42 years ago--development of the concepts of ventilatory and lactate threshold.

At the Third Pan-American Congress of Sport Physicians in Chicago in 1959 we reported the physiological and clinical significance of the spiroergometric determination of the aerobic-anaerobic turnover point for judging the performance of sick and healthy persons for the first time. In this context a distinction was made between a ventilatory and a lactate-related (arterial blood) method of determination. We called the former method the 'point of optimal ventilatory efficiency (PoW)', and the latter one 'endurance performance limit'. In the 1950s the clinical spiroergometric examination of patients and athletes for the determination of the aerobic performance capacity was consistently based on the measurement of the maximal oxygen uptake. As entering the individual border area of the performance capacity of a patient with, for example, cardiopulmonary disease, can provoke accidents, we started to think about a criterion in connection with submaximal work in 1954. Determination of pyruvate and lactic acid in the venous blood did not prove to be a valid parameter. If the spiroergometric values were entered into a coordinate system the most striking similarities during increasing exercise would become evident between the curve of the minute ventilation and the curve of the arterial lactate. The findings were interpreted as follows: during lower grades of performance the oxygen demand in the working muscle cells was saturated, whereas in the case of increasing exercise intensity an additional anaerobic metabolism was necessary. We termed the maximal work load which was covered nearly completely aerobically as the PoW and designated heart frequency at this point as 'pulse endurance limit'. The determination of the parameter was derived in the coordinate system with a tangent to the curve of the minute ventilation as well as to the curve of the arterial lactate. The results of patients and athletes were first published in 1959.