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Patients with stable coronary heart disease exhibit worse cognitive function and reduced post-exercise cerebral oxygenation-perfusion compared to age-matched healthy individuals, with cognitive performance correlating with maximal cardiopulmonary function and cardiac index. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

September 22, 2017Open Access

Cognitive function in patients with stable coronary heart disease: Related cerebrovascular and cardiovascular responses

MGMathieu GaydaPreventive Cardiology VGVincent GrémeauxOlympic Medical Center LBLouis BhererPreventive Cardiology

Structured PICO

Does stable coronary heart disease affect cognitive function and cerebral oxygenation-perfusion during exercise compared to healthy controls?

Population

67 adults, including 25 fit patients with stable coronary heart disease (CHD) (mean age 70, 8% female), 20 age-matched old healthy controls (mean age 67, 20% female), and 22 young healthy controls (mean age 33, 31% female).

Intervention

Maximal cardiopulmonary exercise testing (CEPT) with continuous measurement of cerebral oxygenation-perfusion (via near-infrared spectroscopy) and cardiac hemodynamics (via impedance cardiography).

Comparator

Age-matched old healthy controls and young healthy controls.

Outcome

Cognitive function (short term-working memory, perceptual abilities, processing speed, cognitive inhibition and flexibility, and long-term verbal memory) and its relationship to cerebral oxygenation-perfusion, cardiac hemodynamic responses, and VO2 peak.surrogate

Stable coronary heart disease patients exhibit worse cognitive function and reduced cerebral oxygenation-perfusion during exercise recovery compared to age-matched healthy controls, with cognitive function correlating with VO2 peak and maximal cardiac index.

Abstract

Chronic exercise has been shown to prevent or slow age-related decline in cognitive functions in otherwise healthy, asymptomatic individuals. We sought to assess cognitive function in a stable coronary heart disease (CHD) sample and its relationship to cerebral oxygenation-perfusion, cardiac hemodynamic responses, and Formula: see text peak compared to age-matched and young healthy control subjects. Twenty-two young healthy controls (YHC), 20 age-matched old healthy controls (OHC) and 25 patients with stable CHD were recruited. Cognitive function assessment included short term-working memory, perceptual abilities, processing speed, cognitive inhibition and flexibility and long-term verbal memory. Maximal cardiopulmonary function (gas exchange analysis), cardiac hemodynamic (impedance cardiography) and left frontal cerebral oxygenation-perfusion (near-infra red spectroscopy) were measured during and after a maximal incremental ergocycle test. Compared to OHC and CHD, YHC had higher Formula: see text peak, maximal cardiac index (CI max), cerebral oxygenation-perfusion (ΔO2 Hb, ΔtHb: exercise and recovery) and cognitive function (for all items) (P<0.05). Compared to OHC, CHD patients had lower Formula: see text peak, CI max, cerebral oxygenation-perfusion (during recovery) and short term-working memory, processing speed, cognitive inhibition and flexibility and long-term verbal memory (P<0.05). Formula: see text peak and CI max were related to exercise cerebral oxygenation-perfusion and cognitive function (P<0.005). Cerebral oxygenation-perfusion (exercise) was related to cognitive function (P<0.005). Stable CHD patients have a worse cognitive function, a similar cerebral oxygenation/perfusion during exercise but reduced one during recovery vs. their aged-matched healthy counterparts. In the all sample, cognitive functions correlated with Formula: see text peak, CI max and cerebral oxygenation-perfusion.

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