Ai Hirasawa

Blood flow distribution during heat stress: cerebral and systemic blood flow.

The purpose of the present study was to assess the effect of heat stress-induced changes in systemic circulation on intra- and extracranial blood flows and its distribution. Twelve healthy subjects with a mean age of 22±2 (s.d.) years dressed in a tube-lined suit and rested in a supine position. Cardiac output (Q), internal carotid artery (ICA), external carotid artery (ECA), and vertebral artery (VA) blood flows were measured by ultrasonography before and during whole body heating. Esophageal temperature increased from 37.0±0.2°C to 38.4±0.2°C during whole body heating. Despite an increase in Q (59±31%, P<0.001), ICA and VA decreased to 83±15% (P=0.001) and 87±8% (P=0.002), respectively, whereas ECA blood flow gradually increased from 188±72 to 422±189u2009mL/minute (+135%, P<0.001). These findings indicate that heat stress modified the effect of Q on blood flows at each artery; the increased Q due to heat stress was redistributed to extracranial vascular beds.

Influence of skin blood flow and source‐detector distance on near‐infrared spectroscopy‐determined cerebral oxygenation in humans

Most near‐infrared spectroscopy (NIRS) apparatus fails to isolate cerebral oxygenation from an extracranial contribution although they use different source‐detector distances. Nevertheless, the effect of different source‐detector distances and change in extracranial blood flow on the NIRS signal has not been identified in humans. This study evaluated the extracranial contribution, as indicated by forehead skin blood flow (SkBF) to changes in the NIRS‐determined cerebral oxyhaemoglobin concentration (O2Hb) by use of a custom‐made multidistance probe. Seven males (age 21 ± 1 year) were in a semi‐recumbent position, while extracranial blood flow was restricted by application of four different pressures (+20 to +80 mmHg) to the left temporal artery. The O2Hb was measured at the forehead via a multidistance probe (source‐detector distance; 15, 22·5 and 30 mm), and SkBF was determined by laser Doppler. Heart rate and blood pressure were unaffected by application of pressure to the temporal artery, while SkBF gradually decreased (P<0·001), indicating that extracranial blood flow was manipulated without haemodynamic changes. Also, O2Hb gradually decreased with increasing applied pressure (P<0·05), and the decrease was related to that in SkBF (r = 0·737, P<0·01) independent of the NIRS source to detector distance. These findings suggest that the NIRS‐determined cerebral oxyhaemoglobin is affected by change in extracranial blood flow independent of the source‐detector distance from 15 to 30 mm. Therefore, new algorithms need to be developed for unbiased NIRS detection of cerebral oxygenation.

The effect of changes in cerebral blood flow on cognitive function during exercise

No studies have identified the direct effect of changes in cerebral blood flow (CBF) on cognitive function at rest and during exercise. In this study, we manipulated CBF using hypercapnic gas to examine whether an increase in CBF improves cognitive function during prolonged exercise. The speed and the accuracy of cognitive function were assessed using the Stroop color‐word test. After the Stroop test at rest, the subjects began exercising on a cycling ergometer in which the workload was increased by 0.5 kilopond every minute until a target heart rate of 140 beats/min was achieved. Then, the subjects continued to cycle at a constant rate for 50 min. At four time points during the exercise (0, 10, 20, 50 min), the subjects performed a Stroop test with and without hypercapnic respiratory gas (2.0% CO2), with a random order of the exposures in the two tests. Despite a decrease in the mean blood flow velocity in the middle cerebral artery (MCA Vmean), the reaction time for the Stroop test gradually decreased during the prolonged exercise without any loss of performance accuracy. In addition, the hypercapnia‐induced increase in MCA Vmean produced neither changes in the reaction time nor error in the Stroop test during exercise. These findings suggest that the changes in CBF are unlikely to affect cognitive function during prolonged exercise. Thus, we conclude that improved cognitive function may be due to cerebral neural activation associated with exercise rather than global cerebral circulatory condition.

Blood flow in internal carotid and vertebral arteries during graded lower body negative pressure in humans

What is the central question of this study? Recently, the heterogeneity of the cerebral arterial circulation has been argued. Orthostatic tolerance may be associated with an orthostatic stress‐induced change in blood flow in vertebral arteries rather than in internal carotid arteries, because vertebral arteries supply blood to the medulla oblongata, which is the location of important cardiac, vasomotor and respiratory control centres. What is the main finding and its importance? The effect of graded orthostatic stress on vertebral artery blood flow is different from that on internal carotid artery blood flow. This response allows for the possibility that orthostatic tolerance may be associated with haemodynamic changes in posterior rather than anterior cerebral blood flow.

