Int J Sports Med 2011; 32(6): 438-445
DOI: 10.1055/s-0031-1271788
Training & Testing

© Georg Thieme Verlag KG Stuttgart · New York

Cardiovascular Responses During Hypoventilation at Exercise

X. Woorons1 , 2 , N. Bourdillon1 , C. Lamberto1 , 3 , H. Vandewalle3 , J.-P. Richalet1 , 3 , P. Mollard1 , A. Pichon1
  • 1Université Paris 13, Laboratoire ‘Réponses cellulaires et fonctionnelles à l'hypoxie’, EA 2363, UFR-SMBH, Bobigny, France
  • 2Association pour la Recherche et la Promotion de l'Entraînement en Hypoventilation (ARPEH), Lille, France
  • 3AP-HP, Hôpital Avicenne, Bobigny, France
Further Information

Publication History

accepted after revision January 25, 2011

Publication Date:
11 May 2011 (online)


This study aimed to determine the cardiovascular responses during a prolonged exercise with voluntary hypoventilation (VH). 7 men performed 3 series of 5-min exercise at 65% of normoxic maximal O2 uptake under 3 conditions: (1) normal breathing (NB) in normoxia (NB0.21), (2) VH in normoxia (VH0.21), (3) NB in hypoxia (NB0.157, inspired oxygen fraction=0.157). In both VH0.21 and NB0.157, there was a similar drop in arterial oxygen saturation and arterial O2 content (CaO2) which were lower than in NB0.21. Heart rate (HR), stroke volume, and cardiac output (–) were higher in VH0.21 than in NB0.21 during most parts of exercise whereas there was no difference between NB0.157 and VH0.21 or NB0.21. HR variability analysis suggested an increased sympathetic modulation in VH0.21 only. O2 transport and oxygen uptake were generally not different between interventions. Mixed venous O2 content (C–O2) was lower in NB0.157 than in both VH0.21 and NB0.21 and not different between the latter. CaO2–C–O2 was not different between NB0.157 and NB0.21 but lower in VH0.21. This study shows that a prolonged exercise with VH leads to a greater cardiac activity, independent from the hypoxic effect. The greater – in VH compared to normal breathing seems to be the main factor for compensating the drop of arterial oxygen content.


