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Acute Effects of a Maximal Cardiopulmonary Exercise Test on Cardiac Hemodynamic and Cerebrovascular Response and Their Relationship with Cognitive Performance in Individuals with Type 2 Diabetes
Cardiovascular and cerebrovascular diseases are prevalent in individuals with type 2 diabetes (T2D). Among people with T2D aged over 70 years, up to 45% might have cognitive dysfunction. Cardiorespiratory fitness ([Formula: see text] O(2)max) correlates with cognitive performances in healthy younger...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10138481/ https://www.ncbi.nlm.nih.gov/pubmed/37107835 http://dx.doi.org/10.3390/ijerph20085552 |
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author | Besnier, Florent Gagnon, Christine Monnet, Meghann Dupuy, Olivier Nigam, Anil Juneau, Martin Bherer, Louis Gayda, Mathieu |
author_facet | Besnier, Florent Gagnon, Christine Monnet, Meghann Dupuy, Olivier Nigam, Anil Juneau, Martin Bherer, Louis Gayda, Mathieu |
author_sort | Besnier, Florent |
collection | PubMed |
description | Cardiovascular and cerebrovascular diseases are prevalent in individuals with type 2 diabetes (T2D). Among people with T2D aged over 70 years, up to 45% might have cognitive dysfunction. Cardiorespiratory fitness ([Formula: see text] O(2)max) correlates with cognitive performances in healthy younger and older adults, and individuals with cardiovascular diseases (CVD). The relationship between cognitive performances, [Formula: see text] O(2)max, cardiac output and cerebral oxygenation/perfusion responses during exercise has not been studied in patients with T2D. Studying cardiac hemodynamics and cerebrovascular responses during a maximal cardiopulmonary exercise test (CPET) and during the recovery phase, as well as studying their relationship with cognitive performances could be useful to detect patients at greater risk of future cognitive impairment. Purposes: (1) to compare cerebral oxygenation/perfusion during a CPET and during its post-exercise period (recovery); (2) to compare cognitive performances in patients with T2D to those in healthy controls; and (3) to examine if [Formula: see text] O(2)max, maximal cardiac output and cerebral oxygenation/perfusion are associated with cognitive function in individuals with T2D and healthy controls. Nineteen patients with T2D (61.9 ± 7 years old) and 22 healthy controls (HC) (61.8 ± 10 years old) were evaluated on the following: a CPET test with impedance cardiography and cerebral oxygenation/perfusion using a near-infrared spectroscopy. Prior to the CPET, the cognitive performance assessment was performed, targeting: short-term and working memory, processing speed, executive functions, and long-term verbal memory. Patients with T2D had lower [Formula: see text] O(2)max values compared to HC (34.5 ± 5.6 vs. 46.4 ± 7.6 mL/kg fat free mass/min; p < 0.001). Compared to HC, patients with T2D showed lower maximal cardiac index (6.27 ± 2.09 vs. 8.70 ± 1.09 L/min/m(2), p < 0.05) and higher values of systemic vascular resistance index (826.21 ± 308.21 vs. 583.35 ± 90.36 Dyn·s/cm(5)·m(2)) and systolic blood pressure at maximal exercise (204.94 ± 26.21 vs. 183.61 ± 19.09 mmHg, p = 0.005). Cerebral HHb during the 1st and 2nd min of recovery was significantly higher in HC compared to T2D (p < 0.05). Executive functions performance (Z score) was significantly lower in patients with T2D compared to HC (−0.18 ± 0.7 vs. −0.40 ± 0.60, p = 0.016). Processing speed, working and verbal memory performances were similar in both groups. Brain tHb during exercise and recovery (−0.50, −0.68, p < 0.05), and O(2)Hb during recovery (−0.68, p < 0.05) only negatively correlated with executive functions performance in patients with T2D (lower tHb values associated with longer response times, indicating a lower performance). In addition to reduced [Formula: see text] O(2)max, cardiac index and elevated vascular resistance, patients with T2D showed reduced cerebral hemoglobin (O(2)Hb and HHb) during early recovery (0–2 min) after the CPET, and lower performances in executive functions compared to healthy controls. Cerebrovascular responses to the CPET and during the recovery phase could be a biological marker of cognitive impairment in T2D. |
format | Online Article Text |
