Ventilatory Response to Exercise in Simulated Obesity by Chest Loading

Introduction & Purpose: Obesity-related increases of weight on the chest wall are known to decrease lung volume and chest wall compliance, but the effect of this mass loading, independent of other obesity-related complications on the ventilatory response to exercise is unknown. The purpose of this study was to investigate the effect of chest mass loading on the ventilatory response to exercise. Methods: External chest loading (CL) was used to simulate the effect of moderate obesity (BMI = 32 kg.m^-2). Eight healthy nonobese subjects performed two incremental exercise tests on a cycle ergometer with work rate increasing 25 W every 3 min once without (control; CON) and once with CL. Expiratory reserve volume (ERV), forced vital capacity (FVC), and forced expiratory volume in 1 s (FEV₁) were measured before each test. During exercise, inspiratory capacity (IC), to estimate changes in end-expiratory lung volume, and inspiratory (T₁) and expiratory (T_E) duration, tidal volume (V_t), breathing frequency (F_b), minute ventilation (V̇_E), mean inspiratory (Vt/T_I) and expiratory (V_t/T_E) flow rates, and oxygen consumption (V̇O₂) were measured. Results: Baseline ERV, FVC and FEV₁ were lower with CL (P < 0.05). Compared with CON, the peak work rate achieved during exercise with CL was lower and V̇O ₂, V_E, F_b, V_t/V_I, and V_t/V_E were higher, and V_t was lower at work rates ≥ 100 W (P < 0.05). IC increased progressively in CON during exercise but remained unchanged with CL. Conclusion: Obesity-related chest loading decreases lung volumes and increases the mechanical ventilatory constraints during exercise and is likely a critical factor in reducing exercise capacity in obesity.