Amal Machfer, Sémah Tagougui, Firas Zghal, Hayfa Ben Haj Hassen, Nadia Fekih, Hassen Ibn Hadj Amor, Hamdi Chtourou, Mohamed Amine Bouzid
{"title":"终末期肾病患者运动能力下降的血液动力学和神经肌肉基础。","authors":"Amal Machfer, Sémah Tagougui, Firas Zghal, Hayfa Ben Haj Hassen, Nadia Fekih, Hassen Ibn Hadj Amor, Hamdi Chtourou, Mohamed Amine Bouzid","doi":"10.1007/s00421-024-05427-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The present study aimed to characterize the exercise-induced neuromuscular fatigue and its possible links with cerebral and muscular oxygen supply and utilization to provide mechanistic insights into the reduced exercise capacity characterizing patients with end-stage renal disease (ESRD).</p><p><strong>Methods: </strong>Thirteen patients with ESRD and thirteen healthy males (CTR group) performed a constant-force sustained isometric contraction at 50% of their maximal voluntary isometric contraction (MVC) until exhaustion. Quadriceps muscle activation during exercise was estimated from vastus lateralis, vastus medialis, and rectus femoris EMG. Central and peripheral fatigue were quantified via changes in pre- to postexercise quadriceps voluntary activation (ΔVA) and quadriceps twitch force (ΔQ<sub>tw,pot</sub>) evoked by supramaximal electrical stimulation, respectively. To assess cerebral and muscular oxygenation, throughout exercise, near-infrared spectroscopy allowed investigation of changes in oxyhemoglobin (∆O<sub>2</sub>Hb), deoxyhemoglobin (∆HHb), and total hemoglobin (∆THb) in the prefrontal cortex and in the vastus lateralis muscle.</p><p><strong>Results: </strong>ESRD patients demonstrated lower exercise time to exhaustion than that of CTR (88.8 ± 15.3 s and 119.9 ± 14.6 s, respectively, P < 0.01). Following the exercise, MVC, Q<sub>tw,pot</sub>, and VA reduction were similar between the groups (P > 0.05). There was no significant difference in muscle oxygenation (∆O<sub>2</sub>Hb) between the two groups (P > 0.05). Cerebral and muscular blood volume (∆THb) and oxygen extraction (∆HHb) were significantly blunted in the ESRD group (P < 0.05). A significant positive correlation was observed between time to exhaustion and cerebral blood volume (∆THb) in both groups (r<sup>2</sup> = 0.64, P < 0.01).</p><p><strong>Conclusions: </strong>These findings support cerebral hypoperfusion as a factor contributing to the reduction in exercise capacity characterizing ESRD patients.</p>","PeriodicalId":12005,"journal":{"name":"European Journal of Applied Physiology","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Hemodynamic and neuromuscular basis of reduced exercise capacity in patients with end-stage renal disease.\",\"authors\":\"Amal Machfer, Sémah Tagougui, Firas Zghal, Hayfa Ben Haj Hassen, Nadia Fekih, Hassen Ibn Hadj Amor, Hamdi Chtourou, Mohamed Amine Bouzid\",\"doi\":\"10.1007/s00421-024-05427-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The present study aimed to characterize the exercise-induced neuromuscular fatigue and its possible links with cerebral and muscular oxygen supply and utilization to provide mechanistic insights into the reduced exercise capacity characterizing patients with end-stage renal disease (ESRD).</p><p><strong>Methods: </strong>Thirteen patients with ESRD and thirteen healthy males (CTR group) performed a constant-force sustained isometric contraction at 50% of their maximal voluntary isometric contraction (MVC) until exhaustion. Quadriceps muscle activation during exercise was estimated from vastus lateralis, vastus medialis, and rectus femoris EMG. Central and peripheral fatigue were quantified via changes in pre- to postexercise quadriceps voluntary activation (ΔVA) and quadriceps twitch force (ΔQ<sub>tw,pot</sub>) evoked by supramaximal electrical stimulation, respectively. To assess cerebral and muscular oxygenation, throughout exercise, near-infrared spectroscopy allowed investigation of changes in oxyhemoglobin (∆O<sub>2</sub>Hb), deoxyhemoglobin (∆HHb), and total hemoglobin (∆THb) in the prefrontal cortex and in the vastus lateralis muscle.