id | pubmed-10138481 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-101384812023-04-28 Acute Effects of a Maximal Cardiopulmonary Exercise Test on Cardiac Hemodynamic and Cerebrovascular Response and Their Relationship with Cognitive Performance in Individuals with Type 2 Diabetes Besnier, Florent Gagnon, Christine Monnet, Meghann Dupuy, Olivier Nigam, Anil Juneau, Martin Bherer, Louis Gayda, Mathieu Int J Environ Res Public Health Article Cardiovascular and cerebrovascular diseases are prevalent in individuals with type 2 diabetes (T2D). Among people with T2D aged over 70 years, up to 45% might have cognitive dysfunction. Cardiorespiratory fitness ([Formula: see text] O(2)max) correlates with cognitive performances in healthy younger and older adults, and individuals with cardiovascular diseases (CVD). The relationship between cognitive performances, [Formula: see text] O(2)max, cardiac output and cerebral oxygenation/perfusion responses during exercise has not been studied in patients with T2D. Studying cardiac hemodynamics and cerebrovascular responses during a maximal cardiopulmonary exercise test (CPET) and during the recovery phase, as well as studying their relationship with cognitive performances could be useful to detect patients at greater risk of future cognitive impairment. Purposes: (1) to compare cerebral oxygenation/perfusion during a CPET and during its post-exercise period (recovery); (2) to compare cognitive performances in patients with T2D to those in healthy controls; and (3) to examine if [Formula: see text] O(2)max, maximal cardiac output and cerebral oxygenation/perfusion are associated with cognitive function in individuals with T2D and healthy controls. Nineteen patients with T2D (61.9 ± 7 years old) and 22 healthy controls (HC) (61.8 ± 10 years old) were evaluated on the following: a CPET test with impedance cardiography and cerebral oxygenation/perfusion using a near-infrared spectroscopy. Prior to the CPET, the cognitive performance assessment was performed, targeting: short-term and working memory, processing speed, executive functions, and long-term verbal memory. Patients with T2D had lower [Formula: see text] O(2)max values compared to HC (34.5 ± 5.6 vs. 46.4 ± 7.6 mL/kg fat free mass/min; p < 0.001). Compared to HC, patients with T2D showed lower maximal cardiac index (6.27 ± 2.09 vs. 8.70 ± 1.09 L/min/m(2), p < 0.05) and higher values of systemic vascular resistance index (826.21 ± 308.21 vs. 583.35 ± 90.36 Dyn·s/cm(5)·m(2)) and systolic blood pressure at maximal exercise (204.94 ± 26.21 vs. 183.61 ± 19.09 mmHg, p = 0.005). Cerebral HHb during the 1st and 2nd min of recovery was significantly higher in HC compared to T2D (p < 0.05). Executive functions performance (Z score) was significantly lower in patients with T2D compared to HC (−0.18 ± 0.7 vs. −0.40 ± 0.60, p = 0.016). Processing speed, working and verbal memory performances were similar in both groups. Brain tHb during exercise and recovery (−0.50, −0.68, p < 0.05), and O(2)Hb during recovery (−0.68, p < 0.05) only negatively correlated with executive functions performance in patients with T2D (lower tHb values associated with longer response times, indicating a lower performance). In addition to reduced [Formula: see text] O(2)max, cardiac index and elevated vascular resistance, patients with T2D showed reduced cerebral hemoglobin (O(2)Hb and HHb) during early recovery (0–2 min) after the CPET, and lower performances in executive functions compared to healthy controls. Cerebrovascular responses to the CPET and during the recovery phase could be a biological marker of cognitive impairment in T2D. MDPI 2023-04-18 /pmc/articles/PMC10138481/ /pubmed/37107835 http://dx.doi.org/10.3390/ijerph20085552 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Besnier, Florent Gagnon, Christine Monnet, Meghann Dupuy, Olivier Nigam, Anil Juneau, Martin Bherer, Louis Gayda, Mathieu Acute Effects of a Maximal Cardiopulmonary Exercise Test on Cardiac Hemodynamic and Cerebrovascular Response and Their Relationship with Cognitive Performance in Individuals with Type 2 Diabetes |
title | Acute Effects of a Maximal Cardiopulmonary Exercise Test on Cardiac Hemodynamic and Cerebrovascular Response and Their Relationship with Cognitive Performance in Individuals with Type 2 Diabetes |
title_full | Acute Effects of a Maximal Cardiopulmonary Exercise Test on Cardiac Hemodynamic and Cerebrovascular Response and Their Relationship with Cognitive Performance in Individuals with Type 2 Diabetes |
title_fullStr | Acute Effects of a Maximal Cardiopulmonary Exercise Test on Cardiac Hemodynamic and Cerebrovascular Response and Their Relationship with Cognitive Performance in Individuals with Type 2 Diabetes |
title_full_unstemmed | Acute Effects of a Maximal Cardiopulmonary Exercise Test on Cardiac Hemodynamic and Cerebrovascular Response and Their Relationship with Cognitive Performance in Individuals with Type 2 Diabetes |
title_short | Acute Effects of a Maximal Cardiopulmonary Exercise Test on Cardiac Hemodynamic and Cerebrovascular Response and Their Relationship with Cognitive Performance in Individuals with Type 2 Diabetes |
title_sort | acute effects of a maximal cardiopulmonary exercise test on cardiac hemodynamic and cerebrovascular response and their relationship with cognitive performance in individuals with type 2 diabetes |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10138481/ https://www.ncbi.nlm.nih.gov/pubmed/37107835 http://dx.doi.org/10.3390/ijerph20085552 |
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