Ventilatory and Lactic Thresholds in Subjects with Sickle Cell Trait

Abstract

This study investigated 1) whether ventilatory and lactic thresholds (VT and LT, respectively) are different in sickle cell trait carriers (SCTc) and subjects with normal hemoglobin (control group), and 2) whether the first LT and VT and the second LT and VT are respectively coincident in the two populations. Seven SCTc and 8 control subjects performed an incremental exercise test (IET). Blood lactate concentration and cardioventilatory variables were analyzed at rest and during IET. No significant difference in the ventilatory parameters (notably, maximal oxygen uptake [V·O_2max] and the ventilatory thresholds) or the lactic thresholds was observed between the two groups. In both SCTc and control subjects, the LTs and VTs did not occur at the same exercise intensity. The first VT did not coincide with the first LT, in contrast with the second VT and the second LT, which coincided in both groups. In conclusion, SCTc exhibited normal ventilatory and lactic responses during a progressive and maximal exercise test assessing aerobic physical fitness.

Key words

sickle cell trait - ventilatory threshold - lactic threshold - incremental exercise

References

• 1 Ahmaidi S, Varray A, Collomp K, Mercier J, Prefaut C. Relation between the change of slope of heart rate and second lactic and ventilatory thresholds in muscular exercise with large load.  C R Seances Soc Biol Fil. 1992;  186 145-155
• 2 Ahmaidi S, Hardy J M, Varray A, Collomp K, Mercier J, Prefaut C. Respiratory gas exchange indices used to detect the blood lactate accumulation threshold during an incremental exercise test in young athletes.  Eur J Appl Physiol. 1993;  66 31-36
• 3 Atkinson D W. Sickling and hematuria.  Blood. 1969;  34 736-737
• 4 Beaver W L, Wasserman K, Whipp B J. Bicarbonate buffering of lactic acid generated during exercise.  J Appl Physiol. 1986;  60 472-478
• 5 Bile A, Le Gallais D, Mercier B, Martinez P, Ahmaidi S, Prefaut C, Mercier J. Blood lactate concentrations during incremental exercise in subjects with sickle cell trait.  Med Sci Sports Exerc. 1998;  30 649-654
• 6 Bile A, Le Gallais D, Mercier J, Bogui P, Prefaut C. Sickle cell trait in Ivory Coast athletic throw and jump champions, 1956 - 1995.  Int J Sports Med. 1998;  19 215-219
• 7 Connes P, Martin C, Barthelemy J C, Monchanin G, Atchou G, Forsuh A, Massarelli R, Wouassi D, Thiriet P, Pichot V. Nocturnal autonomic nervous system activity impairment in sickle cell trait carriers.  Clin Physiol Funct Imaging. 2006;  26 87-91
• 8 Connes P, Monchanin G, Perrey S, Wouassi D, Atchou G, Forsuh A, Debaud J, Djoba B, Owona F X, Francina A, Banga P E, Massarelli R, Thiriet P, Martin C. Oxygen uptake kinetics during heavy submaximal exercise: effect of sickle cell trait with or without alpha-thalassemia.  Int J Sports Med. 2006;  27 517-525
• 9 Etienne-Julan M. Drépanocytose en Guadeloupe: origine historique. Info drépano, internal review CCD. avril/1997
• 10 Foxdal P, Sjodin B, Rudstam H, Ostman C, Ostman B, Hedenstierna G C. Lactate concentration differences in plasma, whole blood, capillary finger blood and erythrocytes during submaximal graded exercise in humans.  Eur J Appl Physiol. 1990;  61 218-222
• 11 Freund H, Lonsdorfer J, Oyono-Enguelle S, Lonsdorfer A, Bogui P. Lactate exchange and removal abilities in sickle cell patients and in untrained and trained healthy humans.  J Appl Physiol. 1992;  73 2580-2587
• 12 Freund H, Lonsdorfer J, Oyono-Enguelle S, Lonsdorfer A, Dah C, Bogui P. Lactate exchange and removal abilities in sickle cell trait carriers during and after incremental exercise.  Int J Sports Med. 1995;  16 428-434
• 13 Gima A S, Bemis E L. Absence of major illnesses in sickle cell trait: results from a controlled study.  J Natl Med Assoc. 1975;  67 216-219
• 14 Gozal D, Thiriet P, Mbala E, Wouassi D, Gelas H, Geyssant A, Lacour J R. Effect of different modalities of exercise and recovery on exercise performance in subjects with sickle cell trait.  Med Sci Sports Exerc. 1992;  24 1325-1331
• 15 Hagberg J M, Coyle E F, Carroll J E, Miller J M, Martin W H, Brooke M H. Exercise hyperventilation in patients with McArdle's disease.  J Appl Physiol. 1982;  52 991-994
• 16 Hue O, Julan M E, Blonc S, Martin S, Hertogh C, Marlin L, Pallud C, Le Gallais D. Alactic anaerobic performance in subjects with sickle cell trait and hemoglobin AA.  Int J Sports Med. 2002;  23 174-177
• 17 Jones S R, Binder R A, Donowho Jr E M. Sudden death in sickle-cell trait.  N Engl J Med. 1970;  282 323-325
• 18 Kark J A, Posey D M, Schumacher H R, Ruehle C J. Sickle-cell trait as a risk factor for sudden death in physical training.  N Engl J Med. 1987;  317 781-787
