Ventilatory efficiency in athletes, asthma and obesity

During submaximal exercise, minute ventilation (V'(E)) increases in proportion to metabolic rate (i.e. carbon dioxide production (V'(CO2))) to maintain arterial blood gas homeostasis. The ratio V'(E)/V'(CO2), commonly termed ventilatory efficiency, is a useful tool to evaluate exercise responses in healthy individuals and patients with chronic disease. Emerging research has shown abnormal ventilatory responses to exercise (either elevated or blunted V'(E)/V'(CO2)) in some chronic respiratory and cardiovascular conditions. This review will briefly provide an overview of the physiology of ventilatory efficiency, before describing the ventilatory responses to exercise in healthy trained endurance athletes, patients with asthma, and patients with obesity. During submaximal exercise, the V'(E)/V'(CO2) response is generally normal in endurancetrained individuals, patients with asthma and patients with obesity. However, in endurance-trained individuals, asthmatics who demonstrate exercise induced-bronchoconstriction, and morbidly obese individuals, the V'(E)/V'(CO2) can be blunted at maximal exercise, likely because of mechanical ventilatory constraint.

Automated summary

During submaximal exercise, minute ventilation (V'(E)) increases in proportion to metabolic rate, and the ratio V'(E)/V'(CO2) is used as a useful tool to evaluate exercise responses in healthy individuals and patients with chronic disease. Some chronic respiratory and cardiovascular conditions show abnormal ventilatory responses to exercise, which may be due to mechanical ventilatory constraint.