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Afaghi S, Rahimi FS, Soltani P, Kiani A, Abedini A. Sex-Specific Differences in Cardiovascular Adaptations and Risks in Elite Athletes: Bridging the Gap in Sports Cardiology. Clin Cardiol 2024; 47:e70006. [PMID: 39228309 PMCID: PMC11372237 DOI: 10.1002/clc.70006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Revised: 08/09/2024] [Accepted: 08/12/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND The growing participation of women in competitive sports necessitates a comprehensive understanding of sex-specific cardiovascular adaptations and risks. Historically, research has predominantly focused on male athletes, leaving a gap in knowledge about the unique cardiovascular dynamics of female peers. HYPOTHESIS we hypothesized that female athletes exhibit distinct cardiovascular adaptations and face different risks, influenced by physiological, hormonal, and structural differences. METHODS A systematic review of the literature was conducted, analyzing studies on cardiovascular responses and adaptations in athletes. Data were extracted on hemodynamic changes, autonomic and neural reflex regulation, cardiac remodeling, and arrhythmias. Comparative analyses were performed to identify sex-specific patterns and discrepancies in cardiovascular health outcomes. RESULTS We revealed considerable sex differences in cardiovascular adaptations to athletic training. Female athletes generally have longer QT intervals, greater sinoatrial node automaticity, and enhanced atrioventricular node function compared to males. They also exhibit lower sympathetic activity, lower maximal stroke volumes, and a tendency toward eccentric cardiac remodeling. Conversely, male athletes are more prone to concentric hypertrophy and higher incidences of bradyarrhythmia and accessory pathway arrhythmias. Female athletes are more likely to experience symptomatic atrial fibrillation and face higher procedural complications during catheter ablation. CONCLUSIONS Our findings underscore the necessity for sex-specific approaches in sports cardiology. Recognizing and addressing these differences could enhance performance and reduce adverse cardiac events in athletes. Future research should focus on developing tailored screening, prevention, and treatment strategies to bridge the knowledge gap and promote cardiovascular health in both male and female athletes.
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Affiliation(s)
- Siamak Afaghi
- Chronic Respiratory Diseases Research Department, National Research of Tuberculosis and Lung Disease Institution, Tehran, Iran
| | - Fatemeh Sadat Rahimi
- Chronic Respiratory Diseases Research Department, National Research of Tuberculosis and Lung Disease Institution, Tehran, Iran
| | - Pegah Soltani
- Chronic Respiratory Diseases Research Department, National Research of Tuberculosis and Lung Disease Institution, Tehran, Iran
| | - Arda Kiani
- Chronic Respiratory Diseases Research Department, National Research of Tuberculosis and Lung Disease Institution, Tehran, Iran
| | - Atefeh Abedini
- Chronic Respiratory Diseases Research Department, National Research of Tuberculosis and Lung Disease Institution, Tehran, Iran
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2
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Zeng H, Xie JY, Xu LX, Cao WY, Liu MJ, Que SW. Comparative study of the clinical value of digital subtraction angiography via femoral and radial arterial paths. Am J Transl Res 2024; 16:3064-3071. [PMID: 39114697 PMCID: PMC11301496 DOI: 10.62347/ubev9768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 06/07/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE To evaluate the clinical efficacy of digital subtraction angiography (DSA) performed via femoral artery and radial artery approaches. METHODS This retrospective study included 480 patients requiring cerebral vascular angiography at the First People's Hospital of Changde City from March 2020 to February 2022. Patients were divided into the femoral artery group (transfemoral approach, n=400) and the radial artery group (transradial approach, n=80) according to the surgical route. We compared perioperative metrics, success rates of selective angiography and puncture, and complication rates (including pseudoaneurysm, urinary retention, hematoma, vasospasm) between the groups. Multivariate logistic regression was used to analyze factors influencing the failure of angiography by each approach. RESULTS The radial artery group exhibited shorter durations for puncture, hemostasis, exposure, operation, and postoperative recovery (all P<0.001). The success rate of selective angiography was higher in the radial artery group (93.75%) compared to the femoral artery group (85.25%) (χ2=4.168, P=0.041). No significant difference was found in puncture success rates between the groups (χ2=0.235, P=0.628). The overall complication rate was significantly lower in the radial artery group (2.50%) compared to the femoral artery group (9.25%) (χ2=4.069, P=0.044). Gender and low-density lipoprotein cholesterol levels were significant predictors of angiography failure in both approaches (both P<0.05). CONCLUSION The transradial approach for DSA is safe and feasible, offering advantages in terms of operational time and complication rates, making it the preferred method in clinical settings.
