1
|
Tsukamoto H, Olesen ND, Petersen LG, Suga T, Sørensen H, Nielsen HB, Ogoh S, Secher NH, Hashimoto T. Circulating Plasma Oxytocin Level Is Elevated by High-Intensity Interval Exercise in Men. Med Sci Sports Exerc 2024; 56:927-932. [PMID: 38115226 DOI: 10.1249/mss.0000000000003360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
PURPOSE We evaluated whether repeated high-intensity interval exercise (HIIE) influences plasma oxytocin (OT) concentration in healthy men, and, given that OT is mainly synthesized in the hypothalamus, we assessed the concentration difference between the arterial (OT ART ) versus the internal jugular venous OT concentration (OT IJV ). Additionally, we hypothesized that an increase in cerebral OT release and the circulating concentration would be augmented by repeated HIIE. METHODS Fourteen healthy men (age = 24 ± 2 yr; mean ± SD) performed two identical bouts of HIIE. These HIIE bouts included a warm-up at 50%-60% maximal workload ( Wmax ) for 5 min followed by four bouts of exercise at 80%-90% Wmax for 4 min interspersed by exercise at 50%-60% Wmax for 3 min. The HIIE bouts were separated by 60 min of rest. OT was evaluated in blood through radial artery and internal jugular vein catheterization. RESULTS Both HIIE bouts increased both OT ART (median [IQR], from 3.9 [3.4-5.4] to 5.3 [4.4-6.3] ng·mL -1 in the first HIIE, P < 0.01) and OT IJV (from 4.6 [3.4-4.8] to 5.9 [4.3-8.2] ng·mL -1 , P < 0.01), but OT ART-IJV was unaffected (from -0.24 [-1.16 to 1.08] to 0.04 [-0.88 to 0.78] ng·mL -1 , P = 1.00). The increased OT levels were similar in the first and second HIIE bouts (OT ARTP = 0.25, OT IJVP = 0.36). CONCLUSIONS Despite no change in the cerebral OT release via the internal jugular vein, circulating OT increases during HIIE regardless of the accumulated exercise volume, indicating that OT may play role as one of the exerkines.
Collapse
Affiliation(s)
| | | | | | - Tadashi Suga
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Shiga, JAPAN
| | - Henrik Sørensen
- Department of Anesthesia, Rigshospitalet, Department of Clinical Medicine, University of Copenhagen, Copenhagen, DENMARK
| | | | - Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, Saitama, JAPAN
| | - Niels H Secher
- Department of Anesthesia, Rigshospitalet, Department of Clinical Medicine, University of Copenhagen, Copenhagen, DENMARK
| | | |
Collapse
|
2
|
Olesen ND, Egesborg AH, Frederiksen HJ, Kitchen CC, Svendsen LB, Olsen NV, Secher NH. Influence of blood pressure on internal carotid artery blood flow during combined propofol-remifentanil and thoracic epidural anesthesia. J Anaesthesiol Clin Pharmacol 2022; 38:580-587. [PMID: 36778814 PMCID: PMC9912875 DOI: 10.4103/joacp.joacp_575_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 04/14/2021] [Accepted: 05/14/2021] [Indexed: 12/31/2022] Open
Abstract
Background and Aims Anesthesia often reduces mean arterial pressure (MAP) to a level that may compromise cerebral blood flow. We evaluated whether phenylephrine treatment of anesthesia-induced hypotension affects internal carotid artery (ICA) blood flow and whether anesthesia affects ICA flow and CO2 reactivity. Material and Methods The study included twenty-seven patients (65 ± 11 years; mean ± SD) undergoing esophageal resection (n = 14), stomach resection (n = 12), or a gastroentero anastomosis (n = 1) during combined propofol-remifentanil and thoracic epidural anesthesia. Duplex ultrasound evaluated ICA blood flow. Evaluations were before and after induction of anesthesia, before and after the administration of phenylephrine as part of standard care to treat anesthesia-induced hypotension at a MAP below 60 mmHg, and the hypocapnic reactivity of ICA flow was determined before and during anesthesia. Results Induction of anesthesia reduced MAP from 108 ± 12 to 66 ± 16 mmHg (P < 0.0001) and ICA flow from 340 ± 92 to 196 ± 52 mL/min (P < 0.0001). Phenylephrine was administered to 24 patients (0.1-0.2 mg) and elevated MAP from 53 ± 8 to 73 ± 8 mmHg (P = 0.0001) and ICA flow from 191 ± 43 to 218 ± 50 mL/min (P = 0.0276). Furthermore, anesthesia reduced the hypocapnic reactivity of ICA flow from 23 (18-33) to 14%/kPa (10-22; P = 0.0068). Conclusion Combined propofol-remifentanil and thoracic epidural anesthesia affect ICA flow and CO2 reactivity. Phenylephrine partly restored ICA flow indicating that anesthesia-induced hypotension contributes to the reduction in ICA flow.
