Acta Med. 2026, 69: 3-10
https://doi.org/10.14712/18059694.2026.10
Structural and Functional Determinants of Oxygen Transport in Exercise: The Role of Total Hemoglobin Mass
References
1. AK. Cardiovascular hemodynamics. JAMA. 1968 May 20; 204(8): 742.
<https://doi.org/10.1001/jama.1968.03140210098037>
2. Endrys J. Invazivní hemodynamické metody (Thesis). Prague: Charles University, 2004. 116 pp.
3. Stouffer GA, Klein JL. Cardiovascular Hemodynamics for the Clinician. Cardiovascular Hemodynamics for the Clinician: Third Edition. Wiley, 2025. 1–464 p.
4. DN, Beck KC, Shen PH, Eickhoff TJ, Halliwill JR, Joyner MJ. Influence of age and gender on cardiac output-VO2 relationships during submaximal cycle ergometry. J Appl Physiol (1985). 1998; 84(2): 599–605.
<https://doi.org/10.1152/jappl.1998.84.2.599>
5. JS, Wu MH, Mao TY, Fu TC, Hsu CC. Effects of normoxic and hypoxic exercise regimens on cardiac, muscular, and cerebral hemodynamics suppressed by severe hypoxia in humans. J Appl Physiol. 2010; 109(1): 219–29.
<https://doi.org/10.1152/japplphysiol.00138.2010>
6. PD. Limiting factors of exercise performance. Dtsch Z Sportmed. 2010; 61(5): 108–11.
7. IE, Zotkin SV, Korneev PV, Koprov SV, Grushin AA. Relationship between total hemoglobin mass and competitive performance in endurance athletes. J Sports Med Phys Fitness. 2019 Feb; 59(3): 352–6.
8. I, Zotkin S, Korneev P, Koprov S, Grushin A. Comprehensive overview of hemoglobin mass and blood volume in elite athletes across a wide range of different sporting disciplines. J Sports Med Phys Fitness. 2019 Feb; 59(2): 179-86.
9. I, Millet GP, Zelenkova I, Bourdillon N. Hemoglobin Mass and Blood Volume in Swimming: A Comparison Between Highly Trained, Elite, and World-Class Swimmers. Int J Sports Physiol Perform. 2023 Nov 1; 18(11): 1357–61.
<https://doi.org/10.1123/ijspp.2023-0133>
10. JM, Plumb JOM, Clissold E, et al. Hemoglobin concentration, total hemoglobin mass and plasma volume in patients: Implications for anemia. Haematologica. 2017 Aug 31; 102(9): 1477–85.
<https://doi.org/10.3324/haematol.2017.169680>
<PubMed>
11. R, Fikenzer S, Hoppe S, Busse M. Normal Values of Hemoglobin Mass and Blood Volume in Young, Active Women and Men. Int J Sports Med. 2019; 40(4): 236–44.
12. W, Prommer N. Impact of alterations in total hemoglobin mass on VO2max. Exerc Sport Sci Rev. 2010; 38(2): 68–75.
<https://doi.org/10.1097/JES.0b013e3181d4957a>
13. J, Sitkowski D, Orysiak J, Pokrywka A, Szygula Z. Total haemoglobin mass, blood volume and morphological indices among athletes from different sport disciplines. Arch Med Sci. 2013; 9(5): 780–7.
<https://doi.org/10.5114/aoms.2013.36926>
<PubMed>
14. K, Wolfarth B, Winchenbach P, et al. Blood volume and hemoglobin mass in elite athletes of different disciplines. Int J Sports Med. 2001; 22(7): 504–12.
<https://doi.org/10.1055/s-2001-17613>
15. C, Keiser S, Robach P, Lundby C. CORP: The assessment of total hemoglobin mass by carbon monoxide rebreathing. J Appl Physiol. 2017; 123(3): 645–54.
<https://doi.org/10.1152/japplphysiol.00185.2017>
16. W, Lundby C. Blood doping and its detection. Blood. 2011; 118(9): 2395–404.
<https://doi.org/10.1182/blood-2011-02-303271>
17. JK, Fogh-Andersen N, Bulow K, Devantier A. Blood and plasma volumes determined by carbon monoxide gas, 99mTc-labelled erythrocytes, 125 I-albumin and the T 1824 technique. Scand J Clin Lab Invest. 1991 Jan 29; 51(2): 185–90.
<https://doi.org/10.1080/00365519109091106>
18. W, Prommer N. The optimised CO-rebreathing method: A new tool to determine total haemoglobin mass routinely. Eur J Appl Physiol. 2005; 95(5–6): 486–95.
<https://doi.org/10.1007/s00421-005-0050-3>
19. T, Lenian I, Aamot IL, Dalen H. Safety of the CO-Rebreathing Method in Patients with Coronary Artery Disease. Med Sci Sports Exerc. 2016 Jan; 48(1): 33–8.
<https://doi.org/10.1249/MSS.0000000000000729>
20. CJ, Hopkins WG, Burge CM. Errors of measurement for blood volume parameters: a meta-analysis. J Appl Physiol. 2005; 99: 1745–58.
<https://doi.org/10.1152/japplphysiol.00505.2005>
21. Schmidt W. Classification of total hemoglobin mass and blood volume. Bloodtec GmbH. 2019.
22. W, Prommer N. Effects of various training modalities on blood volume. Scand J Med Sci Sports. 2008; 18 Suppl 1: 57–69.
