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Noninvasive Estimation of the Lactate Threshold in a Subject With Dissociated Ventilatory and Pulmonary Gas Exchange Indices^*

A Case Report

^* From the Institute of Membrane and Systems Biology (Dr. Whipp), University of Leeds, Leeds, UK; and Centro Cardiologico Monzino (Dr. Agostoni), Istituto di Ricovero e Cura a Carattere Scientifico, Istituto di Cardiologia, Università di Milano, Milan, Italy.

Correspondence to: Brian J. Whipp, PhD, DSc, University of Leeds, Institute of Membrane and Systems Biology, Worsley Building, Level 9, Leeds LS2 9JT, UK; e-mail: b.whipp{at}leeds.ac.uk

This case report describes the responses to incremental work-rate exercise in a healthy subject (with normal pulmonary function), for whom the pulmonary gas exchange (V-slope) and ventilatory-related indexes (ie, ventilatory equivalents and end-tidal partial pressures for O₂ and CO₂) uncharacteristically do not occur at the same metabolic rate. Based on the results of additional constant-work-rate exercise tests, we propose that in the (occasional) event of such a dissociation between the V-slope and ventilatory-related responses normally associated with the lactate threshold (L), then the V-slope index should take priority as the L estimator.

Key Words: acid base • exercise • ventilation