Total Hemoglobin Mass Correlates with Peak Oxygen Consumption in Patients with Chronic Stroke
Abstract Background: The peak oxygen consumption (V.O2peak) and blood hemoglobin concentration [Hb] are lower in stroke patients than in age-matched healthy subjects. The ability of skeletal muscles to extract oxygen is diminished after stroke. We hypothesized that the oxygen extraction capacity of...
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| Published in | Cerebrovascular diseases (Basel, Switzerland) Vol. 52; no. 1; pp. 75 - 80 |
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| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Basel, Switzerland
01.01.2023
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| Online Access | Get full text |
| ISSN | 1015-9770 1421-9786 |
| DOI | 10.1159/000525597 |
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| Abstract | Abstract
Background: The peak oxygen consumption (V.O2peak) and blood hemoglobin concentration [Hb] are lower in stroke patients than in age-matched healthy subjects. The ability of skeletal muscles to extract oxygen is diminished after stroke. We hypothesized that the oxygen extraction capacity of skeletal muscles in stroke patients depends on [Hb]. To test the hypothesis, we determined the relationship between V.O2peak and total hemoglobin mass (tHb-mass) in stroke patients. Methods: The subjects were 19 stroke patients (age: 74 ± 2, mean ± SD, 10 males) and 11 age-matched normal subjects (age 76 ± 3, 6 males). Plasma volume (PV) and V.O2peak were measured on the same day. PV was measured using Evans Blue dye dilution method. Blood volume (BV) was calculated from PV and hematocrit, while tHb-mass was estimated from BV and [Hb]. Each subject underwent cardiopulmonary exercise test on a bicycle ergometer using a V.O2peak respiratory gas analyzer. Results: There were no differences in age, height, and weight between the two groups. V.O2peak was lower in stroke patients than in the control. BV and tHb mass were not significantly different between the two groups, but [Hb] was significantly lower in stroke patients. In stroke patients, V.O2peak correlated significantly with tHb-mass (r = 0.497, p < 0.05), but not with BV. Conclusion: Our results suggested that low [Hb] seems to contribute to V.O2peak in stroke patients. The significant correlation between tHb-mass and V.O2peak suggested that treatment to improve [Hb] can potentially improve V.O2peak in stroke patients. |
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| AbstractList | The peak oxygen consumption (V.O2peak) and blood hemoglobin concentration [Hb] are lower in stroke patients than in age-matched healthy subjects. The ability of skeletal muscles to extract oxygen is diminished after stroke. We hypothesized that the oxygen extraction capacity of skeletal muscles in stroke patients depends on [Hb]. To test the hypothesis, we determined the relationship between V.O2peak and total hemoglobin mass (tHb-mass) in stroke patients.
The subjects were 19 stroke patients (age: 74 ± 2, mean ± SD, 10 males) and 11 age-matched normal subjects (age 76 ± 3, 6 males). Plasma volume (PV) and V.O2peak were measured on the same day. PV was measured using Evans Blue dye dilution method. Blood volume (BV) was calculated from PV and hematocrit, while tHb-mass was estimated from BV and [Hb]. Each subject underwent cardiopulmonary exercise test on a bicycle ergometer using a V.O2peak respiratory gas analyzer.
There were no differences in age, height, and weight between the two groups. V.O2peak was lower in stroke patients than in the control. BV and tHb mass were not significantly different between the two groups, but [Hb] was significantly lower in stroke patients. In stroke patients, V.O2peak correlated significantly with tHb-mass (r = 0.497, p < 0.05), but not with BV.