Collapse
Affiliation(s)
- Niels D. Olesen
- Department of Anesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200, Copenhagen N, Denmark
| | - Astrid H. Egesborg
- Department of Anesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
| | - Hans-Jørgen Frederiksen
- Department of Anesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
| | - Carl-Christian Kitchen
- Department of Anesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
| | - Lars B. Svendsen
- Department of Surgical Gastroenterology, Rigshospitalet, University of Copenhagen, Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
| | - Niels V. Olsen
- Department of Anesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200, Copenhagen N, Denmark
| | - Niels H. Secher
- Department of Anesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
| |
Collapse
|
3
|
Nielsen TT, Møller TK, Olesen ND, Zebis MK, Ritz C, Nordsborg N, Hansen PR, Krustrup P. Improved metabolic fitness, but no cardiovascular health effects, of a low-frequency short-term combined exercise programme in 50-70-year-olds with low fitness: A randomized controlled trial. Eur J Sport Sci 2021; 22:460-473. [PMID: 33413034 DOI: 10.1080/17461391.2021.1874057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We evaluated the cardiometabolic effects of a 15-week combined exercise programme, implemented in sports clubs, for 50-70-year-olds with low aerobic fitness. In a randomized controlled trial, 45 participants (26 women) with low fitness were randomly assigned (2:1-ratio) to a training group (TG, n = 30) or inactive control group (CG, n = 15). TG had 15 weeks with one weekly 90-min supervised group-based session in a recreational sports club with combined aerobic exercise and strength training and were encouraged to perform home-based training 30 min/wk. Evaluations of relative VO2max (mLO2/min/kg), blood pressure, resting heart rate (HR), echocardiography, peripheral arterial tonometry, body composition, lipid profile and HbA1c were performed at 0 and 15 wks. Average HR during supervised training was 113 ± 13 bpm (68.6 ± 7.0%HRmax), with 4.3 ± 6.6% spent >90%HRmax. At 15-wk follow-up, intention-to-treat analyses revealed no between-group difference for VO2max/kg (0.4 mLO2/min/kg, 95%CI -0.8-1.5, P = 0.519; -3 mL/min, 95%CI -123-118, P = 0.966) or other cardiovascular outcomes (all P > 0.05). Compared to CG, total fat mass (-1.9 kg; 95%CI -3.2 to -0.5, P = 0.005), total fat percentage (-1.3%, 95%CI -2.2 to -0.3, P = 0.01) and total/HDL cholesterol ratio (P = 0.032) decreased in TG. Regular adherence to supervised training was high (81%), but 0% for home-based exercise. In conclusion, the group-based supervised training was associated with high adherence and moderate exercise intensity, whereas insufficiently supported home-based training was not feasible. Together, 15 wks of combined exercise training did not improve aerobic fitness or affected cardiovascular function in 50-70-yr-olds with low aerobic fitness, whereas some positive effects were observed in metabolic parameters.HighlightsCombined exercise training implemented in a sports club elicited moderate aerobic intensity in 50-70-year-old untrained individuals.Supervised group-based training had high adherence whereas unsupported home-based training had very low adherence.15 weeks of low-frequency combined moderate intensity exercise training improved lipid profile and fat mass, but had no effect on cardiovascular fitness.
