Top

Published in:

Open Access 01-05-2017 | Original Article

Markers of physiological stress during exercise under conditions of normoxia, normobaric hypoxia, hypobaric hypoxia, and genuine high altitude

Authors: David Richard Woods, John Paul O’Hara, Christopher John Boos, Peter David Hodkinson, Costas Tsakirides, Neil Edward Hill, Darren Jose, Amanda Hawkins, Kelly Phillipson, Antonia Hazlerigg, Nicola Arjomandkhah, Liam Gallagher, David Holdsworth, Mark Cooke, Nicholas Donald Charles Green, Adrian Mellor

Published in: European Journal of Applied Physiology | Issue 5/2017

Abstract

Purpose

To investigate whether there is a differential response at rest and following exercise to conditions of genuine high altitude (GHA), normobaric hypoxia (NH), hypobaric hypoxia (HH), and normobaric normoxia (NN).

Method

Markers of sympathoadrenal and adrenocortical function [plasma normetanephrine (PNORMET), metanephrine (PMET), cortisol], myocardial injury [highly sensitive cardiac troponin T (hscTnT)], and function [N-terminal brain natriuretic peptide (NT-proBNP)] were evaluated at rest and with exercise under NN, at 3375 m in the Alps (GHA) and at equivalent simulated altitude under NH and HH. Participants cycled for 2 h [15-min warm-up, 105 min at 55% Wmax (maximal workload)] with venous blood samples taken prior (T0), immediately following (T120) and 2-h post-exercise (T240).

Results

Exercise in the three hypoxic environments produced a similar pattern of response with the only difference between environments being in relation to PNORMET. Exercise in NN only induced a rise in PNORMET and PMET.

Conclusion

Biochemical markers that reflect sympathoadrenal, adrenocortical, and myocardial responses to physiological stress demonstrate significant differences in the response to exercise under conditions of normoxia versus hypoxia, while NH and HH appear to induce broadly similar responses to GHA and may, therefore, be reasonable surrogates.

Banfi G, Lippi G, Susta D, Barassi A, D’Eril GM, Dogliotti G, Corsi MM (2010) NT-proBNP concentrations in mountain marathoners. J Strength Cond Res 24:1369–1372CrossRefPubMed

Boos CJ, Hodkinson PD, Mellor A, Green NP, Bradley D, Greaves K, Woods DR (2013) The effects of prolonged acute hypobaric hypoxia on novel measures of biventricular performance. Echocardiography 30:534–541CrossRefPubMed

Boos CJ, Mellor A, Begley J, Stacey M, Smith C, Hawkins A, Woods DR (2014) The effects of exercise at high altitude on high-sensitivity cardiac troponin release and associated biventricular cardiac function. Clin Res Cardiol 103:291–299CrossRefPubMed

Boos CJ, O’Hara JP, Mellor A, Hodkinson PD, Tsakirides C, Reeve N, Gallagher L, Green ND, Woods DR (2016) A four-way comparison of cardiac function with normobaric normoxia, normobaric hypoxia, hypobaric hypoxia and genuine high altitude. PLoS ONE 21(4):e0152868CrossRef

Bouissou P, Fiet J, Guezennec CY, Pesquies PC (1988) Plasma adrenocorticotrophin and cortisol responses to acute hypoxia at rest and during exercise. Eur J Appl Physiol Occup Physiol 57:110–113CrossRefPubMed

Bracken RM, Brooks S (2010) Plasma catecholamine and nephrine responses following 7 weeks of sprint cycle training. Amino Acids 38:1351–1359CrossRefPubMed

Coppel J, Hennis P, Gilbert-Kawai E, Grocott MP (2015) The physiological effects of hypobaric hypoxia versus normobaric hypoxia: a systematic review of crossover trials. Extrem Physiol Med 26: 4:1–20