• 19 Le Gallais D, Lonsdorfer J, Buguet A, Daures J P, Mercier J, Macabies J, Prefaut C. Aptitude physique des porteurs du trait drépanocytaire.  Sci Sports. 1987;  2 269-277
• 20 Marlin L, Etienne-Julan M, Le Gallais D, Hue O. Sickle cell trait in French West Indian elite sprint athletes.  Int J Sports Med. 2005;  26 622-625
• 21 Monchanin G, Connes P, Wouassi D, Francina A, Djoda B, Banga P E, Owona F X, Thiriet P, Massarelli R, Martin C. Hemorheology, sickle cell trait, and alpha-thalassemia in athletes: effects of exercise.  Med Sci Sports Exerc. 2005;  37 1086-1092
• 22 Omiya K, Itoh H, Harada N, Maeda T, Tajima A, Oikawa K, Koike A, Aizawa T, Fu L T, Osada N. Relationship between double product break point, lactate threshold, and ventilatory threshold in cardiac patients.  Eur J Appl Physiol. 2004;  91 224-229
• 23 Pierce S J, Hahn A G, Davie A, Lawton E W. Prolonged incremental tests do not necessarily compromise V·O_2max in well-trained athletes.  J Sci Med Sport. 1999;  2 356-363
• 24 Riley M, Maehara K, Porszasz J, Engelen M P, Bartstow T J, Tanaka H, Wasserman K. Association between the anaerobic threshold and the break-point in the double product/work rate relationship.  Eur J Appl Physiol. 1997;  75 14-21
• 25 Riley M, Nicholls D P, Nugent A M, Steele I C, Bell N, Davies P M, Stanford C F, Patterson V H. Respiratory gas exchange and metabolic responses during exercise in McArdle's disease.  J Appl Physiol. 1993;  75 745-754
• 26 Samb A, Kane M O, Ba A, Gadji M, Seck D, Badji L, Sarr F B, Sarr M, Dieng S A, Diakhate E M, Gueye L, Diakhate L, Cisse F, Martineaud J P. [Physical performance and thermoregulatory study of subjects with sickle cell trait during a sub-maximal exercise].  Dakar Med. 2005;  50 46-51
• 27 Santos E L, Giannella-Neto A. Comparison of computerized methods for detecting the ventilatory thresholds.  Eur J Appl Physiol. 2004;  93 315-324
• 28 Sara F, Hardy-Dessources M D, Voltaire B, Etienne-Julan M, Hue O. Lactic response in sickle cell trait carriers in comparison with subjects with normal hemoglobin.  Clin J Sport Med. 2003;  13 96-101
• 29 Sara F, Hardy-Dessources M D, Marlin L, Connes P, Hue O. Lactate distribution in the blood compartments of sickle cell trait carriers during incremental exercise and recovery.  Int J Sports Med. 2006;  27 436-443
• 30 Sara F, Connes P, Hue O, Montout-Hedreville M, Etienne-Julan M, Hardy-Dessources M D. Faster lactate transport across red blood cell membrane in sickle cell trait carriers.  J Appl Physiol. 2006;  100 437-442
• 31 Serjeant B E, Mason K P, Kenny M W, Stuart J, Higgs D R, Weatherall D J, Hayes R J, Serjeant G R. Effect of alpha thalassaemia on the rheology of homozygous sickle cell disease.  Br J Haematol. 1983;  55 479-486
• 32 Simon J, Young J L, Blood D K, Segal K R, Case R B, Gutin B. Plasma lactate and ventilation thresholds in trained and untrained cyclists.  J Appl Physiol. 1986;  60 777-781
• 33 Skelton M S, Kremer D E, Smith E W, Gladden L B. Lactate influx into red blood cells from trained and untrained human subjects.  Med Sci Sports Exerc. 1998;  30 536-542
• 34 Smith J A, Telford R D, Kolbuch-Braddon M, Weidemann M J. Lactate/H+ uptake by red blood cells during exercise alters their physical properties.  Eur J Appl Physiol. 1997;  75 54-61
• 35 Tanaka H, Kiyonaga A, Terao Y, Ide K, Yamauchi M, Tanaka M, Shindo M. Double product response is accelerated above the blood lactate threshold.  Med Sci Sports Exerc. 1997;  29 503-508
• 36 Thiriet P, Lobe M M, Gweha I, Gozal D. Prevalence of the sickle cell trait in an athletic West African population.  Med Sci Sports Exerc. 1991;  23 389-390
• 37 Vallier J M, Bigard A X, Carre F, Eclache J P, Mercier J. Détermination des seuils lactiques et ventilatoires. Position de la société française de médecine du sport.  Sci Sports. 2000;  15 133-140
• 38 Wasserman K, McIlroy M B. Detecting the threshold of anaerobic metabolism in cardiac patients during exercise.  Am J Cardiol. 1964;  14 844-852
• 39 Wasserman K, Whipp B J, Koyl S N, Beaver W L. Anaerobic threshold and respiratory gas exchange during exercise.  J Appl Physiol. 1973;  35 236-243
• 40 Wasserman K. Critical capillary PO2 and the role of lactate production in oxyhemoglobin dissociation during exercise.  Adv Exp Med Biol. 1999;  471 321-333
• 41 Weisman I M, Zeballos R J, Johnson B D. Cardiopulmonary and gas exchange responses to acute strenuous exercise at 1270 meters in sickle cell trait.  Am J Med. 1988;  84 377-383
• 42 Weisman I M, Zeballos R J, Johnson B D. Effect of moderate inspiratory hypoxia on exercise performance in sickle cell trait.  Am J Med. 1988;  84 1033-1040
• 43 Weisman I M, Zeballos R J, Martin T W, Johnson B D. Effect of Army basic training in sickle-cell trait.  Arch Intern Med. 1988;  148 1140-1144