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J Appl Physiol (July 28, 2005). doi:10.1152/japplphysiol.00278.2005
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Submitted on March 8, 2005
Accepted on July 12, 2005

Effects of augmented respiratory muscle pressure production on locomotor limb venous return during calf contraction exercise

Jordan D. Miller1*, David F. Pegelow1, Anthony J. Jacques1, and Jerome A. Dempsey1

1 Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA

* To whom correspondence should be addressed. E-mail: jordan-miller{at}uiowa.edu.

We determined the effects of augmented inspiratory and expiratory intrathoracic (PITP) or abdominal (PABD) pressure excursions on within-breath changes in femoral venous blood flow (Qfv) and net Qfv in the steady state during tightly controlled (total breath time = 4 seconds; inspiratory time/total breath time = 0.5) accessory muscle/"ribcage" ({Delta}PABD < 2 cm H2O) or diaphragmatic ({Delta}PABD > 5 cm H2O) breathing patterns. Selectively augmenting the inspiratory PITP excursion during ribcage breathing augmented the inspiratory facilitation of Qfv from the resting limb (69% of all flow occurred during inspiration during non-loaded conditions, 89% during inspiratory loaded conditions), though net Qfv in the steady-state was not altered due to slight reductions in femoral venous return during the ensuing expiratory phase of the breath. Selectively augmenting the inspiratory PES excursion during a predominantly diaphragmatic breath at rest did not alter the within-breath changes in Qfv relative to non-loaded conditions (net retrograde flow of -9 ± 12% during non-loaded conditions, -4 ± 9% during inspiratory loaded), supporting the notion that the inferior vena cava is completely collapsed by relatively small increases in PGA. However, the addition of combined inspiratory and expiratory loading to diaphragmatic breathing at rest resulted in a reversal of the within-breath changes in Qfv, such that >90% of all anterograde Qfv now occurred during inspiration. Combined inspiratory and expiratory loading also reduced steady-state Qfv during calf contractions of both mild and moderate intensities when compared to inspiratory loading alone. From these data, we conclude that: 1) exaggerated inspiratory pressure excursions may augment within-breath changes in femoral venous return but do not increase net femoral venous blood flow in the steady state, and 2) active expiration during diaphragmatic breathing reduces the steady-state hyperemic response to dynamic exercise by mechanically impeding venous return from the locomotor limb, which may ultimately contribute to exercise limitation in both health and disease.




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