  • 1 Aaron EA, Johnson BD, Seow CK, Dempsey JA. Oxygen cost of exercise hyperpnea: measurement.  J Appl Physiol. 1992;  72 1810-1817
  • 2 Anchisi S, Moia C, Ferretti G. Oxygen delivery and oxygen return in humans exercising in acute normobaric hypoxia.  Pflugers Arch. 2001;  442 443-450
  • 3 Angell-James JE, Elsner R, De Burgh Daly M. Lung inflation: effects on heart rate, respiration, and vagal afferent activity in seals.  Am J Physiol. 1981;  240 H190-H198
  • 4 Badra LJ, Cooke WH, Hoag JB, Crossman AA, Kuusela TA, Tahvanainen KU, Eckberg DL. Respiratory modulation of human autonomic rhythms.  Am J Physiol. 2001;  280 H2674-H2688
  • 5 Barker SJ. “Motion-resistant” pulse oximetry: a comparison of new and old models.  Anesth Analg. 2002;  95 967-972
  • 6 Bourdillon N, Mollard P, Letournel M, Beaudry M, Richalet JP. Non-invasive evaluation of the capillary recruitment in the human muscle during exercise in hypoxia.  Respir Physiol Neurobiol. 2009;  165 237-244
  • 7 Bourdillon N, Mollard P, Letournel M, Beaudry M, Richalet JP. Interaction between hypoxia and training on NIRS signal during exercise: contribution of a mathematical model.  Respir Physiol Neurobiol. 2009;  169 50-61
  • 8 Charloux A, Lonsdorfer-Wolf E, Richard R, Lampert E, Oswald-Mammosser M, Mettauer B, Geny B, Lonsdorfer JA. A new impedance cardiograph device for the non-invasive evaluation of cardiac output at rest and during exercise: comparison with the “direct” Fick method.  Eur J Appl Physiol. 2000;  85 313-320
  • 9 Chin LM, Leigh RJ, Heigenhauser GJ, Rossiter HB, Paterson DH, Kowalchuk JM. Hyperventilation-induced hypocapnic alkalosis slows the adaptation of pulmonary O2 uptake during the transition to moderate-intensity exercise.  J Physiol. 2007;  583 351-364
  • 10 Dicker SG, Lofthus GK, Thornton NW, Brooks GA. Respiratory and heart rate responses to tethered controlled frequency breathing swimming.  Med Sci Sports Exerc. 1980;  12 20-23
  • 11 Eckberg DL. Physiological basis for human autonomic rhythms.  Ann Med. 2000;  32 341-349
  • 12 Ehrsam RE, Heigenhauser GJ, Jones NL. Effect of respiratory acidosis on metabolism in exercise.  J Appl Physiol. 1982;  53 63-69
  • 13 Escourrou P, Johnson DG, Rowell LB. Hypoxia increases plasma catecholamine concentrations in exercising humans.  J Appl Physiol. 1984;  57 1507-1511
  • 14 Harriss DJ, Atkinson G. International Journal of Sports Medicine – Ethical Standards in Sport and Exercise Science Research.  Int J Sports Med. 2009;  30 701-702
  • 15 Holmer I, Gullstrand L. Physiological responses to swimming with controlled frequency of breathing.  Scand J Sports Sci. 1980;  2 1-6
  • 16 Hsieh SS, Hermiston RT. The acute effects of controlled breathing swimming on glycolytic parameters.  Can J Appl Sport Sci. 1983;  8 149-154
  • 17 Millet GP, Roels B, Schmitt L, Woorons X, Richalet JP. Combining hypoxic methods for peak performance.  Sports Med. 2010;  40 1-25
  • 18 Mollard P, Woorons X, Letournel M, Cornolo J, Lamberto C, Beaudry M, Richalet JP. Role of maximal heart rate and arterial O2 saturation on the decrement of in moderate acute hypoxia in trained and untrained men.  Int J Sports Med. 2007;  28 186-192
  • 19 Mollard P, Bourdillon N, Letournel M, Herman H, Gibert S, Pichon A, Woorons X, Richalet JP. Validity of arterialized earlobe blood gases at rest and exercise in normoxia and hypoxia.  Respir Physiol Neurobiol. 2010;  172 179-183
  • 20 Nahas GG, Poyart C. Effect of arterial pH alterations on metabolic activity of norepinephrine.  Am J Physiol. 1967;  212 765-772
  • 21 Peltonen JE, Leppavuori AP, Kyro KP, Mäkelä P, Rusko HK. Arterial haemoglobin oxygen saturation is affected by F(I)O2 at submaximal running velocities in elite athletes.  Scand J Med Sci Sports. 1999;  9 265-271
  • 22 Peltonen JE, Tikkanen HO, Rusko HK. Cardiorespiratory responses to exercise in acute hypoxia, hyperoxia and normoxia.  Eur J Appl Physiol. 2001;  85 82-88
  • 23 Peng CK, Havlin S, Stanley HE, Goldberger AL. Quantification of scaling exponents and crossover phenomena in nonstationary heartbeat time series.  Chaos. 1995;  5 82-87