</p><p><strong>Results: </strong>ESRD patients demonstrated lower exercise time to exhaustion than that of CTR (88.8 ± 15.3 s and 119.9 ± 14.6 s, respectively, P < 0.01). Following the exercise, MVC, Q<sub>tw,pot</sub>, and VA reduction were similar between the groups (P > 0.05). There was no significant difference in muscle oxygenation (∆O<sub>2</sub>Hb) between the two groups (P > 0.05). Cerebral and muscular blood volume (∆THb) and oxygen extraction (∆HHb) were significantly blunted in the ESRD group (P < 0.05). A significant positive correlation was observed between time to exhaustion and cerebral blood volume (∆THb) in both groups (r<sup>2</sup> = 0.64, P < 0.01).</p><p><strong>Conclusions: </strong>These findings support cerebral hypoperfusion as a factor contributing to the reduction in exercise capacity characterizing ESRD patients.</p>\",\"PeriodicalId\":12005,\"journal\":{\"name\":\"European Journal of Applied Physiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Applied Physiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00421-024-05427-0\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/2/19 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"PHYSIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Applied Physiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00421-024-05427-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/19 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PHYSIOLOGY","Score":null,"Total":0}
Hemodynamic and neuromuscular basis of reduced exercise capacity in patients with end-stage renal disease.
Purpose: The present study aimed to characterize the exercise-induced neuromuscular fatigue and its possible links with cerebral and muscular oxygen supply and utilization to provide mechanistic insights into the reduced exercise capacity characterizing patients with end-stage renal disease (ESRD).
Methods: Thirteen patients with ESRD and thirteen healthy males (CTR group) performed a constant-force sustained isometric contraction at 50% of their maximal voluntary isometric contraction (MVC) until exhaustion. Quadriceps muscle activation during exercise was estimated from vastus lateralis, vastus medialis, and rectus femoris EMG. Central and peripheral fatigue were quantified via changes in pre- to postexercise quadriceps voluntary activation (ΔVA) and quadriceps twitch force (ΔQtw,pot) evoked by supramaximal electrical stimulation, respectively. To assess cerebral and muscular oxygenation, throughout exercise, near-infrared spectroscopy allowed investigation of changes in oxyhemoglobin (∆O2Hb), deoxyhemoglobin (∆HHb), and total hemoglobin (∆THb) in the prefrontal cortex and in the vastus lateralis muscle.
Results: ESRD patients demonstrated lower exercise time to exhaustion than that of CTR (88.8 ± 15.3 s and 119.9 ± 14.6 s, respectively, P < 0.01). Following the exercise, MVC, Qtw,pot, and VA reduction were similar between the groups (P > 0.05). There was no significant difference in muscle oxygenation (∆O2Hb) between the two groups (P > 0.05). Cerebral and muscular blood volume (∆THb) and oxygen extraction (∆HHb) were significantly blunted in the ESRD group (P < 0.05). A significant positive correlation was observed between time to exhaustion and cerebral blood volume (∆THb) in both groups (r2 = 0.64, P < 0.01).
Conclusions: These findings support cerebral hypoperfusion as a factor contributing to the reduction in exercise capacity characterizing ESRD patients.
期刊介绍:
The European Journal of Applied Physiology (EJAP) aims to promote mechanistic advances in human integrative and translational physiology. Physiology is viewed broadly, having overlapping context with related disciplines such as biomechanics, biochemistry, endocrinology, ergonomics, immunology, motor control, and nutrition. EJAP welcomes studies dealing with physical exercise, training and performance. Studies addressing physiological mechanisms are preferred over descriptive studies. Papers dealing with animal models or pathophysiological conditions are not excluded from consideration, but must be clearly relevant to human physiology.