Vasileios Andrianopoulos
Schoen Klinik Berchtesgadener Land, Germany
Title: Cerebral cortex blood flow response to exercise in COPD patients with and without cognitive impairment
Biography
Biography: Vasileios Andrianopoulos
Abstract
Background: Cognitive impairment (CI) is a prevalent extrapulmonary manifestation in COPD. Potential disturbances in cerebral circulation and oxygen delivery due to reduced ventilatory efficiency and ventilatory drive may be associated with higher rates of CI.We assessed cerebral tissue oxygen index (TOI) and cerebral hemodynamics at exertion in COPD patient with and without CI.
Method: 52 COPD patients (aged: 68±8yrs; FEV1: 45±14%; 40%women) underwent a comprehensive cognitive assessment. Patients were assigned to “CI” and “non-CI” groups according to Montreal Cognitive Assessment (MoCA) cutoff score ≤25points. Patients performed cycle endurance test (CET) at 75% of peak work rate while transcutaneous carbon-dioxide partial-pressure (TCPCO2), cerebral tissue oxygen index (TOI) and cerebral hemoglobin responses were recorded by SenTec and Portalite systems, respectively.
Results: 23 patients (44%) presented evidences of CI (MoCA≤25) with also lower scores in other cognitive tests (all p <0.001). A correlation between TCPCO2 and cerebral oxygenated hemoglobin (O2Hb), and total hemoglobin (tHb) at the end of CET was detected (r: 0.34, p=0.021; r: 0.34 p=0.023, respectively). Oxygen saturation (SpO2) at the end of CET was not related with cerebral deoxygenated hemoglobin (HHb) and tHb. Patient with CI developed similar cerebral hemodynamic pattern and TOI compared to non-CI during CET.
Conclusion: COPD patients have the capacity to autoregulate cerebral cortex blood flow in response to hypercapnia and hypoxemia, at least during exercise, and thus to normalize cerebral tissue oxygenation. These findings suggest that exercise is safe and can be beneficial regarding to cognitive function in COPD.