Introduction: Patients undergoing weight loss surgery do not improve their aerobic capacity or peak oxygen uptake (VO2peak) after bariatric surgery and some still complain about asthenia and/or breathlessness. We investigated the hypothesis that a post-surgery muscular limitation could impact the ventilatory response to exercise by evaluating the post-surgery changes in muscle mass, strength, and muscular aerobic capacity, measured by the first ventilatory threshold (VT). Methods: Thirteen patients with obesity were referred to our university exercise laboratory before and 6 months after bariatric surgery and were matched by sex, age, and height to healthy subjects with normal weight. All subjects underwent a clinical examination, blood sampling, and body composition assessment by dual-energy X-ray absorptiometry, respiratory and limb muscle strength assessments, and cardiopulmonary exercise testing on a cyclo-ergometer. Results: Bariatric surgery resulted in a loss of 34% fat mass, 43% visceral adipose tissue, and 12% lean mass (LM) (p < 0.001). Absolute handgrip, quadriceps, or respiratory muscle strength remained unaffected, while quadriceps/handgrip strength relative to LM increased (p < 0.05). Absolute VO2peak or VO2peak/LM did not improve and the first VT was decreased after surgery (1.4 ± 0.3 vs. 1.1 ± 0.4 L min−1, p < 0.05) and correlated to the exercising LM (LM legs) (R = 0.84, p < 0.001). Conclusions: Although bariatric surgery has numerous beneficial effects, absolute VO2peak does not improve and the weight loss-induced LM reduction is associated to an altered muscular aerobic capacity, as reflected by an early VT triggering early exercise hyperventilation.

Heart transplantation does not normalize exercise capacity or the ventilatory response to exercise. We hypothesized that excessive muscle reflex activity, as assessed by the muscle sympathetic nerve activity (MSNA) response to handgrip exercise, persists after cardiac transplantation and that this mechanism is related to exercise hyperpnea in heart transplant recipients (HTRs). We determined the MSNA, ventilatory, and cardiovascular responses to isometric and dynamic handgrips in 11 HTRs and 10 matched control subjects. Handgrips were followed by a post-handgrip ischemia to isolate the metaboreflex contribution to exercise responses. HTRs and control subjects also underwent recordings during isocapnic hypoxia and a maximal, symptom-limited, cycle ergometer exercise test. HTRs had higher resting MSNA ( P < 0.01) and heart rate ( P < 0.01) than the control subjects. Isometric handgrip increased MSNA in HTRs more than in the controls ( P = 0.003). Dynamic handgrip increased MSNA only in HTRs. During post-handgrip ischemia, MSNA and ventilation remained more elevated in HTRs ( P < 0.05). The MSNA and ventilatory responses to hypoxia were also higher in HTRs (both P < 0.04). In HTRs, metaboreflex overactivity was related to the ventilatory response to exercise, characterized by the regression slope relating ventilation to CO₂ output ( r = +0.8; P < 0.05) and a lower peak ventilation ( r = +0.81; P < 0.05) during cycle ergometer exercise tests. However, increased chemoreflex sensitivity ( r = +0.91; P < 0.005), but not metaboreflex activity, accounted for the lower peak ventilation during exercise in a stepwise regression analysis. In conclusion, heart transplantation does not normalize muscle metaboreceptor activity; both increased metaboreflex and chemoreflex control are related to exercise intolerance in HTRs.

Sex and age affect the pulmonary circulation. Whether there may be racial differences in pulmonary vascular function is unknown. Thirty white European Caucasian subjects (15 women) and age and body-size matched 30 black sub-Saharan African subjects (15 women) underwent a cardiopulmonary exercise test and exercise stress echocardiography with measurements of pulmonary artery pressure (PAP) and cardiac output (CO). A pulmonary vascular distensibility coefficient α was mathematically determined from the natural curvilinearity of multipoint mean PAP (mPAP)-CO plots. Maximum oxygen uptake (V̇o_2max) and workload were higher in the whites, while maximum respiratory exchange ratio and ventilatory equivalents for CO₂ were the same. Pulmonary hemodynamics were not different at rest. Exercise was associated with a higher maximum total pulmonary vascular resistance, steeper mPAP-CO relationships, and lower α-coefficients in the blacks. These differences were entirely driven by higher slopes of mPAP-CO relationships (2.5 ± 0.7 vs. 1.4 ± 0.7 mmHg·l⁻¹·min; P < 0.001) and lower α-coefficients (0.85 ± 0.33 vs. 1.35 ± 0.51%/mmHg; P < 0.01) in black men compared with white men. There were no differences in any of the hemodynamic variables between black and white women. In men only, the slopes of mPAP-CO relationships were inversely correlated to V̇o_2max ( P < 0.01). Thus the pulmonary circulation is intrinsically less distensible in black sub-Saharan African men compared with white Caucasian Europeans men, and this is associated with a lower exercise capacity. This study did not identify racial differences in pulmonary vascular function in women.

