On Jul 30, 9:56 pm, Tim McNamara <
[email protected]> wrote:
> In article <[email protected]>,
>
>
>
> [email protected] wrote:
> > On Jul 30, 2:53 pm, Tim McNamara <[email protected]> wrote:
> > > In article <[email protected]>,
>
> > > [email protected] wrote:
> > > > On Jun 7, 11:57 am, Andy Coggan <[email protected]> wrote:
>
> > > > > In fact, mild-to-moderate arterial desaturation tends to occur
> > > > > during maximal exercise in a significant portion of the
> > > > > population (at least discounting young, healthy, untrained
> > > > > men!), indicating that, at least to some extent, aerobic
> > > > > capacity (i.e., VO2max) is limited, in part, by pulmonary
> > > > > function.
>
> > > > Phoeey. A small arterial desaturation is most likely explained by
> > > > increased left to right shunting
>
> > > Left to right shunting from where to where through what? This term
> > > is usually used to indicate left to right shunting through an
> > > atrial septal defect or cases of tricuspid atresia. There should
> > > be little or no left to right shunting through a patent foramen
> > > ovale and should be no shunting at all in a normal heart. So I am
> > > not clear to what you refer. Thanks.
>
> > My bad, I should have said increased right to left shunting although
> > this is not so much as a physiological shunt but as a ventilation
> > perfusion defect behaving as a shunt.
>
> That didn't really clarify. Ventilation defects are generally caused by
> obstructions somewhere in the airway; perfusion defects are generally
> caused by emboli in the pulmonary vasculature. What is the cause of the
> "ventilation perfusion defect" you are pointing towards? Does this
> occur in non-pathological individuals?
>
> I trimmed the rest of your previous post in an over-zealous fit of good
> netiquette, unfortunately. It would appear that Nielsen (2003) found
> that arterial desaturation during exercise is multifactoral and that
> large lung capacity does offer some protection from this. Perhaps this
> link offers some light on the subject:
>
> http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_...
> =14617055&dopt=AbstractPlus
You are right that ventilation perfusion "abnormalities" can be multi-
factorial. However, some differences are normal. Gravity has a huge
effect on blood flow distribution through the lungs and very little
effect on ventilation distribution. Luckily for us God designed us to
accomodate for this gravitational effect and we were designed to
maximize oxygen transfer in the upright position. Turns out that more
of our inspired air goes into the part of the lung near the diaphragm
and less near the apex (the top near the neck). Luckily, that is the
bottom of the lung where gravity makes it natural for more blood to
go, especially at lower flow rates. At rest and when upright this
distribution is very well balanced. However, as one exercises, more
blood flow "forces" a higher percentage of the blood volume to go
towards the apex where ventilation is less (this "forcing" occurs
because once the lower alveolar capillaries are "maxed out" any
additional flow must move further up the chain where there is room to
accomodaate it). This would change the ventilation perfusion
relationship tending to naturally lower arterial oxygen saturation at
higher efforts. Further, in cycling, one isn't necessarily in the
"optimum" upright position, which can change this relationship further.