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Affiliation(s)
- Hu Zeng
- Neurosurgery Department, Changde Hospital, Xiangya School of Medicine, Central South UniversityChangde 415000, Hunan, China
| | - Jia-Yu Xie
- Neurosurgery Department, Changde Hospital, Xiangya School of Medicine, Central South UniversityChangde 415000, Hunan, China
| | - Li-Xin Xu
- Neurosurgery Department, Changde Hospital, Xiangya School of Medicine, Central South UniversityChangde 415000, Hunan, China
| | - Wu-Yang Cao
- Neurosurgery Department, Changde Hospital, Xiangya School of Medicine, Central South UniversityChangde 415000, Hunan, China
| | - Meng-Jiao Liu
- Gu Lian Rehabilitation Hospital of Changde CityChangde 415000, Hunan, China
| | - Si-Wei Que
- Neurosurgery Department, Changde Hospital, Xiangya School of Medicine, Central South UniversityChangde 415000, Hunan, China
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3
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Chen HF, Lambers H, Nagelmann N, Sandbrink M, Segelcke D, Pogatzki-Zahn E, Faber C, Pradier B. Generation of a whole-brain hemodynamic response function and sex-specific differences in cerebral processing of mechano-sensation in mice detected by BOLD fMRI. Front Neurosci 2023; 17:1187328. [PMID: 37700753 PMCID: PMC10493293 DOI: 10.3389/fnins.2023.1187328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/05/2023] [Indexed: 09/14/2023] Open
Abstract
BOLD fMRI has become a prevalent method to study cerebral sensory processing in rodent disease models, including pain and mechanical hypersensitivity. fMRI data analysis is frequently combined with a general-linear-model (GLM) -based analysis, which uses the convolution of a hemodynamic response function (HRF) with the stimulus paradigm. However, several studies indicated that the HRF differs across species, sexes, brain structures, and experimental factors, including stimulation modalities or anesthesia, and hence might strongly affect the outcome of BOLD analyzes. While considerable work has been done in humans and rats to understand the HRF, much less is known in mice. As a prerequisite to investigate mechano-sensory processing and BOLD fMRI data in male and female mice, we (1) designed a rotating stimulator that allows application of two different mechanical modalities, including innocuous von Frey and noxious pinprick stimuli and (2) determined and statistically compared HRFs across 30 brain structures and experimental conditions, including sex and, stimulus modalities. We found that mechanical stimulation lead to brain-wide BOLD signal changes thereby allowing extraction of HRFs from multiple brain structures. However, we did not find differences in HRFs across all brain structures and experimental conditions. Hence, we computed a whole-brain mouse HRF, which is based on 88 functional scans from 30 mice. A comparison of this mouse-specific HRF with our previously reported rat-derived HRF showed significantly slower kinetics in mice. Finally, we detected pronounced differences in cerebral BOLD activation between male and female mice with mechanical stimulation, thereby exposing divergent processing of noxious and innocuous stimuli in both sexes.