Collapse
Affiliation(s)
- Tina-Thea Nielsen
- Department of Physiotherapy, University College Copenhagen, Copenhagen, Denmark.,Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Trine K Møller
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Niels D Olesen
- Department of Anaesthesia, Rigshospitalet, Copenhagen, Denmark
| | - Mette K Zebis
- Department of Physiotherapy, University College Copenhagen, Copenhagen, Denmark
| | - Christian Ritz
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Nikolai Nordsborg
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Peter R Hansen
- Department of Cardiology, Herlev and Gentofte University Hospital, Gentofte, Denmark
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Department of Sport and Health Sciences, University of Exeter, Exeter, UK.,Department of Physical Education and Sports Training, Shanghai University of Sport (SUS), Shanghai, People's Republic of China
| |
Collapse
|
4
|
Olsen MH, Olesen ND, Karlsson M, Holmlöv T, Søndergaard L, Boutelle M, Mathiesen T, Møller K. Randomized blinded trial of automated REBOA during CPR in a porcine model of cardiac arrest. Resuscitation 2021; 160:39-48. [PMID: 33482264 DOI: 10.1016/j.resuscitation.2021.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/23/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Resuscitative endovascular balloon occlusion of the aorta (REBOA) reportedly elevates arterial blood pressure (ABP) during non-traumatic cardiac arrest. OBJECTIVES This randomized, blinded trial of cardiac arrest in pigs evaluated the effect of automated REBOA two minutes after balloon inflation on ABP (primary endpoint) as well as arterial blood gas values and markers of cerebral haemodynamics and metabolism. METHODS Twenty anesthetized pigs were randomized to REBOA inflation or sham-inflation (n = 10 in each group) followed by insertion of invasive monitoring and a novel, automated REBOA catheter (NEURESCUE® Catheter & NEURESCUE® Assistant). Cardiac arrest was induced by ventricular pacing. Cardiopulmonary resuscitation was initiated three min after cardiac arrest, and the automated REBOA was inflated or sham-inflated (blinded to the investigators) five min after cardiac arrest. RESULTS In the inflation compared to the sham group, mean ABP above the REBOA balloon after inflation was higher (inflation: 54 (95%CI: 43-65) mmHg; sham: 44 (33-55) mmHg; P = 0.06), and diastolic ABP was higher (inflation: 38 (29-47) mmHg; sham: 26 (20-33) mmHg; P = 0.02), and the arterial to jugular oxygen content difference was lower (P = 0.04). After return of spontaneous circulation, mean ABP (inflation: 111 (95%CI: 94-128) mmHg; sham: 94 (95%CI: 65-123) mmHg; P = 0.04), diastolic ABP (inflation: 95 (95%CI: 78-113) mmHg; sham: 78 (95%CI: 50-105) mmHg; P = 0.02), CPP (P = 0.01), and brain tissue oxygen tension (inflation: 315 (95%CI: 139-491)% of baseline; sham: 204 (95%CI: 75-333)%; P = 0.04) were higher in the inflation compared to the sham group. CONCLUSION Inflation of REBOA in a porcine model of non-traumatic cardiac arrest improves central diastolic arterial pressure as a surrogate marker of coronary artery pressure, and cerebral perfusion. INSTITUTIONAL PROTOCOL NUMBER 2017-15-0201-01371.
Collapse
Affiliation(s)
- Markus Harboe Olsen
- Department of Neurointensive Care and Neuroanaesthesiology, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Denmark.
| | - Niels D Olesen
- Department of Anesthesiology, Centre of Cancer and Organ Diseases, Rigshospitalet, University of Copenhagen, Denmark
| | - Michael Karlsson
- Department of Neurosurgery, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Denmark
| | - Theodore Holmlöv
- Department of Neurosurgery, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Denmark; Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Lars Søndergaard
- Department of Cardiology, Centre of Cardiac, Vascular, Pulmonary and Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Martyn Boutelle
- Faculty of Engineering, Department of Bioengineering, Imperial College, London, United Kingdom
| | - Tiit Mathiesen
- Department of Neurosurgery, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kirsten Møller
- Department of Neurointensive Care and Neuroanaesthesiology, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| |
Collapse
|
5
|
Olesen ND, Nielsen HB, Olsen NV, Secher NH. The age-related reduction in cerebral blood flow affects vertebral artery more than internal carotid artery blood flow. Clin Physiol Funct Imaging 2019; 39:255-260. [PMID: 30897269 DOI: 10.1111/cpf.12568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 03/18/2019] [Indexed: 11/26/2022]
Abstract
Ageing reduces cerebral blood flow (CBF), while mean arterial pressure (MAP) becomes elevated. According to 'the selfish brain' hypothesis of hypertension, a reduction in vertebral artery blood flow (VA) leads to increased sympathetic activity and thus increases MAP. In twenty-two young (24 ± 3 years; mean ± SD) and eleven elderly (70 ± 5 years) normotensive men, duplex ultrasound evaluated whether the age-related reduction in CBF affects VA more than internal carotid artery (ICA) blood flow. Pulse-contour analysis evaluated MAP while near-infrared spectroscopy determined frontal lobe oxygenation and transcranial Doppler middle cerebral artery mean blood velocity (MCA Vmean ). During supine rest, MAP (90 ± 13 versus 78 ± 9 mmHg; P<0·001) was elevated in the older subjects while their frontal lobe oxygenation (68 ± 7% versus 77 ± 7%; P<0·001), MCA Vmean (49 ± 9 versus 60 ± 12 cm s-1 ; P = 0·016) and CBF (754 ± 112 versus 900 ± 144 ml min-1 ; P = 0·004) were low reflected in VA (138 ± 48 versus 219 ± 50 ml min-1 ; P<0·001) rather than in ICA flow (616 ± 96 versus 680 ± 120 ml min-1 ; P = 0·099). In conclusion, blood supply to the brain and its oxygenation are affected by ageing and the age-related decline in VA flow appears to be four times as large as that in ICA and could be important for the age-related increase in MAP.
