冠状动脉疾病患者的运动与脑健康：HEART-BRAIN随机对照试验的研究方案

Exercise and brain health in patients with coronary artery disease: study protocol for the HEART-BRAIN randomized controlled trial.

作者信息

Toval Angel, Solis-Urra Patricio, Bakker Esmée A, Sánchez-Aranda Lucía, Fernández-Ortega Javier, Prieto Carlos, Alonso-Cuenca Rosa María, González-García Alberto, Martín-Fuentes Isabel, Fernandez-Gamez Beatriz, Olvera-Rojas Marcos, Coca-Pulido Andrea, Bellón Darío, Sclafani Alessandro, Sanchez-Martinez Javier, Rivera-López Ricardo, Herrera-Gómez Norberto, Peñafiel-Burkhardt Rafael, López-Espinosa Víctor, Corpas-Pérez Sara, García-Ortega María Belén, Vega-Cordoba Alejandro, Barranco-Moreno Emilio J, Morales-Navarro Francisco J, Nieves Raúl, Caro-Rus Alfredo, Amaro-Gahete Francisco J, Mora-Gonzalez Jose, Vidal-Almela Sol, Carlén Anna, Migueles Jairo H, Erickson Kirk I, Moreno-Escobar Eduardo, García-Orta Rocío, Esteban-Cornejo Irene, Ortega Francisco B

机构信息

Department of Physical and Sports Education, Sport and Health University Research Institute (iMUDS), Faculty of Sport Sciences, University of Granada, Granada, Spain.

Faculty of Education and Social Sciences, University Andres Bello, Viña del Mar, Chile.

出版信息

Front Aging Neurosci. 2024 Aug 23;16:1437567. doi: 10.3389/fnagi.2024.1437567. eCollection 2024.

DOI:10.3389/fnagi.2024.1437567

PMID:39246594

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11377337/

Abstract

INTRODUCTION

Patients with coronary artery disease (CAD) have a higher risk of developing cognitive impairment and mental health disorders compared to the general population. Physical exercise might improve their brain health. The overall goal of the HEART-BRAIN randomized controlled trial (RCT) is to investigate the effects of different types of exercise on brain health outcomes in patients with CAD, and the underlying mechanisms.

METHODS

This three-arm, single-blinded RCT will include 90 patients with CAD (50-75 years). Participants will be randomized into: (1) control group-usual care ( = 30), (2) aerobic high-intensity interval training (HIIT) ( = 30), or (3) HIIT combined with resistance exercise training ( = 30). The 12-week intervention includes 3 supervised sessions (45-min each) per week for the exercise groups. Outcomes will be assessed at baseline and post-intervention. The primary outcome is to determine changes in cerebral blood flow assessed by magnetic resonance imaging. Secondary outcomes include changes in brain vascularization, cognitive measures (i.e., general cognition, executive function and episodic memory), and cardiorespiratory fitness. Additional health-related outcomes, and several potential mediators and moderators will be investigated (i.e., brain structure and function, cardiovascular and brain-based biomarkers, hemodynamics, physical function, body composition, mental health, and lifestyle behavior).

CONCLUSION

The HEART-BRAIN RCT will provide novel insights on how exercise can impact brain health in patients with CAD and the potential mechanisms explaining the heart-brain connection, such as changes in cerebral blood flow. The results may have important clinical implications by increasing the evidence on the effectiveness of exercise-based strategies to delay cognitive decline in this high-risk population.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, identifier [NCT06214624].

摘要

引言

与普通人群相比，冠状动脉疾病（CAD）患者发生认知障碍和心理健康障碍的风险更高。体育锻炼可能会改善他们的大脑健康。HEART-BRAIN随机对照试验（RCT）的总体目标是研究不同类型的运动对CAD患者大脑健康结局的影响及其潜在机制。

方法

这项三臂单盲随机对照试验将纳入90名年龄在50至75岁之间的CAD患者。参与者将被随机分为：（1）对照组——常规护理（n = 30），（2）有氧高强度间歇训练（HIIT）组（n = 30），或（3）HIIT联合抗阻运动训练组（n = 30）。为期12周的干预措施包括运动组每周进行3次有监督的训练课程（每次45分钟）。在基线和干预后进行结局评估。主要结局是通过磁共振成像确定脑血流量的变化。次要结局包括脑血管生成的变化、认知指标（即一般认知、执行功能和情景记忆）以及心肺适能。还将研究其他与健康相关的结局以及一些潜在的中介因素和调节因素（即脑结构和功能、心血管和基于脑的生物标志物、血流动力学、身体功能、身体成分、心理健康和生活方式行为）。