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Affiliation(s)
- Hui-Fen Chen
- Clinic of Radiology, Translational Research Imaging Center (TRIC), University of Münster, Münster, Germany
| | - Henriette Lambers
- Clinic of Radiology, Translational Research Imaging Center (TRIC), University of Münster, Münster, Germany
| | - Nina Nagelmann
- Clinic of Radiology, Translational Research Imaging Center (TRIC), University of Münster, Münster, Germany
| | - Martin Sandbrink
- Clinic of Radiology, Translational Research Imaging Center (TRIC), University of Münster, Münster, Germany
| | - Daniel Segelcke
- Department of Anesthesiology, Intensive Care and Pain Medicine, University of Münster, Münster, Germany
| | - Esther Pogatzki-Zahn
- Department of Anesthesiology, Intensive Care and Pain Medicine, University of Münster, Münster, Germany
| | - Cornelius Faber
- Clinic of Radiology, Translational Research Imaging Center (TRIC), University of Münster, Münster, Germany
| | - Bruno Pradier
- Clinic of Radiology, Translational Research Imaging Center (TRIC), University of Münster, Münster, Germany
- Department of Anesthesiology, Intensive Care and Pain Medicine, University of Münster, Münster, Germany
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4
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Cilhoroz BT, DeBlois JP, Lefferts WK, Keller AP, Pagan Lassalle P, Meyer ML, Stoner L, Heffernan KS. Exploration of cerebral hemodynamic pathways through which large artery function affects neurovascular coupling in young women. Front Cardiovasc Med 2022; 9:914439. [PMID: 36035945 PMCID: PMC9411931 DOI: 10.3389/fcvm.2022.914439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe interactions between large artery function and neurovascular coupling (NVC) are emerging as important contributors to cognitive health. Women are disproportionally affected by Alzheimer's disease and related dementia later in life. Understanding large artery correlates of NVC in young women may help with preservation of cognitive health with advancing age.PurposeTo explore the association between large artery function, NVC and cognitive performance in young women.MethodsVascular measurements were made in 61 women (21 ± 4 yrs) at rest and during a cognitive challenge (Stroop task). Transcranial Doppler was used to measure left middle cerebral artery (MCA) maximum velocity (Vmax), mean velocity (Vmean), and pulsatility index (PI). NVC was determined as MCA blood velocity reactivity to the Stroop task. Large artery function was determined using carotid-femoral pulse wave velocity (cfPWV) as a proxy measure of aortic stiffness and carotid ultrasound-derived measures of compliance and reactivity (diameter change to the Stroop task). Cognitive function was assessed separately using a computerized neurocognitive battery that included appraisal of response speed, executive function, information processing efficiency, memory, attention/concentration, and impulsivity.ResultsMCA Vmax reactivity was positively associated with executive function (β = 0.26, 95% CI 0.01–0.10); MCA Vmean reactivity was negatively associated with response speed (β = −0.33, 95% CI −0.19 to −0.02) and positively with memory score (β = 0.28, 95% CI 0.01–0.19). MCA PI reactivity was negatively associated with attention performance (β = −0.29, 95% CI −14.9 to −1.0). Path analyses identified significant paths (p < 0.05) between carotid compliance and carotid diameter reactivity to select domains of cognitive function through MCA reactivity.ConclusionsNVC was associated with cognitive function in young women. Carotid artery function assessed as carotid compliance and carotid reactivity may contribute to optimal NVC in young women through increased blood flow delivery and reduced blood flow pulsatility.