Occupational exposure to charcoal smoke and dust is a threat to workers respiratory system. What is the prevalence of chronic obstructive pulmonary disease (COPD) in charcoal workers as compared to farmers in rural areas of Democratic Republic of Congo (DRC)? This cross-sectional, comparative, and multi-site study was performed in the charcoal-producing provinces of South-Western DRC. We randomly included charcoal workers and compared them to farmers (18 to 70 years old). Air quality indexes, anthropometric, physical activity, sociodemographic characteristics, and related medical events data were recorded. A Lung function questionnaire was used to assess respiratory symptoms (RS) and spirometry was performed. COPD was defined as the presence of RS for more than 3 months with a FEV1/FVC ratio below the lower limit of normal. The prevalence of COPD was calculated, and logistic regression was used to identify COPD-associated factors. We included 485 subjects between August 2020 and July 2021. Charcoal Producers (CP, n = 229) were compared with farmers (n = 118), and charcoal saleswomen (CS, n = 72) were compared to vegetable saleswomen (VS, n = 66). Respective groups were similar in age, job seniority, height, and weight. The air was more polluted at charcoal workplaces. The prevalence of COPD was higher in CP than in farmers (39.7% vs 14.4%; P < 0.0001), and in CS compared to VS (40.3% vs 13.6%; P < 0.0001). Being a charcoal worker was independently associated with COPD in the CP and farmers group: adjusted OR, 3.54 (95% CI, 1.94-6.46), and, in the saleswomen group: 7.85 (95% CI, 2.85-21.5), where it was also independently associated with young age: 0.85 (0.80-0.93) and monthly income: 0.88 (0.83-0.96). In rural areas of DRC, producing or selling charcoal is associated with a higher risk of COPD.

The interaction between oral and/or mental cognitive tasks and postural control and mobility remains unclear. The aim of this study was to analyse the influence of speech production and cognitive load levels on static balance and timed up and go (TUG) during dual-task activities. Thirty healthy young subjects (25 ± 4 years old, 17 women) participated in this study. A control situation and two different cognitive arithmetic tasks were tested: counting backward in increments of 3 and 7 under oral (O) and mental (M) conditions during static balance and the TUG. We evaluated the dual-task cost (DTC) and the effect of speech production (SP) and the level of cognitive load (CL) on these variables. There was a significant increase in the centre of pressure oscillation velocity in static balance when the dual task was performed orally compared to the control situation The DTC was more pronounced for the O than for the M. The SP, but not the CL, had a significant effect on oscillation velocity. There was an increase in TUG associated with the cognitive load, but the mental or oral aspect did not seem to have an influence. Mobility is more affected by SP when the cognitive task is complex. This may be particularly important for the choice of the test and understanding postural control disorders.

Background: Occupational biomass pollutant exposure as observed in charcoal workers may have significant cardiovascular effects. This study aims to ascertain the prevalence and risk factors of hypertension and high pulse pressure (HPP), a marker of arterial stiffness, in charcoal workers compared with a control group of agricultural workers from the Democratic Republic of Congo. Methods and Results: The charcoal worker and agricultural worker groups (n=485; median age, 35–40 years) were composed of male charcoal producers (n=229), charcoal saleswomen (n=72), male farmers (n=118), and vegetable saleswomen (n=66). We assessed workplace air pollution, sociodemographic parameters, self‐reported physical activity, body composition, exhaled air carbon monoxide, and blood pressure. Hypertension and HPP prevalences were determined. Logistic regression, adjusted for confounding variables was used to identify the risk factors. Charcoal workplaces were more polluted than agricultural workplaces ( P <0.01). Charcoal producers performed higher levels of physical activity ( P =0.018) and demonstrated higher levels of exhaled air carbon monoxide ( P <0.0001) and pulse pressure ( P =0.006), and higher prevalence of grade 1 hypertension ( P =0.007), isolated systolic hypertension ( P =0.04), and HPP ( P =0.02) than farmers. Overall, hypertension (adjusted odds ratio [aOR], 11.76 [95% CI, 6.26–22.13]), level of particulate matter <10 μm pollutants (aOR, 1.001 [95% CI, 1.0002–1.0017]), smoking (aOR, 2.21 [95% CI, 1.15–4.24]) and low education (aOR, 2.14 [95% CI, 1.10–4.17]) were independently associated with HPP. The level of particulate matter <1.0 μm pollutants (aOR, 1.0009 [95% CI, 1.0002–1.0015]), male sex (aOR, 2.09 [95% CI, 1.21–3.64]), and job seniority (aOR, 1.022 [95% CI, 1.004–1.044]) were independently associated with isolated systolic hypertension. Conclusions: Charcoal producers appear to develop isolated systolic hypertension and HPP more, both indices of cardiovascular events in which occupational biomass particles seem to play an early significant role.