Cerebral blood flow changes during intermittent acute hypoxia in patients with heart failure

Mansur, Antônio de Pádua; Alvarenga, Glaura Souza; Kopel, Liliane; Gutierrez, Marco Antônio; Consolim‐Colombo, Fernanda Marciano; Abrahão, Ludhmila Hajjar; Lage, Silvia G.

doi:10.1177/0300060518791691

Cited by 9 publications

(5 citation statements)

References 30 publications

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“…Our current findings related to ICA hemodynamics during IH are in line with other studies that have utilized other measures to assess cerebral hemodynamics (22,25,45). Recently, Liu et al (22) used transcranial Doppler and demonstrated that acute cyclic IH augmented MCA velocity up to 20% with no change in arterial pressure.…”

Section: Discussionsupporting

confidence: 90%

Intermittent hypoxia enhances shear-mediated dilation of the internal carotid artery in young adults

Iwamoto

Hanson

Bock

et al. 2020

Journal of Applied Physiology

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Cyclic intermittent hypoxia (IH) increases cerebral blood velocity. This enhanced velocity augments the commensurate shear stimulus and may subsequently increase cerebrovascular endothelial function. This study aimed to examine the effects of cyclic IH on hypercapnia-induced shear-mediated dilation of the internal carotid artery (ICA); a potential index of cerebrovascular endothelial function. Shear-mediated dilation was measured in nine adults (22±4yrs) before as well as after 50min of cyclic IH [5 cycles, 4min normoxia followed by 6min hypoxia (target 80% SpO2) per cycle] and control normoxia (sham, 50min continuous normoxia) on separate days (≥72hrs apart). ICA diameter and velocity were measured using Doppler ultrasound during cyclic IH and hypercapnia. Shear-mediated dilation was induced by 3min of hypercapnia (ΔPETCO2, IH; pre 10.1±1.0mmHg, post 10.8±1.3mmHg, sham; pre 10.5±1.5mmHg, post 10.8±1.5mmHg) and was calculated as the percent rise in peak, relative to, baseline diameter. Hypoxia increased ICA blood flow and shear rate (SR) during each cycle [blood flow; 322±90 to 406±74ml/min, P<0.01, SR; 179±42 to 207±55/s, P=0.06, baseline to hypoxia (average of last minute of each cycle)] which normalized during the succeeding normoxic period (blood flow; 322±90 to 329±68ml/min, P=0.54, SR; 179±42 to 176±32/s, P=0.56). As such, shear-mediated dilation increased following cyclic IH (4.6±1.3% to 6.2±2.2%, P<0.01), but not control normoxia (4.9±1.4% to 4.9±1.4%, P=0.92). Our data indicate that increased blood flow and SR during cyclic IH enhances shear-mediated dilation of the ICA in young adults. These results suggest that cyclic IH could be used to optimize cerebral vascular health.

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Section: Discussionsupporting

confidence: 90%

Intermittent hypoxia enhances shear-mediated dilation of the internal carotid artery in young adults

Iwamoto

Hanson

Bock

et al. 2020

Journal of Applied Physiology

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“…For adult patients without cancer, studies have indicated that diminished gas exchange in the lungs increases cerebrovascular pressure, which can lead to damage in small cerebral arteries. 10 , 11 Hypoxia has been shown to induce chronic low-grade systemic inflammation, which can also contribute to endothelial dysfunction and reduced small artery elasticity (SAE) 12 , 13 These mechanisms can increase the risk of neurocognitive problems. 14 , 15 …”

Section: Introductionmentioning

confidence: 99%

Neurocognitive impairment associated with chronic morbidity in long-term survivors of Hodgkin Lymphoma