Collapse
Affiliation(s)
- Niels D Olesen
- Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henning B Nielsen
- Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Niels V Olsen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels H Secher
- Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
6
|
Egesborg AH, Sørensen H, Olesen ND, Secher NH. Phenylephrine increases near-infrared spectroscopy determined muscle oxygenation during head-up tilt in men. Scand J Clin Lab Invest 2018; 78:601-605. [DOI: 10.1080/00365513.2018.1528505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Astrid H. Egesborg
- Copenhagen Muscle Research Centre, Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Copenhagen Ø, Denmark
| | - Henrik Sørensen
- Copenhagen Muscle Research Centre, Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Copenhagen Ø, Denmark
| | - Niels D. Olesen
- Copenhagen Muscle Research Centre, Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Copenhagen Ø, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen Ø, Denmark
| | - Niels H. Secher
- Copenhagen Muscle Research Centre, Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Copenhagen Ø, Denmark
| |
Collapse
|
7
|
Ogoh S, Washio T, Suzuki K, Ikeda K, Hori T, Olesen ND, Muraoka Y. Effect of leg immersion in mild warm carbonated water on skin and muscle blood flow. Physiol Rep 2018; 6:e13859. [PMID: 30221833 PMCID: PMC6139710 DOI: 10.14814/phy2.13859] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 08/16/2018] [Indexed: 11/24/2022] Open
Abstract
Leg immersion in carbonated water improves endothelial-mediated vasodilator function and decreases arterial stiffness but the mechanism underlying this effect remains poorly defined. We hypothesized that carbonated water immersion increases muscle blood flow. To test this hypothesis, 10 men (age 21 ± 0 years; mean ± SD) underwent lower leg immersion in tap or carbonated water at 38°C. We evaluated gastrocnemius muscle oxyhemoglobin concentration and tissue oxygenation index using near-infrared spectroscopy, skin blood flow by laser Doppler flowmetry, and popliteal artery (PA) blood flow by duplex ultrasound. Immersion in carbonated, but not tap water elevated PA (from 38 ± 14 to 83 ± 31 mL/min; P < 0.001) and skin blood flow (by 779 ± 312%, P < 0.001). In contrast, lower leg immersion elevated oxyhemoglobin concentration and tissue oxygenation index with no effect of carbonation (P = 0.529 and P = 0.495). In addition, the change in PA blood flow in response to immersion in carbonated water correlated with those of skin blood flow (P = 0.005) but not oxyhemoglobin concentration (P = 0.765) and tissue oxygenation index (P = 0.136) while no relations was found for tap water immersion. These findings indicate that water carbonation has minimal effect on muscle blood flow. Furthermore, PA blood flow increases in response to lower leg immersion in carbonated water likely due to a large increase in skin blood flow.
Collapse
Affiliation(s)
- Shigehiko Ogoh
- Department of Biomedical EngineeringToyo UniversityKawagoe‐ShiSaitamaJapan
| | - Takuro Washio
- Department of Biomedical EngineeringToyo UniversityKawagoe‐ShiSaitamaJapan
| | - Kazuya Suzuki
- Department of Biomedical EngineeringToyo UniversityKawagoe‐ShiSaitamaJapan
| | - Keisuke Ikeda
- Institute of Personal Health Care Products ResearchKao co ltd.TokyoJapan
| | - Takaaki Hori
- Institute of Personal Health Care Products ResearchKao co ltd.TokyoJapan
| | - Niels D. Olesen
- Department of AnesthesiaRigshospitaletCopenhagenDenmark
- Department of Biomedical SciencesUniversity of CopenhagenCopenhagenDenmark
| | | |
Collapse
|
8
|
Olesen ND, Fischer M, Secher NH. Sodium nitroprusside dilates cerebral vessels and enhances internal carotid artery flow in young men. J Physiol 2018; 596:3967-3976. [PMID: 29917239 DOI: 10.1113/jp275887] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 06/12/2018] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS Sodium nitroprusside lowers blood pressure by vasodilatation but is reported to reduce cerebral blood flow. In healthy young men sodium nitroprusside reduced blood pressure, total peripheral resistance, and arterial CO2 tension and yet cerebral blood flow was maintained, with an increase in internal carotid artery blood flow and cerebrovascular conductance. Sodium nitroprusside induces both systemic and cerebral vasodilatation affecting internal carotid artery more than vertebral artery flow. ABSTRACT Cerebral autoregulation maintains cerebral blood flow (CBF) despite marked changes in mean arterial pressure (MAP). Sodium nitroprusside (SNP) reduces blood pressure by vasodilatation but is reported to lower CBF, probably by a reduction in its perfusion pressure. We evaluated the influence of SNP on CBF and aimed for a 20% and then 40% reduction in MAP, while keeping MAP ≥ 50 mmHg, to challenge cerebral autoregulation. In 19 healthy men (age 24 ± 4 years; mean ± SD) duplex ultrasound determined right internal carotid (ICA) and vertebral artery (VA) blood flow. The SNP reduced MAP (from 83 ± 8 to 69 ± 8 and 58 ± 4 mmHg; both P < 0.0001), total peripheral resistance, and arterial CO2 tension (P aC O2; 41 ± 3 vs. 39 ± 3 and 37 ± 4 mmHg; both P < 0.01). Yet ICA flow increased with the moderate reduction in MAP but returned to the baseline value with the large reduction in MAP (336 ± 66 vs. 365 ± 69; P = 0.013 and 349 ± 82 ml min-1 ; n.s.), while VA flow (114 ± 34 vs. 112 ± 38 and 110 ± 42 ml min-1 ; both n.s.) and CBF ((ICA + VA flow) × 2; 899 ± 135 vs. 962 ± 127 and 918 ± 197 ml min-1 ; both n.s.) were maintained with increased cerebrovascular conductance. In conclusion, CBF is maintained during SNP-induced reduction in MAP despite reduced P aC O2 and the results indicate that SNP dilates cerebral vessels and increases ICA flow.