<https://doi.org/10.1111/j.1600-0838.2008.00833.x>
23. N, Wachsmuth N, Thieme I, et al. Influence of endurance training during childhood on total hemoglobin mass. Front Physiol. 2018 Mar; 9: 1–9.
<https://doi.org/10.3389/fphys.2018.00251>
<PubMed>
24. T, Wehrlin JP. Does hemoglobin mass increase from age 16 to 21 and 28 in elite endurance athletes? Med Sci Sports Exerc. 2011; 43(9): 1735–43.
<https://doi.org/10.1249/MSS.0b013e3182118760>
25. N, Thoma S, Quecke L, et al. Total hemoglobin mass and blood volume of Elite Kenyan runners. Med Sci Sports Exerc. 2010; 42(4): 791–7.
<https://doi.org/10.1249/MSS.0b013e3181badd67>
26. G, Strunz J, Frese F, Bärtsch P, Friedmann-Bette B. Dependence of hemoglobin mass estimation with the optimized CO-rebreathing method on different spectrophotometers. Scand J Med Sci Sports. 2012; 22(2): 224–31.
<https://doi.org/10.1111/j.1600-0838.2010.01247.x>
27. YO, Saugy M, Pottgiesser T, Robinson N. Detection of EPO doping and blood doping: The haematological module of the Athlete Biological Passport. Drug Test Anal. 2012; 4(11): 846–53.
<https://doi.org/10.1002/dta.406>
28. A, Borry P, et al. Future opportunities for the Athlete Biological Passport. Front Sports Act Living. 2022 Nov; 4: 1–6.
29. A, Eronen T, Koponen A, Tikkanen H, Peltonen JE. Variability in hemoglobin mass response to altitude training camps. Scand J Med Sci Sports. 2021 Jan 1; 31(1): 44–51.
<https://doi.org/10.1111/sms.13804>
30. T, Larsson S, Rix M, et al. Intravascular volumes evaluated by a carbon monoxide rebreathing method in patients undergoing chronic hemodialysis. Hemodial Int. 2020; 24(2): 252–60.
<https://doi.org/10.1111/hdi.12820>
31. C, Birkner P, Seiler F, et al. Applying the optimized CO rebreathing method for measuring blood volumes and hemoglobin mass in heart failure patients. Front Physiol. 2018 Nov 12; 9: 1603.
<https://doi.org/10.3389/fphys.2018.01603>
<PubMed>
32. PP, Crisafulli A. Gender Differences in Hemodynamic Regulation and Cardiovascular Adaptations to Dynamic Exercise. Curr Cardiol Rev. 2019 Mar 25; 16(1): 65–72.
<https://doi.org/10.2174/1573403X15666190321141856>
<PubMed>
33. C, Rasmussen P, Sørensen H, et al. Cardiac output during exercise: A comparison of four methods. Scand J Med Sci Sports. 2015 Feb 1; 25(1): 20–7.
34. PD. Determinants of Maximal Oxygen Transport and Utilization. Annu Rev Physiol. 1996; 58(1): 21–50.
<https://doi.org/10.1146/annurev.ph.58.030196.000321>
35. TW. Circulatory responses to exercise: Are we misreading fick? Chest. 2005; 127(3): 1023–30.
<https://doi.org/10.1378/chest.127.3.1023>
36. AC. Determination of Cardiac Output by Equating Venous Return Curves with Cardiac Response Curves. Physiol Rev. 1955 Jan; 35: 122–9.
<https://doi.org/10.1152/physrev.1955.35.1.123>
37. TW. The circulatory response to exercise: role of the peripheral pump. Int J Sports Med. 2001; 22(8): 558–65.
<https://doi.org/10.1055/s-2001-18526>
38. A, Moatemri F, Kovalska O, et al. Responses to exercise training in patients with heart failure. Analysis by oxygen transport steps. Int J Cardiol. 2021 May 1; 330: 120–7.
<https://doi.org/10.1016/j.ijcard.2021.02.004>
39. C, Pentz B, Sehgal A, Montero D. Differences in Cardiac Output and Aerobic Capacity Between Sexes Are Explained by Blood Volume and Oxygen Carrying Capacity. Front Physiol. 2022 Mar 17; 13: 747903.
<https://doi.org/10.3389/fphys.2022.747903>
<PubMed>
40. PL, Cureton KJ, Outz H, Wilson G. Relationship of cardiac size to maximal oxygen uptake and body size in men and women. Int J Sports Med. 1991; 12(4): 369–73.
<https://doi.org/10.1055/s-2007-1024696>
41. Q, Levine BD. Cardiovascular response to exercise in women. Med Sci Sports Exerc. 2005 Aug; 37(8): 1433–5.
<https://doi.org/10.1249/01.mss.0000174886.08219.85>
42. KF, Bruce RA. Maximal cardiac function in sedentary normal men and women: comparison of age-related changes. J Appl Physiol Respir Environ Exerc Physiol. 1982; 53(4): 799–804.
43. E, Solli GS, Nyberg SK, Hoff J, Helgerud J. Stroke volume does not plateau in female endurance athletes. Int J Sports Med. 2012; 33(9): 734–9.