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Affiliation(s)
- Burak T. Cilhoroz
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States
| | - Jacob P. DeBlois
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States
| | - Wesley K. Lefferts
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Allison P. Keller
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States
| | - Patricia Pagan Lassalle
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, United States
| | - Michelle L. Meyer
- Department of Epidemiology, Gilling's School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, United States
- Department of Epidemiology, Gilling's School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kevin S. Heffernan
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States
- *Correspondence: Kevin S. Heffernan
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5
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Leacy JK, Johnson EM, Lavoie LR, Macilwraith DN, Bambury M, Martin JA, Lucking EF, Linares AM, Saran G, Sheehan DP, Sharma N, Day TA, O'Halloran KD. Variation within the visually evoked neurovascular coupling response of the posterior cerebral artery is not influenced by age or sex. J Appl Physiol (1985) 2022; 133:335-348. [PMID: 35771218 PMCID: PMC9359642 DOI: 10.1152/japplphysiol.00292.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Neurovascular coupling (NVC) is the temporal and spatial coordination between local neuronal activity and regional cerebral blood flow. The literature is unsettled on whether age and/or sex affect NVC, which may relate to differences in methodology and the quantification of NVC in small sample-sized studies. The aim of this study was to 1) determine the relative and combined contribution of age and sex to the variation observed across several distinct NVC metrics (n = 125, 21–66 yr; 41 males) and 2) present an approach for the comprehensive systematic assessment of the NVC response using transcranial Doppler ultrasound. NVC was measured as the relative change from baseline (absolute and percent change) assessing peak, mean, and total area under the curve (tAUC) of cerebral blood velocity through the posterior cerebral artery (PCAv) during intermittent photic stimulation. In addition, the NVC waveform was compartmentalized into distinct regions, acute (0–9 s), mid (10–19 s), and late (20–30 s), following the onset of photic stimulation. Hierarchical multiple regression modeling was used to determine the extent of variation within each NVC metric attributable to demographic differences in age and sex. After controlling for differences in baseline PCAv, the R2 data suggest that 1.6%, 6.1%, 1.1%, 3.4%, 2.5%, and 4.2% of the variance observed within mean, peak, tAUC, acute, mid, and late response magnitude is attributable to the combination of age and sex. Our study reveals that variability in NVC response magnitude is independent of age and sex in healthy human participants, aged 21–66 yr. NEW & NOTEWORTHY We assessed the variability within the neurovascular coupling response attributable to age and sex (n = 125, 21–66 yr; 41 male). Based on the assessment of posterior cerebral artery responses to visual stimulation, 0%–6% of the variance observed within several metrics of NVC response magnitude are attributable to the combination of age and sex. Therefore, observed differences between age groups and/or sexes are likely a result of other physiological factors.
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Affiliation(s)
- Jack K Leacy
- Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Emily M Johnson
- Department of Biology, Faculty of Science and Technology, Mount Royal University, Calgary, Alberta, Canada
| | - Lauren R Lavoie
- Department of Biology, Faculty of Science and Technology, Mount Royal University, Calgary, Alberta, Canada
| | - Diane N Macilwraith
- Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Megan Bambury
- Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Jason A Martin
- Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland.,APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Eric F Lucking
- Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Andrea M Linares
- Department of Biology, Faculty of Science and Technology, Mount Royal University, Calgary, Alberta, Canada
| | - Gurkarn Saran
- Department of Biology, Faculty of Science and Technology, Mount Royal University, Calgary, Alberta, Canada
| | - Dwayne P Sheehan
- Department of Biology, Faculty of Science and Technology, Mount Royal University, Calgary, Alberta, Canada
| | - Nishan Sharma
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Trevor A Day
- Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland.,Department of Biology, Faculty of Science and Technology, Mount Royal University, Calgary, Alberta, Canada
| | - Ken D O'Halloran
- Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland
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6
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Pregnancy-Related Stroke: A Review. Obstet Gynecol Surv 2022; 77:367-378. [PMID: 35672877 DOI: 10.1097/ogx.0000000000001039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Importance The maternal risk of strokes in the United States is approximately 30/100,000 pregnancies, and strokes are the eighth leading cause of maternal death. Because of the relationship between stroke and significant neurological disability/maternal death, obstetrical health care providers must be able to identify, evaluate, diagnosis, and treat these women. Evidence Acquisition PubMed was searched using the search terms "stroke" OR "cerebrovascular accident" OR "intracranial hemorrhage" AND "pregnancy complications" OR "risk factors" OR "management" OR "outcome." The search was limited to the English language and was restricted to articles from 2000 to 2020. Results There were 319 abstracts identified, and 90 of the articles were ultimately used as the basis of this review. Presenting stroke signs and symptoms include headache, composite neurologic defects, seizures, and/or visual changes. Diagnosis is typically made with computed tomography scan using abdominal shielding or magnetic resonance imaging without contrast. Management options for an ischemic stroke include reperfusion therapy with intravenous recombinant tissue plasminogen activator catheter-based thrombolysis and/or mechanical thrombectomy. Hemorrhagic strokes are treated similarly to strokes outside of pregnancy, and that treatment is based on the severity and location of the hemorrhage. Conclusions and Relevance Early recognition and management are integral in decreasing the morbidity and mortality associated with a stroke in pregnancy. Relevance Statement This study was an evidence-based review of stroke in pregnancy and how to diagnose and mange a pregnancy complicated by a stroke.
