Heart failure impairs cerebral oxygenation during exercise in patients with COPD

Oliveira, Mayron F.; Arbex, Flávio; Alencar, Maria Clara; Soares, Aline Alves; Borghi‐Silva, Audrey; Almeida, Dirceu Rodrigues; Neder, J. Alberto

doi:10.1183/09031936.00090913

Cited by 14 publications

(8 citation statements)

References 11 publications

(18 reference statements)

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“…Two studies reported a decline in cerebral O 2 Hb in response to cycling in the patient group. 42,50 Oliveira et al reported that COPD patients with HF demonstrated a decline in PFC O 2 Hb, which is consistent with the findings of Goulart et al who reported a decrease in the PFC O 2 Hb in the HF group. 42,50 Three studies examined the tHb response to cycling.…”

Section: Pre-frontal Cortical Oxygenation and Deoxygenation Response ...supporting

confidence: 80%

“…42,50 Oliveira et al reported that COPD patients with HF demonstrated a decline in PFC O 2 Hb, which is consistent with the findings of Goulart et al who reported a decrease in the PFC O 2 Hb in the HF group. 42,50 Three studies examined the tHb response to cycling. 9,13,43 Two studies 9,43 reported an increase in PFC tHb compared to baseline in COPD patients, while one study reported that COPD patients with HF demonstrated a decrease in PFC blood flow in response to exercise compared to COPD controls.…”

Section: Pre-frontal Cortical Oxygenation and Deoxygenation Response ...supporting

confidence: 80%

“…Twenty-nine articles were included in this scoping review. [2][3][4][5]9,13,17,20,21,[31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50] Quality assessment score of articles ranged between 63% and 88% (10-13 maximum points) with a mean of 72%. 17 studies scored between 60% and 74%, (Table A2).…”

Section: Resultsmentioning

confidence: 99%

“…Of the studies that examined cerebral oxygenation (n ¼ 8), five studies 13,[41][42][43]47 indicated that oxygen delivery (O 2 Hb) levels increased during exercise and one study 9 reported no significant changes to O 2 Hb in COPD patients (Table 3). Two studies reported a decline in cerebral O 2 Hb in response to cycling in the patient group.…”

Section: Pre-frontal Cortical Oxygenation and Deoxygenation Response ...mentioning

confidence: 99%

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Muscle and cerebral oxygenation during cycling in chronic obstructive pulmonary disease: A scoping review

et al. 2021

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To synthesize evidence for prefrontal cortex (PFC), quadriceps, and respiratory muscle oxygenation using near-infrared spectroscopy (NIRS) during cycling in individuals with chronic obstructive pulmonary disease (COPD). A scoping review was performed searching databases (inception-August 2020): Ovid MEDLINE, EMBASE, Cochrane Systematic Reviews, Cochrane Central Register of Controlled Clinical Trials, CINAHL, SPORTDiscus and Pedro. The search focused on COPD, cycling, and NIRS outcomes. 29 studies (541 COPD participants) were included. Compared to healthy individuals (8 studies), COPD patients at lower cycling workloads had more rapid increases in vastus lateralis (VL) deoxygenated hemoglobin (HHb); lower increases in VL total hemoglobin (tHb) and blood flow; and lower muscle tissue saturation (StO2). Heliox and bronchodilators were associated with smaller and slower increases in VL HHb. Heliox increased VL and intercostal blood flow compared to room air and supplemental oxygen in COPD patients (1 study). PFC oxygenated hemoglobin (O2Hb) increased in COPD individuals during cycling in 5 of 8 studies. Individuals with COPD and heart failure demonstrated worse VL and PFC NIRS outcomes compared to patients with only COPD—higher or more rapid increase in VL HHb and no change or decrease in PFC O2Hb. Individuals with COPD present with a mismatch between muscle oxygen delivery and utilization, characterized by more rapid increase in VL HHb, lower muscle O2Hb and lower muscle StO2. PFC O2Hb increases or tends to increase in individuals with COPD during exercise, but this relationship warrants further investigation. NIRS can be used to identify key deoxygenation thresholds during exercise to inform PFC and muscle oxygenation.