Near-infrared spectroscopy determined cerebral oxygenation with eliminated skin blood flow in young males

We estimated cerebral oxygenation during handgrip exercise and a cognitive task using an algorithm that eliminates the influence of skin blood flow (SkBF) on the near-infrared spectroscopy (NIRS) signal. The algorithm involves a subtraction method to develop a correction factor for each subject. For twelve male volunteers (age 21xa0±xa01 yrs) +80xa0mmHg pressure was applied over the left temporal artery for 30xa0s by a custom-made headband cuff to calculate an individual correction factor. From the NIRS-determined ipsilateral cerebral oxyhemoglobin concentration (O2Hb) at two source-detector distances (15 and 30xa0mm) with the algorithm using the individual correction factor, we expressed cerebral oxygenation without influence from scalp and scull blood flow. Validity of the estimated cerebral oxygenation was verified during cerebral neural activation (handgrip exercise and cognitive task). With the use of both source-detector distances, handgrip exercise and a cognitive task increased O2Hb (Pxa0<xa00.01) but O2Hb was reduced when SkBF became eliminated by pressure on the temporal artery for 5xa0s. However, when the estimation of cerebral oxygenation was based on the algorithm developed when pressure was applied to the temporal artery, estimated O2Hb was not affected by elimination of SkBF during handgrip exercise (Pxa0=xa00.666) or the cognitive task (Pxa0=xa00.105). These findings suggest that the algorithm with the individual correction factor allows for evaluation of changes in an accurate cerebral oxygenation without influence of extracranial blood flow by NIRS applied to the forehead.

Hyperthermia modulates regional differences in cerebral blood flow to changes in CO2

The purpose of this study was to assess blood flow responses to changes in carbon dioxide (CO2) in the internal carotid artery (ICA), external carotid artery (ECA), and vertebral artery (VA) during normothermic and hyperthermic conditions. Eleven healthy subjects aged 22 ± 2 (SD) yr were exposed to passive whole body heating followed by spontaneous hypocapnic and hypercapnic challenges in normothermic and hyperthermic conditions. Right ICA, ECA, and VA blood flows, as well as left middle cerebral artery (MCA) mean blood velocity (Vmean), were measured. Esophageal temperature was elevated by 1.53 ± 0.09°C before hypocapnic and hypercapnic challenges during heat stress. Whole body heating increased ECA blood flow and cardiac output by 130 ± 78 and 47 ± 26%, respectively (P < 0.001), while blood flow (or velocity) in the ICA, MCA, and VA was reduced by 17 ± 14, 24 ± 18, and 12 ± 7%, respectively (P < 0.001). Regardless of the thermal conditions, ICA and VA blood flows and MCA Vmean were decreased by hypocapnic challenges and increased by hypercapnic challenges. Similar responses in ECA blood flow were observed in hyperthermia but not in normothermia. Heat stress did not alter CO2 reactivity in the MCA and VA. However, CO2 reactivity in the ICA was decreased (3.04 ± 1.17 vs. 2.23 ± 1.03%/mmHg; P = 0.039) but that in the ECA was enhanced (0.45 ± 0.47 vs. 0.95 ± 0.61%/mmHg; P = 0.032). These results indicate that hyperthermia is capable of altering dynamic cerebral blood flow regulation.

Enhanced muscle pump during mild dynamic leg exercise inhibits sympathetic vasomotor outflow

Muscle sympathetic nerve activity (MSNA) is not increased during leg cycling at light and mild intensities, despite activation of central command and the exercise pressor reflex. We determined whether increasing central blood volume and loading the cardiopulmonary baroreceptors modulate sympathetic vasomotor outflow during leg cycling. To this end, we changed the pedaling frequency to enhance skeletal muscle pump. Subjects performed two leg cycle exercises at differential pedal rates of 60 and 80 rpm (60EX and 80EX trials) for two conditions (with and without MSNA measurement). In each trial, subjects completed leg cycling with a differential workload to maintain constant oxygen consumption (VO2). MSNA was recorded via microneurography at the right median nerve of the elbow. Without MSNA measurement, thoracic impedance, stroke volume (SV), and cardiac output (CO) were measured non‐invasively using impedance cardiography. Heart rate and VO2 during exercise did not differ between the 60EX and 80EX trials. Changes in thoracic impedance, SV, and CO during the 80EX trial were greater than during the 60EX trial. MSNA during the 60EX trial was unchanged compared with that at rest (25.8 ± 3.1 [rest] to 28.3 ± 3.4 [exercise] bursts/min), whereas a significant decrease in MSNA was observed during the 80EX trial (25.8 ± 2.8 [rest] to 19.7 ± 2.0 [exercise] bursts/min). These results suggest that a muscle pump‐induced increase in central blood volume, and thereby loading of cardiopulmonary baroreceptors, could inhibit sympathetic vasomotor outflow during mild dynamic leg exercise, despite activation of central command and the exercise pressor reflex.