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7
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Schneider SC, Archila-Meléndez ME, Göttler J, Kaczmarz S, Zott B, Priller J, Kallmayer M, Zimmer C, Sorg C, Preibisch C. Resting-state BOLD functional connectivity depends on the heterogeneity of capillary transit times in the human brain A combined lesion and simulation study about the influence of blood flow response timing. Neuroimage 2022; 255:119208. [PMID: 35427773 DOI: 10.1016/j.neuroimage.2022.119208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/23/2022] [Accepted: 04/11/2022] [Indexed: 11/25/2022] Open
Abstract
Functional connectivity (FC) derived from blood oxygenation level dependent (BOLD) functional magnetic resonance imaging at rest (rs-fMRI), is commonly interpreted as indicator of neuronal connectivity. In a number of brain disorders, however, metabolic, vascular, and hemodynamic impairments can be expected to alter BOLD-FC independently from neuronal activity. By means of a neurovascular coupling (NVC) model of BOLD-FC, we recently demonstrated that aberrant timing of cerebral blood flow (CBF) responses may influence BOLD-FC. In the current work, we support and extend this finding by empirically linking BOLD-FC with capillary transit time heterogeneity (CTH), which we consider as an indicator of delayed and broadened CBF responses. We assessed 28 asymptomatic patients with unilateral high-grade internal carotid artery stenosis (ICAS) as a hemodynamic lesion model with largely preserved neurocognitive functioning and 27 age-matched healthy controls. For each participant, we obtained rs-fMRI, arterial spin labeling, and dynamic susceptibility contrast MRI to study the dependence of left-right homotopic BOLD-FC on local perfusion parameters. Additionally, we investigated the dependency of BOLD-FC on CBF response timing by detailed simulations. Homotopic BOLD-FC was negatively associated with increasing CTH differences between homotopic brain areas. This relation was more pronounced in asymptomatic ICAS patients even after controlling for baseline CBF and relative cerebral blood volume influences. These findings match simulation results that predict an influence of delayed and broadened CBF responses on BOLD-FC. Results demonstrate that increasing CTH differences between homotopic brain areas lead to BOLD-FC reductions. Simulations suggest that CTH increases correspond to broadened and delayed CBF responses to fluctuations in ongoing neuronal activity.
