes, which consisted of arrested respiration, normal respiration and deep respiration (inspiration or expiration), eight subjects performed a supine one-legged voluntary KEF. FVBF was measured during respiration only (Protocol A) and during KEF synchronized with respiration (Protocol B). The difference between FVBF values obtained in Protocol B and Protocol A was defined as ΔFVBF. When KEF was synchronized with normal or deep respiration, FVBF with inspiration was significantly lower than that with expiration. However, ΔFVBF was significantly higher with inspiration than with expiration during deep respiration but was not significant during normal respiration. Furthermore, ΔFVBF was significantly higher at both normal and deep respiration than at arrested respiration. The effects upon the venous return during KEF differed between inspiration and expiration. The present findings indicate that during a single supine KEF, respiration might promote venous return to a range of 1.5- to 2.3-fold ΔFVBF during arrested respiration.

References

  • 1 Abel F L, Waldhausen J A. Respiratory and cardiac effects on venous return.  Am Heart J. 1969;  78 266-275
  • 2 Abraham P, Leftheriotis G, Desvaux B, Saumet M, Saumet J L. Venous return in lower limb during heat stress.  Am J Physiol Heart Circ Physiol. 1994;  267 H1337-H1340
  • 3 Abu-Yousef M M. Normal and respiratory variations of the hepatic and portal venous duplex Doppler waveforms with simultaneous electrocardiographic correlation.  J Ultrasound Med. 1992;  11 263-268
  • 4 Abu-Yousef M M, Mufid M, Woods K T, Brown B P, Barloon T J. Normal lower limb venous Doppler flow phasicity: Is it cardiac or respiratory?.  AJR Am J Roentgenol. 1997;  169 1721-1725
  • 5 Agrifoglio G, Thorburn G D, Edwards E A. Measurement of blood flow in human lower extremity by indicator-dilution method.  Surg Gynecol Obstet. 1961;  113 641-645
  • 6 Ashby E C, Ashford N S, Campbell M J. Posture, blood velocity in common femoral vein, and prophylaxis of venous thromboembolism.  Lancet. 1995;  345 419-421
  • 7 Brecher G A. Mechanism of venous flow under different degrees of aspiration.  Am J Physiol. 1952;  169 423-433
  • 8 Cobb L A, Smith P H, Lwai S, Short F A. External iliac vein flow: its response to exercise and relation to lactate production.  J AppI Physiol. 1969;  26 606-610
  • 9 Criado E, Daniel P F, Marston W, Mansfield D L, Keagy B A. Physiologic variations in lower extremity venous valvular function.  Ann Vasc Surg. 1995;  9 102-108
  • 10 Duddy M J, McHugo J M. Duplex ultrasound of the common femoral vein in pregnancy and puerperium.  Br J Radiol. 1991;  64 785-791
  • 11 Folse R. Application of the sudden injection dye dilution principle to the study of the femoral circulation.  Surg Gynecol Obstet. 1965;  120 1194-1206
  • 12 Gill R W. Measurement of blood flow by ultrasound: accuracy and sources of error.  Ultrasound Med Biol. 1985;  11 625-641
  • 13 Guyton A C, Adkins L H. Quantitative aspects of the collapse factor in relation to venous return.  Am J Physiol. 1954;  177 523-527
  • 14 Janssen H, Treviño C, Williams D. Hemodynamic alterations in venous blood flow produced by external pneumatic compression.  J Cardiovasc Surg. 1993;  34 441-447
  • 15 Jeanneret C, Labs K H, Aschwanden M, Bollinger A, Hoffmann U, Jäger K. Physiological reflux and venous diameter change in the proximal lower limb veins during a standardised Valsalva manoeuvre.  Eur J Vasc Endovasc Surg. 1999;  17 398-403
  • 16 Jeanneret C, Labs K H, Aschwanden M, Gehrig A, Jäger K A. Venous cross-sectional area: measured or calculated?.  Ultraschall Med. 2000;  21 16-19
  • 17 Jorfeldt L, Juhlin-Dannfelt A, Pernow B, Wassén E. Determination of human leg blood flow: a thermodilution technique based on femoral venous bolus injection.  Clin Sci Mol Med. 1978;  54 517-523
  • 18 Killewich L A, Sandager G P, Nguyen A H, Lilly M P, Flinn W R. Venous hemodynamics during impulse foot pumping.  J Vasc Surg. 1995;  22 598-605
