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Functional implications of impaired dynamic cerebral autoregulation in young healthy women; a comparative investigation

Lawrence Labrecque, Kevan Rahimaly, Sarah Imhoff, Myriam Paquette, Olivier Le Blanc, Simon Malenfant, Audrey Drapeau, Jonathan D. Smirl, Damian M. Bailey, Patrice Brassard
doi: https://doi.org/10.1101/406827
Lawrence Labrecque
1Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
2Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
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Kevan Rahimaly
1Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
2Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
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Sarah Imhoff
1Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
2Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
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Myriam Paquette
1Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
2Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
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Olivier Le Blanc
1Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
2Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
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Simon Malenfant
1Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
2Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
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Audrey Drapeau
1Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
2Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
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Jonathan D. Smirl
3Concussion Research Laboratory, Health and Exercise Sciences, University of British Columbia Okanagan, British Columbia, Canada
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Damian M. Bailey
4Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, United Kingdom
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Patrice Brassard
1Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
2Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
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ABSTRACT

Women exhibit higher prevalence of orthostatic hypotension with presyncopal symptoms compared to men. These symptoms could be influenced by an attenuated ability of the cerebrovasculature to respond to rapid changes in blood pressure (BP) [dynamic cerebral autoregulation (dCA)]. However, the influence of sex on dCA remains equivocal. We compared dCA in 11 women (25 ± 2 y) and 11 age-matched men (24 ± 1 y) using a multimodal approach including a sit-to-stand maneuver and forced oscillations (5 min of squat-stand performed at 0.05 and 0.10 Hz). The prevalence of initial orthostatic hypotension (IOH; decrease in systolic ≥ 40 mmHg and/or diastolic BP ≥ 20 mmHg) during the first 15 sec of sit-to-stand was determined as a functional outcome. In women, the decrease in mean middle cerebral artery blood velocity (MCAvmean) following the sit-to-stand was greater (−20 ± 8 vs. -11 ± 7 cm sec-1; p=0.018) and the onset of the regulatory change (time lapse between the beginning of the sit-to-stand and the increase in the conductance index (MCAvmean/mean arterial pressure(MAP)) was delayed (p=0.007). Transfer function analysis gain during 0.05 Hz squat-stand was ∼48% higher in women (6.4 ± 1.3 vs. 3.8 ± 2.3 sec; p=0.017). The prevalence of IOH was comparable between groups (4/9 vs. 5/9, p=0.637). These results indicate the cerebrovasculature of healthy women has an attenuated ability to react to large and rapid changes in BP in the face of preserved orthostasis, which could be related to a higher cerebrovascular reserve to face a rapid transient hypotension.

NEWS & NOTEWORTHY The novel findings of this study are that healthy women have impaired dynamic cerebral autoregulation, although the prevalence of orthostatic intolerance was similar in women and men. These results indicate the cerebrovasculature of healthy women has an attenuated ability to react to large and rapid changes in blood pressure in the face of preserved orthostasis, which could be related to a higher cerebrovascular reserve to face a rapid transient hypotension.

Authors contribution

P.B. contributed to the original idea of the study; L.L.,K.R, S.I, M.P.,O.L., S.M. and D.A. contributed to data collection; L.L. contributed to data analyses; L.L., J.D.S., D.M.B. and P.B. contributed to data interpretation; L.L.,J.D.S, D.M.B and P.B drafted the article. All authors provided approval of the final article.

Copyright 
The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license.
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Posted September 03, 2018.
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Functional implications of impaired dynamic cerebral autoregulation in young healthy women; a comparative investigation
Lawrence Labrecque, Kevan Rahimaly, Sarah Imhoff, Myriam Paquette, Olivier Le Blanc, Simon Malenfant, Audrey Drapeau, Jonathan D. Smirl, Damian M. Bailey, Patrice Brassard
bioRxiv 406827; doi: https://doi.org/10.1101/406827
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Functional implications of impaired dynamic cerebral autoregulation in young healthy women; a comparative investigation
Lawrence Labrecque, Kevan Rahimaly, Sarah Imhoff, Myriam Paquette, Olivier Le Blanc, Simon Malenfant, Audrey Drapeau, Jonathan D. Smirl, Damian M. Bailey, Patrice Brassard
bioRxiv 406827; doi: https://doi.org/10.1101/406827

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