Cardiorespiratory Fitness Mediates Cognitive Performance in Chronic Heart Failure Patients and Heart Transplant Recipients

Abstract

We compared cognitive profiles in chronic heart failure patients (HF), heart transplant recipients (HT) and healthy controls (HC) and examined the relationship between cardiorespiratory fitness (V˙O2peak), peak cardiac output (COpeak) and cognitive performance. Stable HT patients (n = 11), HF patients (n = 11) and HC (n = 13) (61.5 ± 8.5 years) were recruited. Four cognitive composite scores targeting different cognitive functions were computed from neuropsychological tests: working memory, processing speed, executive functions and verbal memory. Processing speed and executive function scores were higher, which indicates lower performances in HF and HT compared to HC (p < 0.05). V˙O2peak and first ventilatory threshold (VT1) were lower in HF and HT vs. HC (p < 0.01). COpeak was lower in HF vs. HT and HC (p < 0.01). Processing speed, executive function and verbal memory performances were correlated with V˙O2peak, VT1 and peak cardiac hemodynamics (p < 0.05). Mediation analyses showed that V˙O2peak and VT1 mediated the relationship between group and processing speed and executive function performances in HF and HT. COpeak fully mediated executive function and processing speed performances in HF only. V˙O2peak and COpeak were related to cognitive performance in the entire sample. In addition, V˙O2peak and VT1 fully mediated the relationship between group and executive function and processing speed performances.

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

“…Every subject realized a maximal incremental test (CPET) on a bicycle ergometer (Ergoline 800S, Bitz, Germany) using an incremental personalized protocol (ten to twenty watts per min stages), as previously published [ 19 , 20 , 22 ]; see indicated references for details.…”

“…Continuous electrocardiogram monitoring (Marquette, case 12, St. Louis, MO, USA), rating of perceived exertion (Borg Scale, 6–20) and manual blood pressure using a sphygmomanometer (Welch Allyn Inc., Skaneateles Falls, USA) every 2 min were monitored throughout the test [ 19 , 20 , 22 ]. Subjects used a facemask covering their mouth and nose which was attached to the flow module and to the gas sampling line.…”

“…Regular PA also has psychological and cognitive benefits for people with T2D [ 16 , 17 ]. Cardiorespiratory fitness ( O 2 max) correlates with cognitive performance in healthy young subjects, older adults [ 18 ], and individuals with cardiovascular diseases [ 19 , 20 ]. This suggests that cardiorespiratory fitness plays a crucial role in maintaining and improving cognitive functions.…”

COVEPIC (Cognitive and spOrt Virtual EPIC training) investigating the effects of home-based physical exercise and cognitive training on cognitive and physical functions in community-dwelling older adults: study protocol of a randomized single-blinded clinical trial

“…The neuropsychological assessment will include the following paper-pencil tests that will be administered in a fixed order: Rey auditory verbal learning test [ 40 ], Digit Span, an oral Trail Making Test with three conditions (1—counting from 1 to 20 (maximum of 30s); 2—naming letters from A to Z (maximum of 30 s); 3—alternating between naming numbers and letters in chronological and alphabetical order (e.g., 1-A-2-B) (maximum of 30 s) [ 41 ]), Phonological and Semantic Fluency from the D-KEFS battery (Letters P, T, L (60 s maximum); Categories: animals, men’s names (60 s maximum); Switching between naming fruit and furniture (60 s maximum) [ 42 ]), and Similarities subtest from the WAIS-IV [ 43 ]. These tests are validated and normalized for an older adult population [ 40 , 44 , 45 ]. The Similarities subtest will only be administered at baseline to obtain a measure of crystallized intelligence; it will be optional and performed according to the level of the participant’s fatigue.…”

Current recommendations regarding evaluation of cognitive functioning in organ transplant candidates

“…cross-sectional versus prospective). Although cross-sectional comparisons suggest transplant recipients perform better than transplant candidate populations on cognitive assessments [33,34], prospective, longitudinal assessments examining cognitive functioning trajectories and associated factors through posttransplant are overall limited and additional research is needed. However, recent publications in kidney, lung, and liver populations have provided valuable information.…”