Collapse
Affiliation(s)
- Niels D Olesen
- Department of Anaesthesia, The Copenhagen Muscle Research Centre, Rigshospitalet, Copenhagen, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Denmark
| | - Mads Fischer
- Department of Anaesthesia, The Copenhagen Muscle Research Centre, Rigshospitalet, Copenhagen, Denmark.,Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | - Niels H Secher
- Department of Anaesthesia, The Copenhagen Muscle Research Centre, Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
9
|
Hashimoto T, Tsukamoto H, Takenaka S, Olesen ND, Petersen LG, Sørensen H, Nielsen HB, Secher NH, Ogoh S. Maintained exercise‐enhanced brain executive function related to cerebral lactate metabolism in men. FASEB J 2018; 32:1417-1427. [DOI: 10.1096/fj.201700381rr] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Takeshi Hashimoto
- Graduate School of Sport and Health Science Ritsumeikan University Shiga Japan
| | - Hayato Tsukamoto
- Graduate School of Sport and Health Science Ritsumeikan University Shiga Japan
- Japan Society for the Promotion of Science Tokyo Japan
| | - Saki Takenaka
- Graduate School of Sport and Health Science Ritsumeikan University Shiga Japan
| | - Niels D. Olesen
- Department of Biomedical Sciences Panum Institute, University of Copenhagen Copenhagen Denmark
- Department of Anesthesia Copenhagen Muscle Research Center, Rigshospitalet, University of Copenhagen Copenhagen Denmark
| | - Lonnie G. Petersen
- Department of Biomedical Sciences Panum Institute, University of Copenhagen Copenhagen Denmark
| | - Henrik Sørensen
- Department of Anesthesia Copenhagen Muscle Research Center, Rigshospitalet, University of Copenhagen Copenhagen Denmark
| | - Henning B. Nielsen
- Department of Anesthesia Copenhagen Muscle Research Center, Rigshospitalet, University of Copenhagen Copenhagen Denmark
| | - Niels H. Secher
- Department of Anesthesia Copenhagen Muscle Research Center, Rigshospitalet, University of Copenhagen Copenhagen Denmark
| | - Shigehiko Ogoh
- Graduate School of EngineeringToyo University Saitama Japan
| |
Collapse
|
10
|
Tsukamoto H, Olesen ND, Petersen LG, Sørensen H, Nielsen HB, Secher NH, Ogoh S, Hashimoto T. Cerebral Energy Metabolism And Executive Function After Repeated High-intensity Interval Exercise With Decreased Lactate Concentration. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000518508.70652.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
11
|
Olesen ND, Sørensen H, Ambrus R, Svendsen LB, Lund A, Secher NH. A mesenteric traction syndrome affects near-infrared spectroscopy evaluated cerebral oxygenation because skin blood flow increases. J Clin Monit Comput 2017; 32:261-268. [PMID: 28293809 DOI: 10.1007/s10877-017-0014-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 03/07/2017] [Indexed: 11/30/2022]
Abstract
During abdominal surgery manipulation of internal organs may induce a "mesenteric traction syndrome" (MTS) including a triad of flushing, hypotension, and tachycardia that lasts for about 30 min. We evaluated whether MTS affects near-infrared spectroscopy (NIRS) assessed frontal lobe oxygenation (ScO2) by an increase in forehead skin blood flow (SkBF). The study intended to include 10 patients who developed MTS during pancreaticoduodenectomy and 22 patients were enrolled (age 61 ± 8 years; mean ± SD). NIRS determined ScO2, laser Doppler flowmetry determined SkBF, cardiac output (CO) was evaluated by pulse-contour analysis (Modelflow), and transcranial Doppler assessed middle cerebral artery mean flow velocity (MCA Vmean). MTS was identified by flushing within 60 min after start of surgery. MTS developed 20 min (12-24; median with range) after the start of surgery and heart rate (78 ± 16 vs. 68 ± 17 bpm; P = 0.0032), CO (6.2 ± 1.4 vs. 5.3 ± 1.1 L min-1; P = 0.0086), SkBF (98 ± 35 vs. 80 ± 23 PU; P = 0.0271), and ScO2 (71 ± 6 vs. 67 ± 8%; P < 0.0001), but not MCA Vmean (32 ± 8 vs. 32 ± 7; P = 0.1881) were largest in the patients who developed MTS. In some patients undergoing abdominal surgery NIRS-determined ScO2 is at least temporarily affected by an increase in extra-cranial perfusion independent of cerebral blood flow as indicated by MCA Vmean. Thus, NIRS evaluation of ScO2 may overestimate cerebral oxygenation if patients flush during surgery.