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Affiliation(s)
- Sebastian C Schneider
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Neuroradiology, Ismaningerstr. 22, 81675, Munich, Germany; Technical University of Munich, School of Medicine, Klinikum rechts der Isar, TUM Neuroimaging Center, Ismaningerstr. 22, 81675, Munich, Germany
| | - Mario E Archila-Meléndez
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Neuroradiology, Ismaningerstr. 22, 81675, Munich, Germany; Technical University of Munich, School of Medicine, Klinikum rechts der Isar, TUM Neuroimaging Center, Ismaningerstr. 22, 81675, Munich, Germany
| | - Jens Göttler
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Neuroradiology, Ismaningerstr. 22, 81675, Munich, Germany; Technical University of Munich, School of Medicine, Klinikum rechts der Isar, TUM Neuroimaging Center, Ismaningerstr. 22, 81675, Munich, Germany
| | - Stephan Kaczmarz
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Neuroradiology, Ismaningerstr. 22, 81675, Munich, Germany; Technical University of Munich, School of Medicine, Klinikum rechts der Isar, TUM Neuroimaging Center, Ismaningerstr. 22, 81675, Munich, Germany; Philips GmbH Market DACH, Hamburg, Germany
| | - Benedikt Zott
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Neuroradiology, Ismaningerstr. 22, 81675, Munich, Germany; Technical University of Munich, School of Medicine, Klinikum rechts der Isar, TUM Neuroimaging Center, Ismaningerstr. 22, 81675, Munich, Germany
| | - Josef Priller
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Psychiatry, Ismaningerstr. 22, 81675, Munich, Munich, Germany
| | - Michael Kallmayer
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Vascular and Endovascular Surgery, Ismaningerstr. 22, 81675, Munich, Munich, Germany
| | - Claus Zimmer
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Neuroradiology, Ismaningerstr. 22, 81675, Munich, Germany
| | - Christian Sorg
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Neuroradiology, Ismaningerstr. 22, 81675, Munich, Germany; Technical University of Munich, School of Medicine, Klinikum rechts der Isar, TUM Neuroimaging Center, Ismaningerstr. 22, 81675, Munich, Germany
| | - Christine Preibisch
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Neuroradiology, Ismaningerstr. 22, 81675, Munich, Germany; Technical University of Munich, School of Medicine, Klinikum rechts der Isar, TUM Neuroimaging Center, Ismaningerstr. 22, 81675, Munich, Germany; Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Neurology, Ismaningerstr. 22, 81675, Munich, Munich, Germany.
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8
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Alwatban MR, Aaron SE, Kaufman CS, Barnes JN, Brassard P, Ward JL, Miller KB, Howery AJ, Labrecque L, Billinger SA. Effects of age and sex on middle cerebral artery blood velocity and flow pulsatility index across the adult lifespan. J Appl Physiol (1985) 2021; 130:1675-1683. [PMID: 33703940 DOI: 10.1152/japplphysiol.00926.2020] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Reduced middle cerebral artery blood velocity (MCAv) and flow pulsatility are contributors to age-related cerebrovascular disease pathogenesis. It is unknown whether the rate of changes in MCAv and flow pulsatility support the hypothesis of sex-specific trajectories with aging. Therefore, we sought to characterize the rate of changes in MCAv and flow pulsatility across the adult lifespan in females and males as well as within specified age ranges. Participant characteristics, mean arterial pressure, end-tidal carbon dioxide, unilateral MCAv, and flow pulsatility index (PI) were determined from study records compiled from three institutional sites. A total of 524 participants [18-90 yr; females 57 (17) yr, n = 319; males 50 (21) yr, n = 205] were included in the analysis. MCAv was significantly higher in females within the second (P < 0.001), fifth (P = 0.01), and sixth (P < 0.01) decades of life. Flow PI was significantly lower in females within the second decade of life (P < 0.01). Rate of MCAv decline was significantly greater in females than males (-0.39 vs. -0.26 cm s-1·yr, P = 0.04). Rate of flow PI rise was significantly greater in females than males (0.006 vs. 0.003 flow PI, P = 0.01). Rate of MCAv change was significantly greater in females than males in the sixth decade of life (-1.44 vs. 0.13 cm s-1·yr, P = 0.04). These findings indicate that sex significantly contributes to age-related differences in both MCAv and flow PI. Therefore, further investigation into cerebrovascular function within and between sexes is warranted to improve our understanding of the reported sex differences in cerebrovascular disease prevalence.NEW & NOTEWORTHY We present the largest dataset (n = 524) pooled from three institutions to study how age and sex affect middle cerebral artery blood velocity (MCAv) and flow pulsatility index (PI) across the adult lifespan. We report the rate of MCAv decline and flow PI rise is significantly greater in females compared with in males. These data suggest that sex-specific trajectories with aging and therapeutic interventions to promote healthy brain aging should consider these findings.