Our results suggested that low [Hb] seems to contribute to V.O2peak in stroke patients. The significant correlation between tHb-mass and V.O2peak suggested that treatment to improve [Hb] can potentially improve V.O2peak in stroke patients. Abstract Background: The peak oxygen consumption (V.O2peak) and blood hemoglobin concentration [Hb] are lower in stroke patients than in age-matched healthy subjects. The ability of skeletal muscles to extract oxygen is diminished after stroke. We hypothesized that the oxygen extraction capacity of skeletal muscles in stroke patients depends on [Hb]. To test the hypothesis, we determined the relationship between V.O2peak and total hemoglobin mass (tHb-mass) in stroke patients. Methods: The subjects were 19 stroke patients (age: 74 ± 2, mean ± SD, 10 males) and 11 age-matched normal subjects (age 76 ± 3, 6 males). Plasma volume (PV) and V.O2peak were measured on the same day. PV was measured using Evans Blue dye dilution method. Blood volume (BV) was calculated from PV and hematocrit, while tHb-mass was estimated from BV and [Hb]. Each subject underwent cardiopulmonary exercise test on a bicycle ergometer using a V.O2peak respiratory gas analyzer. Results: There were no differences in age, height, and weight between the two groups. V.O2peak was lower in stroke patients than in the control. BV and tHb mass were not significantly different between the two groups, but [Hb] was significantly lower in stroke patients. In stroke patients, V.O2peak correlated significantly with tHb-mass (r = 0.497, p < 0.05), but not with BV. Conclusion: Our results suggested that low [Hb] seems to contribute to V.O2peak in stroke patients. The significant correlation between tHb-mass and V.O2peak suggested that treatment to improve [Hb] can potentially improve V.O2peak in stroke patients. |
| Author | Sato, Chika Sakurai, Yuta Nishimura, Yukihide Araki, Shohei Tajima, Fumihiro Yoshioka, Izumi Kamijo, Yoshi-ichiro Ogawa, Takahiro Murai, Kota Umemoto, Yasunori |
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| Keywords | Stroke patients Total hemoglobin mass Peak oxygen consumption |
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| References | Barlas RS, Honney K, Loke YK, McCall SJ, Bettencourt-Silva JH, Clark AB, . Impact of hemoglobin levels and anemia on mortality in acute stroke: analysis of UK regional registry data, systematic review, and meta-analysis. J Am Heart Assoc. 2016;5(8):e003019. Dunn A, Marsden DL, Van Vliet P, Spratt NJ, Callister R. Independently ambulant, community-dwelling stroke survivors have reduced cardiorespiratory fitness, mobility and knee strength compared to an age- and gender-matched cohort. Top Stroke Rehabil. 2017;24(3):163–9. Ito T, Takamata A, Yaegashi K, Itoh T, Yoshida T, Kawabata T, . Role of blood volume in the age-associated decline in peak oxygen uptake in humans. Jpn J Physiol. 2001;51(5):607–12. Eng JJ, Dawson AS, Chu KS. Submaximal exercise in persons with stroke: test-retest reliability and concurrent validity with maximal oxygen consumption. Arch Phys Med Rehabil. 2004;85(1):113–8. Chan T, Ganasekaran G. The effect of anemia on the functional outcomes of the stroke patients and the efficiency of their stroke rehabilitation. J Stroke Cerebrovasc Dis. 2015;24(6):1438–42. Montero D, Diaz-Cañestro C, Lundby C. Endurance training and VO2max: role of maximal cardiac output and oxygen extraction. Med Sci Sports Exerc. 2015;47(10):2024–33. Lundgren KM, Aspvik NP, Langlo KAR, Braaten T, Wisløff U, Stensvold D, . Blood volume, hemoglobin mass, and peak oxygen uptake in older adults: the generation 100 study. Front Sports Act Living. 2021;3(3):638139. Heo J, Youk TM, Seo KD. Anemia is a risk factor for the development of ischemic stroke and post-stroke mortality. J Clin Med. 2021;10(12):2556. Ivey FM, Hafer-Macko CE, Ryan AS, Macko RF. Impaired leg vasodilatory function after stroke: adaptations with treadmill exercise training. Stroke. 