Collapse
Affiliation(s)
- Niels D Olesen
- Department of Anaesthesia, Rigshospitalet 2043, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark. .,Department of Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Henrik Sørensen
- Department of Anaesthesia, Rigshospitalet 2043, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Rikard Ambrus
- Department of Surgical Gastroenterology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lars B Svendsen
- Department of Surgical Gastroenterology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anton Lund
- Department of Anaesthesia, Rigshospitalet 2043, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Niels H Secher
- Department of Anaesthesia, Rigshospitalet 2043, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| |
Collapse
|
12
|
Barbosa TC, Vianna LC, Hashimoto T, Petersen LG, Olesen ND, Tsukamoto H, Sørensen H, Ogoh S, Nóbrega ACL, Secher NH. Carotid baroreflex function at the onset of cycling in men. Am J Physiol Regul Integr Comp Physiol 2016; 311:R870-R878. [DOI: 10.1152/ajpregu.00173.2016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 08/24/2016] [Indexed: 01/06/2023]
Abstract
Arterial baroreflex function is important for blood pressure control during exercise, but its contribution to cardiovascular adjustments at the onset of cycling exercise remains unclear. Fifteen healthy male subjects (24 ± 1 yr) performed 45-s trials of low- and moderate-intensity cycling, with carotid baroreceptor stimulation by neck suction at −60 Torr applied 0–5, 10–15, and 30–35 s after the onset of exercise. Cardiovascular responses to neck suction during cycling were compared with those obtained at rest. An attenuated reflex decrease in heart rate following neck suction was detected during moderate-intensity exercise, compared with the response at rest ( P < 0.05). Furthermore, compared with the reflex decrease in blood pressure elicited at rest, neck suction elicited an augmented decrease in blood pressure at 0–5 and 10–15 s during low-intensity exercise and in all periods during moderate-intensity exercise ( P < 0.05). The reflex depressor response at the onset of cycling was primarily mediated by an increase in the total vascular conductance. These findings evidence altered carotid baroreflex function during the first 35 s of cycling compared with rest, with attenuated bradycardic response, and augmented depressor response to carotid baroreceptor stimulation.
Collapse
Affiliation(s)
- Thales C. Barbosa
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
- The Copenhagen Muscle Research Centre, Department of Anesthesia, University of Copenhagen, Copenhagen, Denmark
| | - Lauro C. Vianna
- Faculty of Physical Education, University of Brasilia, Brasilia, Brazil
| | - Takeshi Hashimoto
- Graduate School of Sport and Health Science, Ritsumeikan University, Kyoto, Japan
| | - Lonnie G. Petersen
- The Copenhagen Muscle Research Centre, Department of Anesthesia, University of Copenhagen, Copenhagen, Denmark
| | - Niels D. Olesen
- The Copenhagen Muscle Research Centre, Department of Anesthesia, University of Copenhagen, Copenhagen, Denmark
- Department of Neuroscience and Pharmacology, University of Copenhagen; and
| | - Hayato Tsukamoto
- Graduate School of Sport and Health Science, Ritsumeikan University, Kyoto, Japan
| | - Henrik Sørensen
- The Copenhagen Muscle Research Centre, Department of Anesthesia, University of Copenhagen, Copenhagen, Denmark
| | - Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, Kawagoe-Shi, Japan
| | - Antonio C. L. Nóbrega
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
| | - Niels H. Secher
- The Copenhagen Muscle Research Centre, Department of Anesthesia, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
