Exercise gas exchange in asthmatics after beta-adrenergic blockade

Abstract

Pharmacologic beta-adrenergic blockade reduces maximal heart rate (HR) during exercise but variable results have been reported for minute ventilation (VE), CO2 output (VCO2), and O2 uptake (VO2). A total group of 19 subjects with mild asthma was studied. We studied 16 subjects from the group who received placebo or pindolol, a beta-adrenergic antagonist, during 1-min incremental exercise on a cycle ergometer. During incremental exercise, HR, VE, VCO2, and VO2 were less after beta-blockade than after placebo at the same work rate below the anaerobic threshold. Maximal HR, VE, VO2, VCO2, and work rate were significantly less after beta-blockade. In addition, we studied six subjects from the group, including three who had also performed incremental exercise, during the steady state of constant-work cycling exercise. We found no difference in VE, VCO2, or VO2 although HR was less after beta-blockade. We conclude that beta-adrenergic blockade affects gas exchange by delaying the normal cardiovascular response to exercise. Decreased VE during incremental exercise is due to slowed delivery of CO2 load to the lungs rather than alterations in substrate, lung function, or ventilatory control.