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Exercise hyperventilation in patients with McArdle's disease

J M Hagberg, E F Coyle, J E Carroll

    Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology
    |April 1, 1982
    PubMed
    Summary

    Patients with McArdle's disease, lacking lactic acid production, still exhibit normal hyperventilation during exercise. This suggests exercise hyperventilation may be triggered by non-metabolic factors, not just increased acidity.

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    Area of Science:

    • Exercise Physiology
    • Metabolic Myopathies

    Background:

    • McArdle's disease is a metabolic myopathy characterized by a deficiency in muscle phosphorylase.
    • This deficiency impairs glycogenolysis, preventing lactic acid production during exercise.

    Purpose of the Study:

    • To investigate the ventilatory response during progressive incremental exercise in patients with McArdle's disease.
    • To determine if the absence of lactic acid production affects hyperventilation during exercise.

    Main Methods:

    • Progressive incremental exercise testing was performed on patients with McArdle's disease and healthy controls.
    • Measurements included blood lactate, venous pH, end-tidal partial pressures of O2 and CO2, and ventilation relative to O2 consumption.

    Main Results:

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    • Patients with McArdle's disease did not show increased blood lactate levels, unlike controls who had 8-10 fold increases.
    • Both groups exhibited hyperventilation at 70-85% maximal O2 consumption, with patients showing an increased pH due to lack of metabolic acidosis.
    • Ventilation increased appropriately with O2 consumption in patients during submaximal exercise.

    Conclusions:

    • Hyperventilation during intense exercise can occur independently of increased plasma [H+] (metabolic acidosis).
    • Non-humoral stimuli from muscles or the brain may initiate hyperventilation during strenuous exercise.
    • These findings challenge the traditional view that lactic acidosis is the primary driver of exercise hyperventilation.