Effect of an acute increase in central blood volume on cerebral hemodynamics

Systemic blood distribution is an important factor involved in regulating cerebral blood flow (CBF). However, the effect of an acute change in central blood volume (CBV) on CBF regulation remains unclear. To address our question, we sought to examine the CBF and systemic hemodynamic responses to microgravity during parabolic flight. Twelve healthy subjects were seated upright and exposed to microgravity during parabolic flight. During the brief periods of microgravity, mean arterial pressure was decreased (-26 ± 1%, P < 0.001), despite an increase in cardiac output (+21 ± 6%, P < 0.001). During microgravity, central arterial pulse pressure and estimated carotid sinus pressure increased rapidly. In addition, this increase in central arterial pulse pressure was associated with an arterial baroreflex-mediated decrease in heart rate (r = -0.888, P < 0.0001) and an increase in total vascular conductance (r = 0.711, P < 0.001). The middle cerebral artery mean blood velocity (MCA Vmean) remained unchanged throughout parabolic flight (P = 0.30). During microgravity the contribution of cardiac output to MCA Vmean was gradually reduced (P < 0.05), and its contribution was negatively correlated with an increase in total vascular conductance (r = -0.683, P < 0.0001). These findings suggest that the acute loading of the arterial and cardiopulmonary baroreceptors by increases in CBV during microgravity results in acute and marked systemic vasodilation. Furthermore, we conclude that this marked systemic vasodilation decreases the contribution of cardiac output to CBF. These findings suggest that the arterial and cardiopulmonary baroreflex-mediated peripheral vasodilation along with dynamic cerebral autoregulation counteracts a cerebral overperfusion, which otherwise would occur during acute increases in CBV.

Dynamic cerebral autoregulation is unrelated to decrease in external carotid artery blood flow during acute hypotension in healthy young men

What is the central question of this study? Dynamic cerebral autoregulation (CA) is impaired by sympathetic blockade, and the external carotid artery (ECA) vascular bed may prevent adequate internal carotid artery blood flow. We examined whether α1‐receptor blockade‐induced attenuation of dynamic CA is related to reduced ECA vasoconstriction. What is the main finding and its importance? α1‐Receptor blockade attenuated dynamic CA, but in contrast to our hypothesis did not affect the ECA blood flow response to acute hypotension. These findings suggest that the recovery of cerebral blood flow during acute hypotension is unrelated to vasoconstriction within the ECA territory.

Impact of short-term training camp on arterial stiffness in endurance runners.

Lack of elasticity in the central artery causes an increase in left ventricular (LV) afterload. Although regular moderate-intensity endurance exercise improves cardiovascular function, including arterial destiffening, little is known about the effect of short-term vigorous exercise on cardiovascular function (i.e., the interaction between cardiac and arterial functions). We measured arterial stiffness [via pulse wave velocity from the heart to ankle (haPWV)] and LV contractility (via systolic interval time) before and after a 1-week training camp in a total of 33 regularly highly-trained collegiate endurance runners. They participated in three training sessions per day which mainly consisted of long-distance running and sprint training. The averaged running distance was ≈44xa0% longer during the camp than the regular training program. After the camp, heart rate at rest and haPWV were significantly increased, whereas blood pressure remained unchanged. Although a ratio of pre-ejection period and LV ejection time (PEP/LVET, an index of blunted LV contractility) was unaltered, presumably due to the large variability of individual response, there was a significant correlation between changes in haPWV and PEP/LVET (rxa0=xa00.54, Pxa0<xa00.01). These results suggest that, in regularly highly-trained endurance athletes, arterial stiffness increases after a training camp characterized by greater training volume (vs. regular training), and that the individual response in arterial stiffness correlates with the corresponding changes in myocardial contractility.