title: Cerebral oxygenation decreases during exercise in humans with beta-adrenergic blockade.
abstract: OBJECTIVE
  Beta-blockers reduce exercise capacity by attenuated increase in cardiac output, but it remains unknown whether performance also relates to attenuated cerebral oxygenation.
  
  
  METHODS
  Acting as their own controls, eight healthy subjects performed a continuous incremental cycle test to exhaustion with or without administration of the non-selective beta-blocker propranolol. Changes in cerebral blood flow velocity were measured with transcranial Doppler ultrasound and those in cerebral oxygenation were evaluated using near-infrared spectroscopy and the calculated cerebral mitochondrial oxygen tension derived from arterial to internal jugular venous concentration differences.
  
  
  RESULTS
  Arterial lactate and cardiac output increased to 15.3 +/- 4.2 mM and 20.8 +/- 1.5 L min(-1) respectively (mean +/- SD). Frontal lobe oxygenation remained unaffected but the calculated cerebral mitochondrial oxygen tension decreased by 29 +/- 7 mmHg (P < 0.05). Propranolol reduced resting heart rate (58 +/- 6 vs. 69 +/- 8 beats min(-1)) and at exercise exhaustion, cardiac output (16.6 +/- 3.6 L min(-1)) and arterial lactate (9.4 +/- 3.7 mM) were attenuated with a reduction in exercise capacity from 239 +/- 42 to 209 +/- 31 W (all P < 0.05). Propranolol also attenuated the increase in cerebral blood flow velocity and frontal lobe oxygenation (P < 0.05) whereas the cerebral mitochondrial oxygen tension decreased to a similar degree as during control exercise (delta 28 +/- 10 mmHg; P < 0.05).
  
  
  CONCLUSIONS
  Propranolol attenuated the increase in cardiac output of consequence for cerebral perfusion and oxygenation. We suggest that a decrease in cerebral oxygenation limits exercise capacity.
authors.affiliation: Department of Anaesthesia, The Copenhagen Muscle Research Centre, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. tseifert78@gmail.com
authors.forename: T
authors.initials: T
authors.lastname: Seifert
authors.forename: P
authors.initials: P
authors.lastname: Rasmussen
authors.forename: N H
authors.initials: NH
authors.lastname: Secher
authors.forename: H B
authors.initials: HB
authors.lastname: Nielsen
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D001921:Brain / Q000098:blood supply / Q000187:drug effects / Q000378:metabolism*; D002245:Carbon Dioxide / Q000097:blood; D002302:Cardiac Output / Q000187:drug effects / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000187:drug effects / Q000502:physiology; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000187:drug effects / Q000502:physiology; D005625:Frontal Lobe / Q000098:blood supply / Q000187:drug effects / Q000378:metabolism; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D008928:Mitochondria / Q000378:metabolism; D010100:Oxygen / Q000097:blood / Q000378:metabolism*; D010313:Partial Pressure; D011433:Propranolol / Q000494:pharmacology; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D002245:Carbon Dioxide; D011433:Propranolol; D010100:Oxygen