Deutschbein T, Unger N, Jaeger A, Broecker-Preuss M, Mann K, Petersenn S (2010) Influence of various confounding variables and storage conditions on metanephrine and normetanephrine levels in plasma. Clin Endocrinol 73: 153–160

Girard O, Koehle MS, MacInnis MJ, Guenette JA, Koehle MS, Verges S, Rupp T, Jubeau M, Perrey S, Millet GY, Chapman RF, Levine BD, Conkin J, Wessel JH 3rd, Nespoulet H, Wuyam B, Tamisier R, Verges S, Levy P, Casey DP, Taylor BJ, Snyder EM, Johnson BD, Laymon AS, Stickford JL, Weavil JC, Loeppky JA, Pun M, Schommer K, Bartsch P, Vagula MC, Nelatury CF (2012) Comments on point: counterpoint: hypobaric hypoxia induces/does not induce different responses from normobaric hypoxia. J Appl Physiol 112:1788–1794CrossRefPubMed

Heinonen I, Luotolahti M, Vuolteenaho O, Nikinmaa M, Saraste A, Hartiala J, Koskenvuo J, Knuuti J, Arjamaa O (2014) Circulating N-terminal brain natriuretic peptide and cardiac function in response to acute systemic hypoxia in healthy humans. J Transl Med 12:189. doi:10.1186/1479-5876-12-189 CrossRefPubMedPubMedCentral

Hew-Butler T, Noakes TD, Soldin SJ, Verbalis JG (2008) Acute changes in endocrine and fluid balance markers during high intensity, steady-state, and prolonged endurance running: unexpected increases in oxytocin and brain natriuretic peptide during exercise. Eur J Endocrinol 159:729–737CrossRefPubMed

Hough JP, Papacosta E, Wraith E, Gleeson M (2011) Plasma and salivary steroid hormone responses of men to high-intensity cycling and resistance exercise. J Strength Cond Res 25:23–31CrossRefPubMed

Li F, Hu Y, Nie J, Fu FH (2016) Effects of acute, intermittent exercise in hypoxic environments on the release of cardiac troponin. Scand J Med Sci Sports 26:397–403CrossRefPubMed

Lundby C, Nielsen TK, Dela F, Damsgaard R (2005) The influence of intermittent altitude exposure to 4100 m on exercise capacity and blood variables. Scand J Med Sci Sports 15:182–187CrossRefPubMed

Maher JT, Jones LG, Hartley LH, Williams GH, Rose LI (1975) Aldosterone dynamics during graded exercise at sea level and high altitude. J Appl Physiol 1:18–22

Mazzeo RS, Bender PR, Brooks GA, Butterfield GE, Groves BM, Sutton JR, Wolfel EE, Reeves JT (1991) Arterial catecholamine responses during exercise with acute and chronic high altitude exposure. Am J Physiol Endocrinol Metab 261:E419–E424

Mazzeo RS, Brooks GA, Butterfield GE, Podolin DA, Wolfel EE, Reves JT (1995) Acclimatization to high altitude increases muscle sympathetic activity both at rest and during exercise. Am J Physiol Regul Integr Comp Physiol 269:R201–R207

Mazzeo RS, Child A, Butterfield GE, Braun B, Rock PB, Wolfel EE, Zamudio S, Moore LG (2000) Sympathoadrenal responses to submaximal exercise in women after acclimatization to 4,000 m. Metabolism 49:1036–1042CrossRefPubMed

Mellor A, Boos C, Holdsworth D, Begley J, Hall D, Lumley A, Burnett A, Hawkins A, O’Hara J, Ball S, Woods DR (2014) Cardiac biomarkers at high altitude. High Alt Med Biol 15:452–458CrossRefPubMed

Millet GP, Faiss R, Pialoux V (2012a) Point: hypobaric hypoxia induces different physiological responses from normobaric hypoxia. J Appl Physiol 112:1783–1784CrossRefPubMed

Millet GP, Faiss R, Pialoux V (2012b) Last word on point: counterpoint: hypobaric hypoxia induces different responses from normobaric hypoxia. J Appl Physiol 112:1795CrossRefPubMed

