Double Anaerobic Threshold in Athletes

Evaluation of the Presence of a Double Anaerobic Threshold in a Population of Athletes

During an incremental cardiopulmonary exercise test (CPET) performed with a ramp protocol, it is very important to determine the anaerobic threshold, defined as the point at which the metabolism switches from being predominantly aerobic to also being anaerobic. The anaerobic threshold can be determined invasively, by identifying the increase in blood lactates with an arterial sampling, or, more commonly, non-invasively by three methods: the V-slope method, the ventilatory equivalents method and by using end-expiratory oxygen and carbon dioxide pressure (PETO2 and PETCO2 respectively). Normally, the anaerobic threshold is determined by the first method and the other two are used to confirm the value. The finding of different anaerobic threshold values using these three methods has been reported anecdotally in the past, while a prevalence of 11% in a healthy population has recently been described. Regular training, particularly that aimed at endurance sports, is able to shift the anaerobic threshold to higher exercise intensities. At present, the physiological reasons for the presence of a double threshold are unclear.

The aim of the study is to identify the anaerobic threshold by means of the V-slope method and by means of the ventilatory equivalents method in athletes who have performed an incremental ramp CPET at the laboratories of the investigating centres, to assess in how many athletes a double threshold is present and to try to interpret the physiological/ pathophysiological significance of this finding.

In this retrospective and prospective observational study, healthy male and female athletes who have had a cardiopulmonary test at our laboratories from 2007 to the present (retrospectively recruited) and prospectively recruited until the calculated sample size is reached will be enrolled.

Study Overview

• Status: Recruiting
• Conditions: Athlete; Cardiopulmonary Exercise Test; Anaerobic Threshold

• Study Type: Observational
• Enrollment (Anticipated): 100

Contacts and Locations

• Study Contact: Name: Piergiuseppe Agostoni, Prof; Phone Number: +39 0258002772; Email: piergiuseppe.agostoni@cardiologicomonzino.it

Study Locations

• Italy
  • Florence, Italy
    • Recruiting
    • Azienda Ospedaliero-Universitaria Careggi
    • Contact: Pietro Amedeo Modesti, Prof
  • Foggia, Italy
    • Not yet recruiting
    • University of Foggia
    • Contact: Michele Correale, MD
  • Milan, Italy, 20138
    • Recruiting
    • Centro Cardiologico Monzino
    • Contact: Piergiuseppe Agostoni, Prof; Phone Number: +39 0258002010; Email: piergiuseppe.agostoni@cardiologicomonzino.it

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Healthy male and female athletes who performed a cardiopulmonary test at our laboratories from 2007 to the present (retrospectively recruited) and prospectively recruited will be enrolled

Description

Inclusion Criteria:

• no major present or past illnesses, no ongoing treatment
• At least 2 training sessions per week.

Exclusion Criteria:

• Current illnesses and treatments for any physical condition that could potentially alter performance
• Subjects who have performed a submaximal test (RER < 1.05)
• CPET during which the AT determination is poorly assessable, i.e. due to changes in respiration.
• obese subjects (BMI >30)

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Athletes groups	Identification of two groups of athletes (those with identified double anaerobic threshold and those without)	immediately after the incremental cardiopulmonary exercise test evaluation

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Groups differences in age	Assess whether there are differences in age (years) between the two groups of subjects.	immediately after the incremental cardiopulmonary exercise test evaluation
Groups differences in sport practised	Assess whether the two groups of subjects differ in term of the sport practised (information collected during patient interview)	immediately after the incremental cardiopulmonary exercise test evaluation
Groups differences in exercise performance	Assess whether the two groups of subjects differ in term of exercise performance (peak power (Watts) reached during CPET)	immediately after the incremental cardiopulmonary exercise test evaluation
Groups differences in VO2	Assess whether there are differences in the oxygen intake VO2 (cardiopulmonary exercise test) between the two groups	immediately after the incremental cardiopulmonary exercise test evaluation
Groups differences in VE/VCO2 slope	Assess whether there are differences in minute ventilation/carbon dioxide production relationship VE/VCO2 slope (cardiopulmonary exercise test) between the two groups	immediately after the incremental cardiopulmonary exercise test evaluation
Groups differences in VE	Assess whether there are differences in minute ventilation VE (cardiopulmonary exercise test) between the two groups	immediately after the incremental cardiopulmonary exercise test evaluation
Differences in VO2 at the two thresholds	Highlight the differences in oxygen intake VO2 (cardiopulmonary exercise test), in the subjects with double anaerobic threshold, at the two thresholds.	immediately after the incremental cardiopulmonary exercise test evaluation
Differences in VE/VCO2 at the two thresholds	Highlight the differences in minute ventilation/carbon dioxide production relationship VE/VCO2 slope (cardiopulmonary exercise test), in the subjects with double anaerobic threshold, at the two thresholds.	immediately after the incremental cardiopulmonary exercise test evaluation
Differences in VE at the two thresholds	Highlight the differences in minute ventilation VE (cardiopulmonary exercise test), in the subjects with double anaerobic threshold, at the two thresholds.	immediately after the incremental cardiopulmonary exercise test evaluation

Collaborators and Investigators

• Sponsor: Centro Cardiologico Monzino
• Collaborators: Azienda Ospedaliero-Universitaria Careggi; University of Foggia
• Investigators: Principal Investigator: Piergiuseppe Agostoni, Prof., Centro Cardiologico Monzino

Study record dates

Study Major Dates

• Study Start (Actual): March 15, 2022
• Primary Completion (Anticipated): December 1, 2023
• Study Completion (Anticipated): December 1, 2023

Study Registration Dates

• First Submitted: February 21, 2023
• First Submitted That Met QC Criteria: March 2, 2023
• First Posted (Actual): March 15, 2023

Study Record Updates

• Last Update Posted (Actual): March 15, 2023
• Last Update Submitted That Met QC Criteria: March 2, 2023
• Last Verified: February 1, 2023

More Information

Terms related to this study

• Other Study ID Numbers: CCM 1719

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No