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Home / Equine Research Bank / J Appl Physiol (1985) / Equine exercise-induced pulmonary hemorrhage: the role of hi...
Journal of applied physiology (Bethesda, Md. : 1985)2024; 137(5); 1359-1373; doi: 10.1152/japplphysiol.00575.2023

Equine exercise-induced pulmonary hemorrhage: the role of high left-heart pressures secondary to exercise-induced hypervolemia, and high inspiratory pressures.

Abstract: Exercise-induced pulmonary hemorrhage (EIPH) is common in racehorses. Stress failure of the blood-gas barrier causes EIPH when the transmural pulmonary capillary (Pcap)-alveolar pressure difference (Ptm) exceeds the barrier's stress failure threshold. Why Pcap increases is incompletely understood. We hypothesized that alterations in blood volume (BV) could affect left ventricular (LV) and pulmonary arterial wedge (PAW) pressures and Pcap, and correspondingly affect EIPH severity. Six thoroughbreds with EIPH exercised at the same treadmill speed (≈11.9 m/s [11.1, 12.2]; median [IQR]) before (≈119% V̇o; B), 2 h after 14 L depletion of blood (≈132% V̇o; D), and 2 h after reinfusing the blood (≈111% V̇o; R). LV, pulmonary arterial (PAP), PAW, and intrapleural (Ppl) pressures were measured throughout exercise. Pcap = (PAP + PAW)/2 and Ptm = (Pcap - Ppl). EIPH severity was assessed 60 min postexercise by tracheoendoscopy (EIPHgrade) and bronchoalveolar lavage erythrocyte number (BALRBC). A mixed-effect model and Tukey post hoc test analyzed the effects of BV changes on LV, PAW, Pcap, Ppl, Ptm, and EIPH. ≤ 0.05 was significant. Peak intrapleural inspiratory pressure (Ppl) was high (-41 mmHg), unaffected by changes in BV ( = 0.44), and did not contribute to fluctuations in Ptm and EIPH severity, whereas changes in BV did (EIPHgrade: = 0.01, BALRBC: = 0.003). EIPH prevalence was 100% with B and R but 50% with D. MaxPtm was not different between B (146 mmHg [140, 151]) and R (151 mmHg [137, 160]) but was lower for D (128 mmHg [127, 130]; B: = 0.005, R: = 0.02). Vascular pressures and Ppl fluctuated constantly during exercise and independently influenced Ptm. Left ventricular end diastolic (LVED) pressure was correlated with Ptm ( = 0.90, = 0.03) and EIPH = 0.82, = 0.004). Exercise BV was strongly correlated with EIPH severity in racehorses ( = 0.86, = 0.009). Hypervolemia induced by the infusion of erythrocyte-rich blood stored in the spleen is normal in high-speed thoroughbred exercise and increases capillary-alveolar transmural pressure (Ptm), leading to exercise-induced pulmonary hemorrhage (EIPH). In this study, decreasing blood volume reduced Ptm and EIPH. Large negative inspiratory pressures also contribute to high Ptm and the occurrence of EIPH. Ptm is dynamic and oscillates constantly during exercise. A significant relationship existed between circulating blood volume and EIPH severity in racehorses.
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Publication Date: 2024-10-10 PubMed ID: 39388286PubMed Central: PMC11573257DOI: 10.1152/japplphysiol.00575.2023Google Scholar: Lookup
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APA
Bayly WM, Leguillette R, Sides RH, Massie S, Guigand C, Jones KB, Warlick LM, Thueson EL, Troudt TA, Slocombe RF, Jones JH. (2024). Equine exercise-induced pulmonary hemorrhage: the role of high left-heart pressures secondary to exercise-induced hypervolemia, and high inspiratory pressures. J Appl Physiol (1985), 137(5), 1359-1373. https://doi.org/10.1152/japplphysiol.00575.2023

Publication

Journal of applied physiology (Bethesda, Md. : 1985)
ISSN: 1522-1601
NlmUniqueID: 8502536
Country: United States
Language: English
Volume: 137
Issue: 5
Pages: 1359-1373

Researcher Affiliations

Bayly, Warwick M
  • Department of Veterinary Clinical Sciences, Washington State University, College of Veterinary Medicine, Pullman, Washington, United States.
Leguillette, Renaud
  • Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada.
Sides, Raymond H
  • Department of Veterinary Clinical Sciences, Washington State University, College of Veterinary Medicine, Pullman, Washington, United States.
Massie, Shannon
  • Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada.
Guigand, Charline
  • Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada.
Jones, K Blythe
  • Department of Veterinary Clinical Sciences, Washington State University, College of Veterinary Medicine, Pullman, Washington, United States.
Warlick, Linnea M
  • Department of Veterinary Clinical Sciences, Washington State University, College of Veterinary Medicine, Pullman, Washington, United States.
Thueson, Emily L
  • Department of Veterinary Clinical Sciences, Washington State University, College of Veterinary Medicine, Pullman, Washington, United States.
Troudt, Tristan A
  • Department of Veterinary Clinical Sciences, Washington State University, College of Veterinary Medicine, Pullman, Washington, United States.
Slocombe, Ronald F
  • School of Veterinary and Agricultural Science, University of Melbourne, Werribee, Victoria, Australia.
Jones, James H
  • Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA, United States.

MeSH Terms

  • Animals
  • Horses
  • Physical Conditioning, Animal / physiology
  • Hemorrhage / physiopathology
  • Blood Volume / physiology
  • Male
  • Lung Diseases / physiopathology
  • Lung Diseases / etiology
  • Lung / physiopathology
  • Female
  • Pulmonary Wedge Pressure / physiology
  • Horse Diseases / physiopathology
  • Inhalation / physiology
  • Blood Pressure / physiology
  • Ventricular Function, Left / physiology

Grant Funding

  • The Grayson-Jockey Club Research Foundation
  • The Washington State Equine Research Fund
  • The Calgary Chair in Sports Medicine

Conflict of Interest Statement

No conflicts of interest, financial or otherwise, are declared by the authors.

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Citations

This article has been cited 1 times.
  1. Park T, Hong S, Murray L, Lee J, Shah A, Mesa JC, Lee H, Couetil L, Lee CH. Wearable smart textile band for continuous equine health monitoring.. Biosens Bioelectron 2026 Jan 15;292:118073.
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