2010;41(12):2913–7. Masoudi Motlagh M, Sugar JJ, Azimipour M, Linz WW, Michalak G, Seo NJ, . Monitoring hemodynamic changes in stroke-affected muscles using near-infrared spectroscopy. J Rehabil Assist Technol Eng. 2015;2:205566831561419. 2055668315614195 https://doi.org/10.1177/2055668315614195. Yoshimura Y, Wakabayashi H, Shiraishi A, Nagano F, Bise T, Shimazu S, . Hemoglobin improvement is positively associated with functional outcomes in stroke patients with anemia. J Stroke Cerebrovasc Dis. 2021;30(1):105453. Nakamura T, Mizushima T, Yamamoto M, Kawazu T, Umezu Y, Tajima F, . Muscle sympathetic nerve activity during isometric exercise in patients with cerebrovascular accidents. Arch Phys Med Rehabil. 2005;86(3):436–41. Tanaka H, Desouza CA, Jones PP, Stevenson ET, Davy KP, Seals DR, . Greater rate of decline in maximal aerobic capacity with age in physically active versus sedentary healthy women. J Appl Physiol. 1997;83(6):1947–53. Warburton DER, Gledhill N, Quinney HA. Blood volume, aerobic power, and endurance performance: potential ergogenic effect of volume loading. Clin J Sport Med. 2000;10(1):59–66. Convertino VA, Ludwig DA. Validity of VO2max in predicting blood volume: implications for the effect of fitness on aging. Am J Physiol Regul Integr Comp Physiol. 2000;279(3):1068–75. Ministry of Health LaW, JAPAN, Health Statistics Office. Number of patients with major diseases, overview of patient survey. 2017. Hagberg JM, Goldberg AP, Lakatta L, O'Connor FC, Becker LC, Lakatta EG, . Expanded blood volumes contribute to the increased cardiovascular performance of endurance-trained older men. J Appl Physiol. 1998;85(2):484–9. Schmidt W, Prommer N. Impact of alterations in total hemoglobin mass on VO 2max. Exerc Sport Sci Rev. 2010;38(2):68–75. Ivey FM, Macko RF, Ryan AS, Hafer-Macko CE. Cardiovascular health and fitness after stroke. Top Stroke Rehabil. 2005;12(1):1–16. Krip B, Gledhill N, Jamnik V, Warburton D. Effect of alterations in blood volume on cardiac function during maximal exercise. Med Sci Sports Exerc. 1997;29(11):1469–76. Pimentel AE, Gentile CL, Tanaka H, Seals DR, Gates PE. Greater rate of decline in maximal aerobic capacity with age in endurance-trained than in sedentary men. J Appl Physiol. 2003;94(6):2406–13. Jakovljevic DG, Moore SA, Tan LB, Rochester L, Ford GA, Trenell MI, . Discrepancy between cardiac and physical functional reserves in stroke. Stroke. 2012;43(5):1422–5. |
| References_xml | – reference: Convertino VA, Ludwig DA. Validity of VO2max in predicting blood volume: implications for the effect of fitness on aging. Am J Physiol Regul Integr Comp Physiol. 2000;279(3):1068–75. – reference: Schmidt W, Prommer N. Impact of alterations in total hemoglobin mass on VO 2max. Exerc Sport Sci Rev. 2010;38(2):68–75. – reference: Yoshimura Y, Wakabayashi H, Shiraishi A, Nagano F, Bise T, Shimazu S, . Hemoglobin improvement is positively associated with functional outcomes in stroke patients with anemia. J Stroke Cerebrovasc Dis. 2021;30(1):105453. – reference: Heo J, Youk TM, Seo KD. Anemia is a risk factor for the development of ischemic stroke and post-stroke mortality. J Clin Med. 2021;10(12):2556. – reference: Ivey FM, Hafer-Macko CE, Ryan AS, Macko RF. Impaired leg vasodilatory function after stroke: adaptations with treadmill exercise training. Stroke. 2010;41(12):2913–7. – reference: Masoudi Motlagh M, Sugar JJ, Azimipour M, Linz WW, Michalak G, Seo NJ, . Monitoring hemodynamic changes in stroke-affected muscles using near-infrared spectroscopy. J Rehabil Assist Technol Eng. 2015;2:205566831561419. 2055668315614195 https://doi.org/10.1177/2055668315614195. – reference: Nakamura T, Mizushima T, Yamamoto M, Kawazu T, Umezu Y, Tajima F, . Muscle sympathetic nerve activity during isometric exercise in patients with cerebrovascular accidents. Arch Phys Med Rehabil. 