13
|
Staalsø JM, Rokamp KZ, Olesen ND, Lonn L, Secher NH, Olsen NV, Mantoni T, Helgstrand U, Nielsen HB. ADRB2 gly16gly Genotype, Cardiac Output, and Cerebral Oxygenation in Patients Undergoing Anesthesia for Abdominal Aortic Aneurysm Surgery. Anesth Analg 2016; 123:1408-1415. [PMID: 27632347 DOI: 10.1213/ane.0000000000001563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Gly16arg polymorphism of the adrenergic β2-receptor is associated with the elevated cardiac output (Q) in healthy gly16-homozygotic subjects. We questioned whether this polymorphism also affects Q and regional cerebral oxygen saturation (SCO2) during anesthesia in vascular surgical patients. METHODS One hundred sixty-eight patients (age 71 ± 6 years) admitted for elective surgery were included. Cardiovascular variables were determined before and during anesthesia by intravascular pulse contour analysis (Nexfin) and SCO2 by cerebral oximetry (INVOS 5100C). Genotyping was performed with the TaqMan assay. RESULTS Before anesthesia, Q and SCO2 were 4.7 ± 1.2 L/min and 66% ± 8%, respectively, and linearly correlated (r = 0.35, P < .0001). In patients with the gly16gly genotype baseline, Q was approximately 0.4 L/min greater than in arg16 carriers (CI95: 0.0-0.8, Pt test = .03), but during anesthesia, the difference was 0.3 L/min (Pmixed-model = .07). Post hoc analysis revealed the change in SCO2 from baseline to the induction of anesthesia to be on average 2% greater in gly16gly homozygotes than in arg16 patients when adjusted for the change in Q (P = .03; CI95: 0.2-4.0%). CONCLUSIONS This study suggests that the β2-adrenoceptor gly16gly genotype is associated with the elevated resting Q. An interesting trend to greater frontal lobe oxygenation at induction of anesthesia in patients with gly16gly genotype was found, but because of insufficient sample size and lack of PCO2 control throughout the measurements, the presented data may only serve as the hypothesis generating for future studies. The confidence limits indicate that the magnitude of the effects may range from clinically insignificant to potentially important.
Collapse
Affiliation(s)
- Jonatan Myrup Staalsø
- From the *Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark; †Department of Anesthesia Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Departments of ‡Radiology and §Vascular Surgery Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; and ‖Department of Neuroanesthesia Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Olesen ND, van Lieshout JJ, Fisher JP, Seifert T, Nielsen HB, Secher NH. Case report: (Pre)syncopal symptoms associated with a negative internal jugular venous pressure. Front Physiol 2014; 5:317. [PMID: 25191276 PMCID: PMC4139713 DOI: 10.3389/fphys.2014.00317] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 08/03/2014] [Indexed: 11/13/2022] Open
Abstract
A siphon is suggested to support cerebral blood flow but appears not to be established because internal jugular venous (IJV) pressure is close to zero in upright humans. Thus, in eleven young healthy males, IJV pressure was 9 ± 1 mmHg (mean ± SE) when supine and fell to 3 ± 1 mmHg when seated, and middle cerebral artery mean blood velocity (MCA Vmean; P < 0.007) and the near-infrared spectroscopy-determined frontal lobe oxygenation (ScO2; P = 0.028) also decreased. Another subject, however, developed (pre)syncopal symptoms while seated and his IJV pressure decreased to −17 mmHg. Furthermore, his MCA Vmean decreased and yet within the time of observation ScO2 was not necessarily affected. These findings support the hypothesis that a negative IJV pressure that is a prerequisite for creation of a siphon provokes venous collapse inside the dura, and thereby limits rather than supports CBF.