  • 19 Laughlin M H. Skeletal muscle blood flow capacity: role of muscle pump in exercise hyperemia.  Am J Physiol Heart Circ Physiol. 1987;  253 H993-H1004
  • 20 Leyk D, Eßfeld D, Baum K, Stegemann J. Early leg blood flow adjustment during dynamic foot plantarflexions in upright and supine body position.  Int J Sports Med. 1994;  15 447-452
  • 21 Makin G S. Velocity in the femoral vein. The effect of respiration exercise and tilt on blood velocity in the femoral vein as detected by an ultrasonic technique.  Angéiologie. 1969;  21 319-328
  • 22 Meissner M H, Manzo R A, Bergelin R O, Strandness, D E Jr. Venous diameter and compliance after deep venous thrombosis.  Thromb Haemost. 1994;  72 372-376
  • 23 Moneta G L, Bedford G, Beach K, Strandness D E. Duplex ultrasound assessment of venous diameters, peak velocities, and flow patterns.  J Vasc Surg. 1988;  8 286-291
  • 24 Mortensen J D, Talbot S, Burkart J A. Cross-sectional internal diameters of human cervical and femoral blood vessels: relationship to subject's sex, age, body size.  Anat Rec. 1990;  225 115-124
  • 25 Naamani R, Hussain S NA, Magder S. The mechanical effects of contractions on blood flow to the muscle.  Eur J Appl Physiol. 1995;  71 102-112
  • 26 Osada T, Katsumura T, Hamaoka T, Inoue S, Esaki K, Sakamoto A, Murase N, Kajiyama J, Shimomitsu T, Iwane H. Reduced blood flow in abdominal viscera measured by Doppler ultrasound during one-legged knee extension.  J Appl Physiol. 1999;  86 709-719
  • 27 Pentecost B L. The effect of exercise on the external iliac vein blood flow and local oxygen consumption in normal subjects, and in those with occlusive arterial disease.  Clin Sci. 1964;  27 437-445
  • 28 Pollack A A, Wood E H. Venous pressure in the saphenous vein at the ankle in man during exercise and changes in posture.  J Appl Physiol. 1949;  1 649-662
  • 29 Rabe E, Pannier-Fischer F. Venous mapping with Doppler and duplex sonography. In: Hafner J, Ramelet AA, Schmeller W, Brunner UV (eds) Management of Leg Ulcers. Current Problems in Dermatology. Basel; Karger 1999 27: 89-95
  • 30 Rabinovici N, Navot N. The relationship between respiration, pressure and flow distribution in the vena cava and portal and hepatic veins.  Surg Gynecol Obstet. 1980;  151 753-763
  • 31 Rådegran G. Ultrasound Doppler estimates of femoral artery blood flow during dynamic knee extensor exercise in humans.  J Appl Physiol. 1997;  83 1383-1388
  • 32 Rådegran G, Saltin B. Muscle blood flow at onset of dynamic exercise in humans.  Am J Physiol Heart Circ Physiol. 1998;  274 H314-H322
  • 33 Shoemaker J K, Hughson R L. Adaptation of blood flow during the rest to work transition in humans.  Med Sci Sports Exerc. 1999;  31 1019-1026
  • 34 Stegall H F. Muscle pumping in the dependent leg.  Circ Res. 1966;  19 180-190
  • 35 Teichgräber U KM, Gebel M, Benter T, Manns M P. Effect of respiration, exercise, and food intake on hepatic vein circulation.  J Ultrasound Med. 1997;  16 549-554
  • 36 Tschakovsky M E, Shoemaker J K, Hughson R L. Vasodilation and muscle pump contribution to immediate exercise hyperemia.  Am J Physiol Heart Circ Physiol. 1996;  271 H1697-H1701
  • 37 Wahren J, Jorfeldt L. Determination of leg blood flow during exercise in man: an indicator-dilution technique based on femoral venous dye infusion.  Clin Sci Mol Med. 1973;  45 135-146
  • 38 Wexler L, Bergel D H, Gabe I T, Makin G S, Mills C J. Velocity of blood flow in normal human venae cavae.  Circ Res. 1968;  23 349-359
  • 39 Willeput R, Rondeux C, De Troyer A. Breathing affects venous return from legs in humans.  J Appl Physiol. 1984;  57 971-976
  • 40 Youmans W B, Murphy Q R, Turner J K, Davis L D, Briggs D I, Hoye A S. Activity of abdominal muscles elicited from the circulatory system.  Am J Phys Med. 1963;  42 1-70

T. Osada, M. D., Ph. D. 

Department of Preventive Medicine and Public Health · Tokyo Medical University

6-1-1 Shinjuku · Shinjuku-ku · Tokyo 160-8402 · Japan

Phone: +81 (3) 5379-4339

Fax: +81 (3) 3226-5277

    >