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Section: Pre-frontal Cortical Oxygenation and Deoxygenation Response ...supporting

confidence: 80%

Section: Pre-frontal Cortical Oxygenation and Deoxygenation Response ...supporting

confidence: 80%

Section: Resultsmentioning

confidence: 99%

Section: Pre-frontal Cortical Oxygenation and Deoxygenation Response ...mentioning

confidence: 99%

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Muscle and cerebral oxygenation during cycling in chronic obstructive pulmonary disease: A scoping review

et al. 2021

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“…The combined effects of ''hypoxic'' (COPD-induced) and ''ischemic'' (CHF-related) hypoxia may impair cerebral blood flow and oxygenation during whole-body exercise in coexistent COPD-CHF. In fact, it was found that lower mean arterial pressure and cardiac output in association with a low arterial partial pressure of CO 2 in COPD-CHF led to poorer resting cerebral blood flow and oxygenation vs. COPD (Figure 4; Oliveira et al, 2013Oliveira et al, , 2016. Such differences were magnified when transitioning to exercise: whereas cerebral blood flow increased by ∼40% in COPD, a drop of ∼10% was observed in COPD-CHF (Oliveira et al, 2016).…”

Section: Chronic Obstructive Pulmonary Disease/heart Failure Overlapmentioning

confidence: 96%

The Exercising Brain: An Overlooked Factor Limiting the Tolerance to Physical Exertion in Major Cardiorespiratory Diseases?

Marillier

Gruet

Bernard

et al. 2022

Front. Hum. Neurosci.

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“Exercise starts and ends in the brain”: this was the title of a review article authored by Dr. Bengt Kayser back in 2003. In this piece of work, the author highlights that pioneer studies have primarily focused on the cardiorespiratory-muscle axis to set the human limits to whole-body exercise tolerance. In some circumstances, however, exercise cessation may not be solely attributable to these players: the central nervous system is thought to hold a relevant role as the ultimate site of exercise termination. In fact, there has been a growing interest relative to the “brain” response to exercise in chronic cardiorespiratory diseases, and its potential implication in limiting the tolerance to physical exertion in patients. To reach these overarching goals, non-invasive techniques, such as near-infrared spectroscopy and transcranial magnetic stimulation, have been successfully applied to get insights into the underlying mechanisms of exercise limitation in clinical populations. This review provides an up-to-date outline of the rationale for the “brain” as the organ limiting the tolerance to physical exertion in patients with cardiorespiratory diseases. We first outline some key methodological aspects of neuromuscular function and cerebral hemodynamics assessment in response to different exercise paradigms. We then review the most prominent studies, which explored the influence of major cardiorespiratory diseases on these outcomes. After a balanced summary of existing evidence, we finalize by detailing the rationale for investigating the “brain” contribution to exercise limitation in hitherto unexplored cardiorespiratory diseases, an endeavor that might lead to innovative lines of applied physiological research.

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Cardiovascular Comorbidity in Chronic Lung Disease: The Role of Cardiopulmonary Exercise Testing

Neder

Rocha

Arbex

et al. 2020

Cardiac Considerations in Chronic Lung Disease

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Heart failure impairs cerebral oxygenation during exercise in patients with COPD

Cited by 14 publications

References 11 publications

Muscle and cerebral oxygenation during cycling in chronic obstructive pulmonary disease: A scoping review

Muscle and cerebral oxygenation during cycling in chronic obstructive pulmonary disease: A scoping review

The Exercising Brain: An Overlooked Factor Limiting the Tolerance to Physical Exertion in Major Cardiorespiratory Diseases?

Cardiovascular Comorbidity in Chronic Lung Disease: The Role of Cardiopulmonary Exercise Testing

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