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Cerebrovascular and blood pressure responses during voluntary apneas are larger than rebreathing

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Abstract

Both voluntary rebreathing (RB) of expired air and voluntary apneas (VA) elicit changes in arterial carbon dioxide and oxygen (CO2 and O2) chemostimuli. These chemostimuli elicit synergistic increases in cerebral blood flow (CBF) and sympathetic nervous system activation, with the latter increasing systemic blood pressure. The extent that simultaneous and inverse changes in arterial CO2 and O2 and associated increases in blood pressure affect the CBF responses during RB versus VAs are unclear. We instrumented 21 healthy participants with a finometer (beat-by-beat mean arterial blood pressure; MAP), transcranial Doppler ultrasound (middle and posterior cerebral artery velocity; MCAv, PCAv) and a mouthpiece with sample line attached to a dual gas analyzer to assess pressure of end-tidal (PET)CO2 and PETO2. Participants performed two protocols: RB and a maximal end-inspiratory VA. A second-by-second stimulus index (SI) was calculated as PETCO2/PETO2 during RB. For VA, where PETCO2 and PETO2 could not be measured throughout, SI values were calculated using interpolated end-tidal gas values before and at the end of the apneas. MAP reactivity (MAPR) was calculated as the slope of the MAP/SI, and cerebrovascular reactivity (CVR) was calculated as the slope of MCAv or PCAv/SI. We found that compared to RB, VA elicited ~ fourfold increases in MAPR slope (P < 0.001), translating to larger anterior and posterior CVR (P ≤ 0.01). However, cerebrovascular conductance (MCAv or PCAv/MAP) was unchanged between interventions (P ≥ 0.2). MAP responses during VAs are larger than those during RB across similar chemostimuli, and differential CVR may be driven by increases in perfusion pressure.

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Availability of data and material

The deidentified data from this study will be made available upon reasonable request by request to the corresponding author by a qualified researcher.

Code availability

Not applicable.

Abbreviations

CBF:

Cerebral blood flow

CBV:

Cerebral blood velocity

MAP:

Mean arterial blood pressure

MAPR:

Mean arterial blood pressure reactivity

MCAv:

Middle cerebral artery blood velocity

PCAv:

Posterior cerebral artery blood velocity

P ETCO2/O2 :

Pressure of end-tidal CO2/O2

SI:

Stimulus index (PETCO2/PETO2)

CVR:

Cerebrovascular reactivity

CVC:

Cerebrovascular conductance

PaCO2/O2 :

Partial pressure of CO2/O2

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Acknowledgements

We are grateful to our participants for their time and effort in supporting our study.

Funding

Funding was provided by Natural Sciences and Engineering Research Council of Canada Discovery Grants (TAD: grant 04915; CDS: 06637).

Author information

Author notes

  1. Craig D. Steinback and Trevor A. Day denote equal contributions to senior authorship.

Authors and Affiliations

  1. Department of Biology, Faculty of Science and Technology, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, AB, T3E 6K6, Canada

    Anthony L. Marullo, Christina D. Bruce, Jamie R. Pfoh, Maria Abrosimova, Emily R. Vanden Berg, Nicholas D. J. Strzalkowski & Trevor A. Day

  2. Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB, Canada

    Uday V. Chauhan, Rachel J. Skow, Margie H. Davenport & Craig D. Steinback

Authors
  1. Anthony L. Marullo
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  2. Christina D. Bruce
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  3. Jamie R. Pfoh
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  4. Uday V. Chauhan
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  5. Maria Abrosimova
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  6. Emily R. Vanden Berg
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  9. Nicholas D. J. Strzalkowski
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  10. Craig D. Steinback
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  11. Trevor A. Day
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Contributions

TAD, CDS and MHD, conception or design of the work; All co-authors, acquisition, analysis, or interpretation of data for the work; ALM, CDB, NDJS, CDS, TAD, drafting of the work or revising it critically for important intellectual content; All co-authors approved the final version of the manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All persons designated as authors qualify for authorship, and all those who qualify for authorship are listed.

Corresponding author

Correspondence to Trevor A. Day.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

This study received ethical approval in advance from the University of Alberta Human Research Ethics Board (Protocol #00048741), was harmonized with the Mount Royal University Human Research Ethics Board (Protocol #102663) and abided by the Canadian Government Tri-Council Policy Statement (TCPS2) for Integrity in Research, and the Declaration of Helsinki, except for registration in a data base.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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The authors affirm that human research participants provided informed consent for publication of the deidentified, numerical data.

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Communicated by I. Mark Olfert.

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Marullo, A.L., Bruce, C.D., Pfoh, J.R. et al. Cerebrovascular and blood pressure responses during voluntary apneas are larger than rebreathing. Eur J Appl Physiol 122, 735–743 (2022). https://doi.org/10.1007/s00421-021-04864-5

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  • DOI: https://doi.org/10.1007/s00421-021-04864-5

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