  • 24 Pichon AP, de Bisschop C, Roulaud M, Denjean A, Papelier Y. Spectral analysis of heart rate variability during exercise in trained subjects.  Med Sci Sports Exerc. 2004;  36 1702-1708
  • 25 Pichon A, Roulaud M, Antoine-Jonville S, de Bisschop C, Denjean A. Spectral analysis of heart rate variability: interchangeability between autoregressive analysis and fast Fourier transform.  J Electrocardiol. 2006;  39 31-37
  • 26 Pichon A, Cornolo J. The effect of ventilation on spectral analysis of heart rate variability during exercise.  Respir Physiol Neurobiol. 2006;  150 118-119
  • 27 Richalet JP, Mehdioui H, Rathat C, Vignon P, Keromes A, Herry JP, Sabatier C, Tanche M, Lhoste F. Acute hypoxia decreases cardiac response to catecholamines in exercising humans.  Int J Sports Med. 1988;  9 l57-162
  • 28 Richard R, Lonsdorfer-Wolf E, Charloux A, Doutreleau S, Buchheit M, Oswald Mammosser M, Lampert E, Mettauer B, Geny B, Lonsdorfer J. Non-invasive cardiac output evaluation during a maximal progressive exercise test, using a new impedance cardiograph device.  Eur J Appl Physiol. 2001;  85 202-207
  • 29 Sharp RL, Williams DJ, Bevan L. Effects of controlled frequency breathing during exercise on blood gases and acid-base balance.  Int J Sports Med. 1991;  12 62-65
  • 30 Tordi N, Mourot L, Matusheski B, Hughson RL. Measurement of cardiac output during constant exercise: comparison of two non-invasive techniques.  Int J Sports Med. 2004;  25 145-149
  • 31 Town GP, Vanness JM. Metabolic responses to controlled frequency breathing in competitive swimmers.  Med Sci Sports Exerc. 1990;  22 112-116
  • 32 Tran TK, Sailasuta N, Kreutzer U, Hurd R, Chung Y, Mole P, Kuno S, Jue T. Comparative analysis of NMR and NIRS measurements of intracellular PO2 in human skeletal muscle.  Am J Physiol. 1999;  276 R1682-R1690
  • 33 Trivedi NS, Ghouri AF, Lai E, Shah NK, Barker SJ. Pulse oximeter performance during desaturation and resaturation: a comparison of seven models.  J Clin Anesth. 1997;  9 184-188
  • 34 Tulppo MP, Mäkikallio TH, Takala TE, Seppänen T, Huikuri HV. Quantitative beat-to-beat analysis of heart rate dynamics during exercise.  Am J Physiol. 1996;  271 H244-H252
  • 35 Welsman J, Bywater K, Farr C, Welford D, Armstrong N. Reliability of peak VO(2) and maximal cardiac output assessed using thoracic bioimpedance in children.  Eur J Appl Physiol. 2005;  94 228-234
  • 36 West JF. Respiratory Physiology: The Essentials.. Hagerstown, MD: Lippincott Williams & Wilkins; 2005: 127-128
  • 37 Woorons X, Mollard P, Lamberto C, Letournel M, Richalet JP. Effect of acute hypoxia on maximal exercise in trained and sedentary women.  Med Sci Sports Exerc. 2005;  37 147-154
  • 38 Woorons X, Mollard P, Pichon A, Duvallet A, Richalet JP, Lamberto C. Prolonged expiration down to residual volume leads to severe arterial hypoxemia in athletes during submaximal exercise.  Respir Physiol Neurobiol. 2007;  158 75-82
  • 39 Woorons X, Mollard P, Pichon A, Duvallet A, Richalet J-P, Lamberto C. Effects of a 4-week training with voluntary hypoventilation carried out at low pulmonary volumes.  Respir Physiol Neurobiol. 2008;  160 123-130
  • 40 Woorons X, Bourdillon N, Vandewalle H, Lamberto C, Mollard P, Richalet JP, Pichon A. Exercise with hypoventilation induces lower muscle oxygenation and higher blood lactate concentration: role of hypoxia and hypercapnia.  Eur J Appl Physiol. 2010;  110 367-377
  • 41 Yamamoto Y, Mutoh Y, Kobayashi H, Miyashita M. Effects of reduced frequency breathing on arterial hypoxemia during exercise.  Eur J Appl Physiol. 1987;  56 522-527
  • 42 Yamamoto Y, Takei Y, Mutoh Y, Miyashita M. Delayed appearance of blood lactate with reduced frequency breathing during exercise.  Eur J Appl Physiol. 1988;  57 462-466
  • 43 Zupet P, Princi T, Finderle Z. Effect of hypobaric hypoxia on heart rate variability during exercise: a pilot field study.  Eur J Appl Physiol. 2009;  107 345-350


Dr. Aurelien Pichon

Laboratoire ‘Réponses

cellulaires et fonctonnelles à



Université Paris 13

74 rue Marcel Cachin

93017 Bobigny


Phone: +33/14/8387/632

Fax: +33/14/8388/924