Acute effects of a maximal cardiopulmonary exercise test on cardiac hemodynamic and cerebrovascular response and their relationship with cognitive performance in individuals with type II diabetes
Notice bibliographique
Résumé
Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Mirella and Lino Saputo Research Chair in Cardiovascular Diseases and the Prevention of Cognitive Decline from Université de Montréal at the Montreal Heart Institute. Montreal Heart Institute and the EPIC Center Foundations. FB are financially supported by a grant from the Fonds de Recherche du Québec – Santé (FRQ-S). Background/Introduction Cardiovascular and cerebrovascular disease are prevalent in type 2 diabetes (T2D) patient. Among people older than 70 years with T2D, up to 45% of might have cognitive dysfunction. Cardiorespiratory fitness (V̇O2peak) correlate with cognitive performances in healthy subjects, older adults, and people with CV diseases. The relationship between cognitive functions, V̇O2peak, cardiac output and cerebral oxygenation/perfusion responses during exercise has not been studied in patients with T2D. Studying cardiac and cerebrovascular hemodynamic responses during cardiopulmonary maximal exercise test (CPET) and its recovery phase and their relationship with cognition could be useful to detect patients at greater risk of future cognitive dysfunction. Purpose 1) To compare cerebral oxygenation/perfusion during a CPET and its post-exercise period (recovery), cognitive performances in T2D patients to those in healthy controls. 2) To examine if V̇O2peak, cardiac and cerebral hemodynamic are related to cognitive performances. Methods Nineteen T2D patients (61.9±7 years) and 22 healthy controls (HC) (61.8±10 years) were evaluated using a maximal CPET with impedance cardiography and cerebral oxygenation/perfusion (near-infrared spectroscopy) measure. The neuropsychological test battery evaluated short-term and working memory, processing speed, executive functions, and long-term verbal memory. Results T2D patients add a lower O2peak values compared to HC (34.5±5.6 vs 46.4±7.6 mL.kgFFM.min p<0.001). Peak cardiac index are also lowered compared to HC (p<0.05). Systemic vascular resistance index and systolic blood pressure at peak exercise were higher in T2D (p=0.005). Cerebral deoxyhemoglobin (HHb) during the 1st and 2nd min of the recovery remains significantly higher in HC compared to T2D (p<0.05). Executive functions were significantly lower in T2D patients compared to HC (p=0.016). Processing speed, working and verbal memory were similar in both groups. Total haemoglobin (tHb) during exercise and recovery, and oxyhemoglobin (O2Hb) during recovery only negatively correlated with executive function (p<0.05) in T2D patients (lower tHb values were associated with slower response times). Conclusion In addition to a reduced V̇O2peak and elevated vascular resistance, T2D patients showed a reduced cerebral O2Hb and HHb during early recovery (0 – 2 min) after peak exercise and a lower cognitive performance in executive function compared to healthy controls. Cerebrovascular responses with exercise and during the recovery phase could be a biological marker of cognitive impairment in T2D.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».