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PURPOSE At constant work-rates below the gas exchange threshold (VO(2 theta)), VO(2) normally achieves steady-state values within 3 min, whereas at heavier work-rates, VO(2) may continue to rise. The VO(2) response to heavy exercise can be described by a three-exponential model with the slow phase usually commencing 2-3 min after the onset of exercise. The aim of our study was to estimate precisely the VO(2), VCO(2), VE and f(C) required for above-VO(2 theta) exercise from the relationship of the specific variable to work-rate below VO(2 theta) and to compare this with the actual value achieved. METHODS Nine cyclists performed five constant work-rates of 8 min duration, four below VO(2 theta) (40, 80, 120, 160 W) and one midway between VO(2 theta) and VO(2max) (295 +/- 34 W). The VO(2), VCO(2), VE and f(C) were averaged for the final 2 min of each below-VO(2 theta) test and were found to be linear with respect to work-rate (average r2 >0.95). Variables for the above-VO(2 theta) work-rate were predicted by extrapolation and compared with the actual measured values at the end of the exercise bout. RESULTS VO(2) exceeded the predicted value by 0.48 +/- 0.21 L x min(-1) (12.4 +/- 5.1%), VCO(2) by 0.78 +/- 0.26 L x min(-1) (23.2 +/- 7.2%), VE by 40.3 +/- 16.3 L x min(-1) (51.0 +/- 23.1%), and f(C) by 12.2 +/- 12.5 beats x min(-1) (8.8 +/- 9.3%), all P < 0.0001 except f(C) P < 0.02, paired t-test. The point at which VO(2) during above-VO(2 theta) exercise exceeded the predicted value (145.7 +/- 64.9 s) agreed with the point at which the slow component of VO(2) began, as determined by nonlinear regression analysis (131.5 +/- 44.3 s, P = NS, ANOVA). CONCLUSION There is an excessive metabolic response to heavy exercise over and above that predicted by extrapolation from light-moderate exercise and this excess VO(2) approximates on average to the slow phase of a three-compartment exponential model.

Chronic pulmonary diseases are common in the community and their pathophysiology is complex. The principal symptoms are dyspnea and limited exercise capacity. Some, but not all, patients have true ventilatory limitation where the maximal exercise ventilation (VEmax) equals the measured maximal ventilatory volume (MVV). Those with obstructive disease have impeded expiration requiring an obligatory expiratory time for adequate lung emptying (i.e., a timing constraint). In these patients, increased breathing frequency during exercise tends to lead to hyperinflation and smaller tidal volumes, circumstances that predictably worsen breathing efficiency (i.e., result in high VD/VT). Those with restrictive disease characteristically have limited inspiratory capacity but-unimpeded or even accelerated expiration (i.e. tidal volume constraint). These patients characteristically exhibit rapid respiratory rates (e.g., >50-min−1) at end exercise.