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Cardiorespiratory and metabolic responses to exercise in HbSC sickle cell patients

OYONO-ENGUÉLLÉ, SAMUEL; LE GALLAIS, DANIEL; LONSDORFER, ANNICK; DAH, CYRILLE; FREUND, HUBERT; BOGUI, PASCAL; LONSDORFER, JEAN

Medicine & Science in Sports & Exercise: April 2000 - Volume 32 - Issue 4 - p 725-731
Clinical Sciences: Clinically Relevant

OYONO-ENGUÉLLÉ, S., D. LE GALLAIS, A. LONSDORFER, C. DAH, H. FREUND, P. BOGUI, and J. LONSDORFER. Cardiorespiratory and metabolic responses to exercise in HbSC sickle cell patients. Med. Sci. Sports Exerc., Vol. 32, No. 4, pp. 725–731, 2000.

Purpose: Relative to healthy control individuals with normal hemoglobin (Hb), patients carrying the double heterozygous form of sickle cell disease (HbSC) display an impaired oxygen transport capacity. The present study was undertaken to determine the influence of the decreased oxygen availability associated with the presence of HbSC on the cardiorespiratory and metabolic responses to endurance exercise.

Methods: Eleven black men affected by the double heterozygous form of the sickle cell disease (HbSC group) and seven healthy subjects with normal Hb (HbAA group) of the same ethnic origin submitted successively to an incremental exercise test to exhaustion on a cycle ergometer for the determination of their maximal tolerated power and to a 20-min endurance exercise.

Results: The HbSC had a significantly lower exercise tolerance than the HbAA. During the endurance exercise, they exhibited furthermore significantly lower V̇O2, V̇CO2, and minute ventilation V̇E than the HbAA. Despite the fact that the HbSC exercised at a significantly lower mean absolute work rate than the HbAA, except for the ventilatory equivalent for CO2 (V̇E/V̇CO2), which was higher (P < 0.001) in the HbSC group, the other parameters recorded during the 20-min endurance exercise (heart rate, arterial PaO2, PaCO2, pH, lactate, and V̇E/V̇O2, the ventilatory equivalent for O2) and during the subsequent recovery (blood lactate) were similar for both groups.

Conclusion: The study underscores the importance of considering relative work rate as well as absolute work rate to arrive at a correct interpretation of exercise and recovery data. The results give evidence that the modifications of homeostasis brought into play by exercise were shifted toward distinctly lower absolute work rates in HbSC patients.

Laboratoire de Physiologie Appliquée, Faculté de Médecine, F-67085 Strasbourg Cedex, FRANCE; Laboratoire de Physiologie des Interactions, Hôpital Arnaud de Villeneuve, F-34295 Montpellier Cedex 5, FRANCE; Laboratoires de Biochimie and Pharmacologie et Physico-Chimie des Interactions Cellulaires et Moléculaires, Faculté de Pharmacie, F-67401 Illkirch-Graffenstaden Cedex, FRANCE; Laboratoire de Physiologie, Faculté de Médecine, Abidjan 01, CÔTE D’IVOIRE; and Laboratoire de Physiologie, Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé 1, CAMEROUN

Submitted for publication November 1998.

Accepted for publication May 1999.

Address for correspondence: Pr. J. Lonsdorfer, Laboratoire de Physiologie Appliquée, Faculté de Médecine, 4 rue Kirschleger, F-67085 Strasbourg Cedex, France; E-mail: Jean.Lonsdorfer@physio-ulp.u-strasbg.fr.

© 2000 Lippincott Williams & Wilkins, Inc.