Collapse
Affiliation(s)
- Niels D Olesen
- Department of Anesthesia, Rigshospitalet, University of Copenhagen Copenhagen, Denmark
| | - Johannes J van Lieshout
- Department of Internal Medicine, Academic Medical Centre, University of Amsterdam Amsterdam, Netherlands ; Laboratory for Clinical Cardiovascular Physiology, Centre for Heart Failure Research, Academic Medical Centre Amsterdam, Netherlands ; MRC/Arthritis Research UK Centre for Musculoskeletal Ageing Research, School of Life Sciences, The Medical School, University of Nottingham, Queen's Medical Centre Nottingham, UK
| | - James P Fisher
- School of Sport, Exercise & Rehabilitation Sciences, College of Life and Environmental Sciences University of Birmingham, UK
| | - Thomas Seifert
- Department of Anesthesia, Rigshospitalet, University of Copenhagen Copenhagen, Denmark
| | - Henning B Nielsen
- Department of Anesthesia, Rigshospitalet, University of Copenhagen Copenhagen, Denmark
| | - Niels H Secher
- Department of Anesthesia, Rigshospitalet, University of Copenhagen Copenhagen, Denmark
| |
Collapse
|
15
|
Rokamp KZ, Olesen ND, Larsson HBW, Hansen AE, Seifert T, Nielsen HB, Secher NH, Rostrup E. Glycopyrrolate does not influence the visual or motor-induced increase in regional cerebral perfusion. Front Physiol 2014; 5:45. [PMID: 24575051 PMCID: PMC3920105 DOI: 10.3389/fphys.2014.00045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 01/24/2014] [Indexed: 02/06/2023] Open
Abstract
Acetylcholine may contribute to the increase in regional cerebral blood flow (rCBF) during cerebral activation since glycopyrrolate, a potent inhibitor of acetylcholine, abolishes the exercise-induced increase in middle cerebral artery mean flow velocity. We tested the hypothesis that cholinergic vasodilatation is important for the increase in rCBF during cerebral activation. The subjects were 11 young healthy males at an age of 24 ± 3 years (mean ± SD). We used arterial spin labeling and blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) to evaluate rCBF with and without intravenous glycopyrrolate during a handgrip motor task and visual stimulation. Glycopyrrolate increased heart rate from 56 ± 9 to 114 ± 14 beats/min (mean ± SD; p < 0.001), mean arterial pressure from 86 ± 8 to 92 ± 12 mmHg, and cardiac output from 5.6 ± 1.4 to 8.0 ± 1.7 l/min. Glycopyrrolate had, however, no effect on the arterial spin labeling or BOLD responses to the handgrip motor task or to visual stimulation. This study indicates that during a handgrip motor task and visual stimulation, the increase in rCBF is unaffected by blockade of acetylcholine receptors by glycopyrrolate. Further studies on the effect of glycopyrrolate on middle cerebral artery diameter are needed to evaluate the influence of glycopyrrolate on mean flow velocity during intense exercise.
Collapse
Affiliation(s)
- Kim Z Rokamp
- Department of Anaesthesia, Rigshospitalet Copenhagen, Denmark
| | - Niels D Olesen
- Department of Anaesthesia, Rigshospitalet Copenhagen, Denmark
| | - Henrik B W Larsson
- Functional Imaging Unit, Department of Diagnostics, Glostrup Hospital Glostrup, Denmark
| | - Adam E Hansen
- Functional Imaging Unit, Department of Diagnostics, Glostrup Hospital Glostrup, Denmark
| | - Thomas Seifert
- Department of Anaesthesia, Rigshospitalet Copenhagen, Denmark
| | | | - Niels H Secher
- Department of Anaesthesia, Rigshospitalet Copenhagen, Denmark
| | - Egill Rostrup
- Functional Imaging Unit, Department of Diagnostics, Glostrup Hospital Glostrup, Denmark
| |
Collapse
|
16
|
Fisher JP, Hartwich D, Seifert T, Olesen ND, McNulty CL, Nielsen HB, van Lieshout JJ, Secher NH. Cerebral perfusion, oxygenation and metabolism during exercise in young and elderly individuals. J Physiol 2012; 591:1859-70. [PMID: 23230234 DOI: 10.1113/jphysiol.2012.244905] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
We evaluated cerebral perfusion, oxygenation and metabolism in 11 young (22 ± 1 years) and nine older (66 ± 2 years) individuals at rest and during cycling exercise at low (25% W(max)), moderate (50% Wmax), high (75% W(max)) and exhaustive (100% W(max)) workloads. Mean middle cerebral artery blood velocity (MCA V(mean)), mean arterial pressure (MAP), cardiac output (CO) and partial pressure of arterial carbon dioxide (P(aCO2)) were measured. Blood samples were obtained from the right internal jugular vein and brachial artery to determine concentration differences for oxygen (O2), glucose and lactate across the brain. The molar ratio between cerebral uptake of O2 versus carbohydrate (O2-carbohydrate index; O2/[glucose + 1/2 lactate]; OCI), the cerebral metabolic rate of O2 (CMRO2) and changes in mitochondrial O2 tension ( P(mitoO2)) were calculated. 100% W(max) was ~33% lower in the older group. Exercise increased MAP and CO in both groups (P < 0.05 vs. rest), but at each intensity MAP was higher and CO lower in the older group (P < 0.05). MCA V(mean), P(aCO2) and cerebral vascular conductance index (MCA V(mean)/MAP) were lower in the older group at each exercise intensity (P < 0.05). In contrast, young and older individuals exhibited similar increases in CMRO2 (by ~30 μmol (100 g(-1)) min(-1)), and decreases in OCI (by ~1.5) and (by ~10 mmHg) during exercise at 75% W(max). Thus, despite the older group having reduced cerebral perfusion and maximal exercise capacity, cerebral oxygenation and uptake of lactate and glucose are similar during exercise in young and older individuals.
Collapse
Affiliation(s)
- James P Fisher
- School of Sport and Exercise Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
| | | | | | | | | | | | | | | |
Collapse
|