Mounier R, Brugniaux JV (2012) Counterpoint: hypobaric hypoxia does not induce different physiological responses from normobaric hypoxia. J Appl Physiol 112:1784–1786CrossRefPubMed

Nishikimi T, Morimoto A, Ishikawa K, Saito Y, Kangawa K, Matsuo H, Kitamura K, Takishita S, Matsuoka H (1997) Different secretion patterns of adrenomedullin, brain natriuretic peptide, and atrial natriuretic peptide during exercise in hypertensive and normotensive subjects. Clin Exp Hypertens 19:503–518CrossRefPubMed

Nishikimi T, Kuwahara K, Nakao K (2011) Current biochemistry, molecular biology, and clinical relevance of natriuretic peptides. J Cardiol 57:131–140CrossRefPubMed

Okazaki S, Tamura Y, Hatano T, Matsui N (1984) Hormonal disturbances of fluid-electrolyte metabolism under altitude exposure in man. Aviat Space Environ Med 55:200–205PubMed

Pagé M, Henri C, Pagé P, Sauvé C, Schampaert E (2015) Brain natriuretic peptide levels and the occurrence of subclinical pulmonary edema in healthy lowlanders at high altitude. Can J Cardiol 31:1025–1031CrossRefPubMed

Peaston RT, Weinkove C (2004) Measurement of catecholamines and their metabolites. Ann Clin Biochem 41:17–38CrossRefPubMed

Raber W, Raffesberg W, Bischof M, Scheuba C, Niederle B, Gasic S, Waldhäusl W, Roden M (2000) Diagnostic efficacy of unconjugated plasma metanephrines for the detection of pheochromocytoma. Arch Intern Med 160:2957–2963CrossRefPubMed

Raber W, Raffesberg W, Waldhäusl W, Gasic S, Roden M (2003) Exercise induces excessive normetanephrine responses in hypertensive diabetic patients. Eur J Clin Invest 33:480–487CrossRefPubMed

Richalet JP, Letournel M, Souberbielle JC (2010) Effects of high-altitude hypoxia on the hormonal response to hypothalamic factors. Am J Physiol Regul Integr Comp Physiol 299:1685–1692CrossRef

Roden M, Raffesberg W, Raber W, Bernroider E, Niederle B, Waldhäusl W, Gasic S (2001) Quantification of unconjugated metanephrines in human plasma without interference by acetaminophen. Clin Chem 47:1061–1067PubMed

Ros G, Dantas EHM, de Mello DB (2011) The response of serum leptin, cortisol and zinc concentrations to concurrent training. Hormones 10:215–221CrossRef

Rostrup M (1998) Catecholamines, hypoxia and high altitude. Acta Physiol Scand 162:389–399CrossRefPubMed

Savourey G, Launay JC, Besnard Y, Guinet A, Travers S (2003) Normo- and hypobaric hypoxia: are there any physiological differences? Eur J Appl Physiol 89:122–126CrossRefPubMed

Savourey G, Launay JC, Besnard Y, Guinet-Lebreton A, Alonso A, Sauvet F, Bourrilhon C (2007) Normo or hypobaric hypoxic tests: propositions for the determination of the individual susceptibility to altitude illnesses. Eur J Appl Physiol 100:193–205CrossRefPubMed

Scharhag J, Herrmann M, Urhausen A, Haschke M, Herrmann W, Kindermann W (2005) Independent elevations of N-terminal pro-brain natriuretic peptide and cardiac troponins in endurance athletes after prolonged strenuous exercise. Am Heart J 150:1128–1134CrossRefPubMed

Schmerbach K, Patzak A (2013) Pathophysiological mechanisms in acute mountain sickness. Acta Physiol 209:246–249CrossRef

Sutton JR, Viol GW, Gray GW, McFadden M, Keane PM (1977) Renin, aldosterone, electrolyte, and cortisol responses to hypoxic decompression. J Appl Physiol 43:421–424PubMed