Phillips,

Mulrooney,

Williams

et al. 2023

Blood Advances

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Thoracic radiation is associated with significant cardiopulmonary morbidities in long-term Hodgkin lymphoma (HL) survivors and may impact neurocognitive outcomes. Survivors (N=204, 52.5% female, mean[SD] age 36.6[8.01] years), treated with thoracic radiation, and age-, sex- and race/ethnicity-matched community controls (N=205, 51.7% female, age 36.7[9.17] years) completed standardized neurocognitive testing, echocardiography, pulmonary function tests, and vascular studies during the same visit. Treatments were abstracted from medical records. Cardiac (i.e., left ventricular ejection fraction [LVEF], global longitudinal strain [GLS]), vascular (i.e., large [LAE] and small artery elasticity [SAE]), pulmonary (i.e., diffusing capacity of the lungs for carbon monoxide [DLCO], forced expiratory volume [FEV1]), and chronic health conditions were evaluated for associations with age-adjusted neurocognitive performance using multivariable linear regression. Compared to controls, survivors had lower performance (P's<0.05) in visuomotor (0.11 v 0.41), visual processing speed (0.25 v 0.64), short-term recall (-0.24 v 0.12), and flexibility (-0.04 v 0.28). Survivors had lower pulmonary (FEV1 82.69% v 96.23%; DLCOcorr 83.31% v 98.03%), cardiac (LVEF 56% v 60%; GLS -18.30% v -20.37%), and vascular function (SAE 6.94 v 8.25 mL/mm Hg) than controls (all p's<0.001). FEV1 was associated with visuomotor (β[95% CI] 0.11[0.003-0.02], p=0.008) and visual processing speed (0.01[0.004-0.20], p=0.05), and flexibility (0.01[-0.001-0.03], p= 0.05). GLS was associated with short-term recall (0.06[0.005-0.11], p=0.03). SAE was associated with flexibility (0.09[0.02-0.16], p=0.007). Neurocognitive outcomes were also associated with moderate to severe neurologic chronic conditions (p's<0.05). Findings suggest a link between subclinical cardiopulmonary and vascular findings, neurologic morbidity, and neurocognitive impairments. Prevention of health morbidity may benefit neurocognitive outcomes.

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“…Hypoxia is an important factor causing vascular disease, and further vascular changes aggravate hypoxia ( Rathnasamy et al, 2015 ). It has been reported that hypoxia environment can cause many pathological changes of blood vessels ( Mansur et al, 2018 ). Subsequently, we focused on the blood vessels in the brain tissue.…”

Section: Discussionmentioning

confidence: 99%

Allergic Asthma-Induced Cognitive Impairment is Alleviated by Dexamethasone

et al. 2021

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Allergic asthma is a typical chronic inflammatory disease of respiratory tract. Clinical data shows that patients with allergic asthma have different degrees of cognitive dysfunction. The molecular mechanism underlying the pathogenesis of asthma-induced cognitive disorder is not yet well defined. Dexamethasone (DEX), one of the first-line drugs being widely used in the treatment of asthma, has not been reported to have an effect on cognitive dysfunction in mice model. To investigate the effect of asthma on cognitive impairment as well as the effect of DEX on asthma-caused morphological and behavioral changes, C57BL/6J mice received treatment with house dust mites (HDM) for 60 days to become allergic asthma model mice, and a group of HDM-treated asthma model mice were treated with DEX. HDM-treated asthma model mice exhibited increased airway hyperresponsiveness (AHR) and inflammatory infiltration in lung tissue. An elevated level of IL-4, IL-5, and TNF-α was detected in bronchoalveolar lavage fluid (BALF) by Luminex liquid suspension chip. Asthma model mice also presented memory deficits accompanied with morphological changes at the synaptic levels in the cortex and hippocampus. Meanwhile, vascular edema and increased expression of HIF-1α and HIF-2α were found in the brain of asthma model mice. Interestingly, DEX treatment could reverse the inflammatory changes in asthma model mice airway, rescue the cognitive impairment and improve the synaptic plasticity. Besides, DEX significantly decreased the expression of HIF-1α and HIF-2α in mice brain and lung. These processes may be used to decipher the complex interplay and pathological changes between asthma and cognition. This study provides laboratory evidence for the prevention and treatment of cognitive malfunction induced by asthma.

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Cerebral blood flow changes during intermittent acute hypoxia in patients with heart failure

Cited by 9 publications

References 30 publications

Intermittent hypoxia enhances shear-mediated dilation of the internal carotid artery in young adults

Intermittent hypoxia enhances shear-mediated dilation of the internal carotid artery in young adults

Neurocognitive impairment associated with chronic morbidity in long-term survivors of Hodgkin Lymphoma

Allergic Asthma-Induced Cognitive Impairment is Alleviated by Dexamethasone

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