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Affiliation(s)
- Mohammed R Alwatban
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas.,Abiomed, Inc., Danvers, Massachusetts
| | - Stacey E Aaron
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Carolyn S Kaufman
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Jill N Barnes
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Quebec, Canada
| | - Jaimie L Ward
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Kathleen B Miller
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Anna J Howery
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Lawrence Labrecque
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Quebec, Canada
| | - Sandra A Billinger
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas.,Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas.,Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas City, Kansas.,Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas
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9
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Roberts DR, Collins HR, Lee JK, Taylor JA, Turner M, Zaharchuk G, Wintermark M, Antonucci MU, Mulder ER, Gerlach DA, Asemani D, McGregor HR, Seidler RD. Altered cerebral perfusion in response to chronic mild hypercapnia and head-down tilt Bed rest as an analog for Spaceflight. Neuroradiology 2021; 63:1271-1281. [PMID: 33587162 DOI: 10.1007/s00234-021-02660-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/26/2021] [Indexed: 01/01/2023]
Abstract
PURPOSE Following prolonged stays on the International Space Station (ISS), some astronauts exhibit visual acuity changes, ophthalmological findings, and mildly elevated intracranial pressures as part of a novel process called spaceflight-associated neuro-ocular syndrome (SANS). To determine the pathophysiology of SANS, NASA conducted a multi-investigator study in which 11 healthy participants underwent head-down tilt bed rest, mimicking microgravity-induced cephalad fluid shifts, combined with elevated ambient CO2 levels similar to those on the ISS (HDT+CO2). As part of that study, we examined the effects of HDT+CO2 on cerebral perfusion. METHODS Using arterial spin labeling, we compared cerebral perfusion before, during, and after HDT+CO2 in participants who developed SANS (n = 5) with those who did not (n = 6). RESULTS All participants demonstrated a decrease in perfusion during HDT+CO2 (mean decrease of 25.1% at HDT7 and 16.2% at HDT29); however, the timing and degree of change varied between the groups. At day 7 of HDT+CO2, the SANS group experienced a greater reduction in perfusion than the non-SANS group (p =.05, 95% CI:-0.19 to 16.11, d=.94, large effect). Conversely, by day 29 of HDT+CO2, the SANS group had significantly higher perfusion (approaching their baseline) than the non-SANS group (p = .04, 95% CI:0.33 to 13.07, d=1.01, large effect). CONCLUSION Compared with baseline and recovery, HDT+CO2 resulted in reduced cerebral perfusion which varied based on SANS status. Further studies are needed to unravel the relative role of HDT vs hypercapnia, to determine if these perfusion changes are clinically relevant, and whether perfusion changes contribute to the development of SANS during spaceflight.
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Affiliation(s)
- Donna R Roberts
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA. .,Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA.
| | - Heather R Collins
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - Jessica K Lee
- German Aerospace Center (DLR, Institute of Aerospace Medicine), Cologne, Germany.,Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - James A Taylor
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - Matthew Turner
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - Greg Zaharchuk
- Department of Radiology, Division of Neuroradiology, Stanford University, Stanford, CA, USA
| | - Max Wintermark
- Department of Radiology, Division of Neuroradiology, Stanford University, Stanford, CA, USA
| | - Michael U Antonucci
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - Edwin R Mulder
- German Aerospace Center (DLR, Institute of Aerospace Medicine), Cologne, Germany
| | - Darius A Gerlach
- German Aerospace Center (DLR, Institute of Aerospace Medicine), Cologne, Germany
| | - Davud Asemani
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - Heather R McGregor
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Rachael D Seidler
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL, USA.,Norman Fixel Institute for Neurological Diseases, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
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