Wahl P, Hein M, Achtzehn S, Bloch W, Mester J (2014) Acute metabolic, hormonal and psychological responses to cycling with superimposed electromyostimulation. Eur J Appl Physiol 114:2331–2339CrossRefPubMed

Wille M, Gatterer H, Mairer K, Philippe M, Schwarzenbacher H, Faulhaber M, Burtscher M (2012) Short-term intermittent hypoxia reduces the severity of acute mountain sickness. Scand J Med Sci Sports 22:e79–e85CrossRefPubMed

Woods D, Hooper T, Hodkinson P Ball S, Wakeford R, Peaston B, Bairsto C, Green N, Mellor A (2011a) Effects of altitude exposure on brain natriuretic peptide in humans. Eur J Appl Physiol 111:2687–2693CrossRefPubMed

Woods D, Hooper T, Mellor A, Hodkinson P, Wakeford R, Peaston B, Ball S, Green N (2011b) Brain natriuretic peptide and acute hypobaric hypoxia in humans. J Physiol Sci 61:217–220CrossRefPubMed

Woods DR, Begley J, Stacey M, Smith C, Boos CJ, Hooper T, Hawkins A, Hodkinson P, Green N, Mellor A (2012a) Severe acute mountain sickness, brain natriuretic peptide and NT-proBNP in humans. Acta Physiol 205:349–355CrossRef

Woods DR, Davison A, Stacey M, Smith C, Hooper T, Neely D, Turner S, Peaston R, Mellor A (2012b) The cortisol response to hypobaric hypoxia at rest and post-exercise. Horm Metab Res 44:302–305CrossRefPubMed

Woods DR, Mellor A, Begley J, Stacey M, O’Hara J, Hawkins A, Yarker J, Foxen S, Smith C, Boos C (2013) Brain natriuretic peptide and NT-proBNP levels reflect pulmonary artery systolic pressure in trekkers at high altitude. Physiol Res 6:597–603

Wu AH, Feng YJ, Moore R, Apple FS, McPherson PH, Buechler KF, Bodor G (1998) Characterization of cardiac troponin subunit release into serum after acute myocardial infarction and comparison of assays for troponin T and I: American Association for Clinical Chemistry Subcommittee on cTnI Standardization. Clin Chem 44:1198–1208PubMed

Title: Markers of physiological stress during exercise under conditions of normoxia, normobaric hypoxia, hypobaric hypoxia, and genuine high altitude
Authors: David Richard Woods
John Paul O’Hara
Christopher John Boos
Peter David Hodkinson
Costas Tsakirides
Neil Edward Hill
Darren Jose
Amanda Hawkins
Kelly Phillipson
Antonia Hazlerigg
Nicola Arjomandkhah
Liam Gallagher
David Holdsworth
Mark Cooke
Nicholas Donald Charles Green
Adrian Mellor
Publication date: 01-05-2017
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Applied Physiology / Issue 5/2017
Print ISSN: 1439-6319
Electronic ISSN: 1439-6327
DOI: https://doi.org/10.1007/s00421-017-3573-5

ACC 2024 Congress

Springer Medicine

Markers of physiological stress during exercise under conditions of normoxia, normobaric hypoxia, hypobaric hypoxia, and genuine high altitude

Abstract

Purpose

Method

Results

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2017

β-alanine supplementation improves in-vivo fresh and fatigued skeletal muscle relaxation speed

Wearing graduated compression stockings augments cutaneous vasodilation in heat-stressed resting humans

The effect of Nordic hamstring strength training on muscle architecture, stiffness, and strength

Relationship between isometric contraction intensity and muscle hardness assessed by ultrasound strain elastography

Blood glucose kinetics and physiological changes in a type 1 diabetic finisher of the Ultraman triathlon: a case study

Post-absorptive muscle protein turnover affects resistance training hypertrophy