2005;86(3):436–41. – reference: Lundgren KM, Aspvik NP, Langlo KAR, Braaten T, Wisløff U, Stensvold D, . Blood volume, hemoglobin mass, and peak oxygen uptake in older adults: the generation 100 study. Front Sports Act Living. 2021;3(3):638139. – reference: Pimentel AE, Gentile CL, Tanaka H, Seals DR, Gates PE. Greater rate of decline in maximal aerobic capacity with age in endurance-trained than in sedentary men. J Appl Physiol. 2003;94(6):2406–13. – reference: Ministry of Health LaW, JAPAN, Health Statistics Office. Number of patients with major diseases, overview of patient survey. 2017. – reference: Eng JJ, Dawson AS, Chu KS. Submaximal exercise in persons with stroke: test-retest reliability and concurrent validity with maximal oxygen consumption. Arch Phys Med Rehabil. 2004;85(1):113–8. – reference: Ivey FM, Macko RF, Ryan AS, Hafer-Macko CE. Cardiovascular health and fitness after stroke. Top Stroke Rehabil. 2005;12(1):1–16. – reference: Tanaka H, Desouza CA, Jones PP, Stevenson ET, Davy KP, Seals DR, . Greater rate of decline in maximal aerobic capacity with age in physically active versus sedentary healthy women. J Appl Physiol. 1997;83(6):1947–53. – reference: Jakovljevic DG, Moore SA, Tan LB, Rochester L, Ford GA, Trenell MI, . Discrepancy between cardiac and physical functional reserves in stroke. Stroke. 2012;43(5):1422–5. – reference: Krip B, Gledhill N, Jamnik V, Warburton D. Effect of alterations in blood volume on cardiac function during maximal exercise. Med Sci Sports Exerc. 1997;29(11):1469–76. – reference: Ito T, Takamata A, Yaegashi K, Itoh T, Yoshida T, Kawabata T, . Role of blood volume in the age-associated decline in peak oxygen uptake in humans. Jpn J Physiol. 2001;51(5):607–12. – reference: Chan T, Ganasekaran G. The effect of anemia on the functional outcomes of the stroke patients and the efficiency of their stroke rehabilitation. J Stroke Cerebrovasc Dis. 2015;24(6):1438–42. – reference: Dunn A, Marsden DL, Van Vliet P, Spratt NJ, Callister R. Independently ambulant, community-dwelling stroke survivors have reduced cardiorespiratory fitness, mobility and knee strength compared to an age- and gender-matched cohort. Top Stroke Rehabil. 2017;24(3):163–9. – reference: Hagberg JM, Goldberg AP, Lakatta L, O'Connor FC, Becker LC, Lakatta EG, . Expanded blood volumes contribute to the increased cardiovascular performance of endurance-trained older men. J Appl Physiol. 1998;85(2):484–9. – reference: Barlas RS, Honney K, Loke YK, McCall SJ, Bettencourt-Silva JH, Clark AB, . Impact of hemoglobin levels and anemia on mortality in acute stroke: analysis of UK regional registry data, systematic review, and meta-analysis. J Am Heart Assoc. 2016;5(8):e003019. – reference: Warburton DER, Gledhill N, Quinney HA. Blood volume, aerobic power, and endurance performance: potential ergogenic effect of volume loading. Clin J Sport Med. 2000;10(1):59–66. – reference: Montero D, Diaz-Cañestro C, Lundby C. Endurance training and VO2max: role of maximal cardiac output and oxygen extraction. Med Sci Sports Exerc. 2015;47(10):2024–33. |
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Background: The peak oxygen consumption (V.O2peak) and blood hemoglobin concentration [Hb] are lower in stroke patients than in age-matched healthy... The peak oxygen consumption (V.O2peak) and blood hemoglobin concentration [Hb] are lower in stroke patients than in age-matched healthy subjects. The ability... |
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| SubjectTerms | Aged Exercise Test Female Hemoglobins - metabolism Humans Male Original Paper Oxygen Oxygen Consumption - physiology Stroke - diagnosis |
| Title | Total Hemoglobin Mass Correlates with Peak Oxygen Consumption in Patients with Chronic Stroke |
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