title: Effects of heart failure on cerebral blood flow in COPD: Rest and exercise.
abstract: Cerebral blood flow (CBF) and oxygenation (COx) are generally well-preserved in COPD. It is unknown whether prevalent cardiovascular co-morbidities, such as heart failure, may impair CBF and COx responses to exertion. Eighteen males with moderate-to-severe COPD (8 with and 10 without overlapping heart failure) underwent a progressive exercise test with pre-frontal CBF and COx measurements (indocyanine green and near-infrared spectroscopy). Mean arterial pressure and cardiac output were lower from rest to exercise in overlap. Only COPD patients demonstrated an increase in arterialized PCO2 towards the end of progressive exercise. CBF index was consistently higher and increased further by ∼40% during exercise in COPD whereas a ∼10% reduction was observed in overlap. COx was lower in overlap despite preserved arterial oxygenation. In conclusion, heart failure introduces pronounced negative effects on CBF and COx in COPD which may be associated with clinically relevant outcomes, including dyspnea, exercise intolerance, cerebrovascular disease and cognitive impairment.
authors.affiliation: Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Mayron F
authors.initials: MF
authors.lastname: Oliveira
authors.affiliation: Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Maria Clara
authors.initials: MC
authors.lastname: Alencar
authors.affiliation: Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Flavio
authors.initials: F
authors.lastname: Arbex
authors.affiliation: Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Aline
authors.initials: A
authors.lastname: Souza
authors.affiliation: Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Priscila
authors.initials: P
authors.lastname: Sperandio
authors.affiliation: Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Luiz
authors.initials: L
authors.lastname: Medina
authors.affiliation: Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Wladimir M
authors.initials: WM
authors.lastname: Medeiros
authors.affiliation: Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil; Respiratory Investigation Unit & Laboratory of Clinical Exercise Physiology, Queen's University & Kingston General Hospital, Kingston, ON, Canada.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Hirai
authors.affiliation: Respiratory Investigation Unit & Laboratory of Clinical Exercise Physiology, Queen's University & Kingston General Hospital, Kingston, ON, Canada.
authors.forename: Denis E
authors.initials: DE
authors.lastname: O'Donnell
authors.affiliation: Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil; Respiratory Investigation Unit & Laboratory of Clinical Exercise Physiology, Queen's University & Kingston General Hospital, Kingston, ON, Canada. Electronic address: alberto.neder@queensu.ca.
authors.forename: J Alberto
authors.initials: JA
authors.lastname: Neder
mesh_terms: D000368:Aged; D002560:Cerebrovascular Circulation / Q000502:physiology*; D015444:Exercise; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage / Q000097:blood; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012146:Rest; D019265:Spectroscopy, Near-Infrared; D018709:Statistics, Nonparametric; D013997:Time Factors
chemical_list: D010100:Oxygen
keywords: Cerebral oxygenation; Chronic obstructive pulmonary disease; Comorbidity; Near-infrared spectroscopy