High physical fitness was associated with lower orthostatic tolerance, with poor tolerance linked to larger stroke volumes (120 vs 103 ml) and greater decline during LBNP (40% vs 26%).
Observational (n=24)
We studied three groups of eight men each--high, mid, and low fit (peak O2 consumption 60.0 +/- 0.8, 48.9 +/- 1.0, and 35.7 +/- 0.9 ml.min-1.kg-1)--to determine the mechanism of orthostatic intolerance in endurance athletes. Tolerance was defined by progressive lower body negative pressure (LBNP) to presyncope. Maximal calf vascular conductance (Gmax) was measured. The carotid baroreflex was characterized using both stepwise R-wave-triggered and sustained (2 min) changes in neck chamber pressure. High-fit subjects tended to have lower LBNP tolerance than mid- and low-fit subjects but similar baroreflex responses. Subjects with poor LBNP tolerance had larger stroke volumes (SV) (120 +/- 6 vs. 103 +/- 3 ml) and greater decline in SV with LBNP to -40 mmHg (40 +/- 2 vs. 26 +/- 4%). Stepwise multiple linear regression analysis revealed that Gmax and steady-state gain of the carotid baroreflex contributed significantly toward explaining interindividual variations in LBNP tolerance. Thus endurance athletes may have decreased LBNP tolerance, but apparently not as a simple linear function of aerobic fitness. Orthostatic tolerance depends on complex interactions among functional characteristics that appear both related (Gmax and SV) and unrelated (baroreflex function) to fitness or exercise training.
Levine et al. (Tue,) conducted a observational in Orthostatic intolerance (n=24). Physical fitness level (high, mid, low) vs. Between-group comparison was evaluated on Orthostatic tolerance (defined by progressive lower body negative pressure to presyncope). High physical fitness was associated with lower orthostatic tolerance, with poor tolerance linked to larger stroke volumes (120 vs 103 ml) and greater decline during LBNP (40% vs 26%).