Pilot Study to Characterize Middle Cerebral Artery Dynamic Response to an Acute Bout of Moderate Intensity Exercise at 3- and 6-Months Poststroke

• Published in: Journal of the American Heart Association 2021-02, Vol.10 (3), p.e017821-e017821
• Main Authors: Billinger, Sandra A, Whitaker, Alicen A, Morton, Allegra, Kaufman, Carolyn S, Perdomo, Sophy J, Ward, Jaimie L, Eickmeyer, Sarah M, Bai, Stephen X, Ledbetter, Luke, Abraham, Michael G
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; blood flow; Blood Flow Velocity - physiology; Blood Pressure - physiology; brain; Cerebrovascular Circulation - physiology; exercise; Exercise - physiology; Exercise Therapy - methods; Female; Follow-Up Studies; Heart Rate - physiology; Humans; Male; Middle Aged; Middle Cerebral Artery - diagnostic imaging; Middle Cerebral Artery - physiopathology; Original Research; Pilot Projects; Prognosis; stroke; Stroke - diagnosis; Stroke - physiopathology; Stroke Rehabilitation - methods; Time Factors; Ultrasonography, Doppler, Transcranial - methods; vascular function
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.120.017821

Background The primary aim of this study was to characterize the middle cerebral artery blood velocity (MCAv) dynamic response to an acute bout of exercise in humans at 3- and 6-months poststroke. As a secondary objective, we grouped individuals according to the MCAv dynamic response to the exercise bout as responder or nonresponder. We tested whether physical activity, aerobic fitness, and exercise mean arterial blood pressure differed between groups. Methods and Results Transcranial Doppler ultrasound measured MCAv during a 90-second baseline followed by a 6-minute moderate intensity exercise bout. Heart rate, mean arterial blood pressure, and end-tidal CO were additional variables of interest. The MCAv dynamic response variables included the following: baseline, time delay, amplitude, and time constant. Linear mixed model revealed no significant differences in our selected outcomes between 3- and 6-months poststroke. Individuals characterized as responders demonstrated a faster time delay, higher amplitude, and reported higher levels of physical activity and aerobic fitness when compared with the nonresponders. No between-group differences were identified for baseline, time constant, or exercise mean arterial blood pressure. In the nonresponders, we observed an immediate rise in MCAv following exercise onset followed by an immediate decline to near baseline values, while the responders showed an exponential rise until steady state was reached. Conclusions The MCAv dynamic response profile has the potential to provide valuable information during an acute exercise bout following stroke. Individuals with a greater MCAv response to the exercise stimulus reported statin use and regular participation in exercise.