Doneddu Azzurrra, Roberto Silvana, Pinna Virginia, Magnani Sara, Ghiani Giovanna, Sainas Gianmarco, Mulliri Gabriele, Serra Stefano, Kakhak Seyed Alireza Hosseini, Milia Raffaele, Lecis Romina, Guicciardi Marco, Crisafulli Antonio
Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy.
International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy.
Front Physiol. 2020 May 14;11:397. doi: 10.3389/fphys.2020.00397. eCollection 2020.
The hemodynamic response to muscle metaboreflex has been reported to be significantly altered by metabolic syndrome (MS), with exaggerated systemic vascular resistance (SVR) increments and reduced cardiac output (CO) in comparison to healthy controls (CTLs). Moreover, patients with metabolic disorders, such as type 2 diabetes, have proven to have impaired cerebral blood flow in response to exercise. Thus, we hypothesized that contemporary mental task (MT) and metaboreflex would result in reduced cerebral oxygenation (COX) in these patients. Thirteen MS patients (five women) and 14 normal age-matched CTLs (six women) were enrolled in this study. All the participants underwent five different tests, each lasting 12 min: post-exercise muscle ischemia (PEMI) to activate the metaboreflex, control exercise recovery (CER), PEMI + MT, CER + MT, and MT alone. Cerebral oxygenation was evaluated using near-infrared spectroscopy with sensors applied to the forehead. Hemodynamics were measured using impedance cardiography. The main results show that MS patients had higher SVR and lower CO levels compared to the CTL group during metaboreflex activation. Stroke volume and ventricular filling and emptying rates were also significantly reduced. Moreover, when MT was added to PEMI, COX was significantly increased in the CTL group with respect to the baseline (103.46 ± 3.14%), whereas this capacity was reduced in MS patients (102.37 ± 2.46%). It was concluded that (1) patients with MS showed hemodynamic dysregulation during the metaboreflex, with exaggerated vasoconstriction and that (2) as compared to CTL, MS patients had reduced capacity to enhance COX when an MT superimposed the metaboreflex.
据报道，代谢综合征（MS）会显著改变对肌肉代谢反射的血流动力学反应，与健康对照者（CTLs）相比，其全身血管阻力（SVR）增加更为明显，心输出量（CO）降低。此外，已证实患有代谢紊乱（如2型糖尿病）的患者在运动时脑血流量受损。因此，我们推测，在这些患者中，当代心理任务（MT）和代谢反射会导致脑氧合（COX）降低。本研究纳入了13例MS患者（5名女性）和14名年龄匹配的正常CTLs（6名女性）。所有参与者均接受了五项不同的测试，每项测试持续12分钟：运动后肌肉缺血（PEMI）以激活代谢反射、对照运动恢复（CER）、PEMI + MT、CER + MT和单独的MT。使用应用于前额的传感器通过近红外光谱法评估脑氧合。使用阻抗心动图测量血流动力学。主要结果表明，在代谢反射激活期间，与CTL组相比，MS患者的SVR更高，CO水平更低。每搏输出量以及心室充盈和排空率也显著降低。此外，当在PEMI中加入MT时，CTL组的COX相对于基线显著增加（103.46 ± 3.14%），而MS患者的这种能力降低（102.37 ± 2.46%）。得出的结论是：（1）MS患者在代谢反射期间表现出血流动力学失调，血管收缩过度；（2）与CTL相比，当MT叠加在代谢反射上时，MS患者增强COX的能力降低。
