Abstract
BackgroundCoronary artery disease (CAD) is associated with verbal memory decline, although deterioration may be mitigated in individuals undertaking exercise interventions. Ceramide sphingolipids, suggested to play a role in pathological neurodegeneration, have been associated with the development and progression of CAD but their relationship with cognitive response to exercise has not been assessed. In this study, concentrations of very long chain ceramides (C22:0 and C24:0) were assessed as predictors of changes in verbal memory performance over 1 year in subjects with CAD undertaking cardiac rehabilitation (CR).MethodsVerbal memory was measured using the California Verbal Learning Test 2nd Ed. (CVLT-II), from which Z-scores were calculated based on age, gender and education matched norms. Baseline plasma C22:0 and C24:0 ceramide concentrations were measured from fasting blood samples using high performance liquid chromatography coupled electrospray ionization tandem mass spectrometry (LC/MS/MS). Repeated measures general linear models were used to determine the association between baseline plasma ceramides and the change in verbal memory performance over 1 year of CR controlling for age and body mass index (BMI).ResultsIn patients with CAD (n = 33, mean age = 62 ± 9 years, 84.8% male, years of education = 17 ± 3 years), higher baseline plasma C22:0 (F1, 29 = 5.30, p = 0.03) and C24:0 (F1, 29 = 4.04, p = 0.05) concentrations significantly predicted less improvement in verbal memory performance over 1 year of CR controlling for age and BMI.ConclusionsPlasma ceramide concentrations should be further examined as potential predictors of cognitive response to exercise and worse cognitive outcomes in patients with CAD.Trial registrationNCT01625754
Highlights
Coronary artery disease (CAD) is associated with verbal memory decline, deterioration may be mitigated in individuals undertaking exercise interventions
Exercise is increasingly recognized as a promising intervention to improve cardiac outcomes [13] and to delay verbal memory decline [14,15]; effects of fitness and cognitive response to exercise can be heterogeneous [16] indicating a need to explore the mechanisms that may hinder the cognitive benefits of exercise
In repeated measures analyses controlling for age and body mass index (BMI), significant ceramides × time interactions were found within subjects; higher baseline log C22:0 (F1, 29 = 5.30, p = 0.03) and C24:0 (F1, 29 = 4.04, p = 0.05) concentrations were significantly predictive of less improvement in verbal memory performance
Summary
Coronary artery disease (CAD) is associated with verbal memory decline, deterioration may be mitigated in individuals undertaking exercise interventions. Concentrations of very long chain ceramides (C22:0 and C24:0) were assessed as predictors of changes in verbal memory performance over 1 year in subjects with CAD undertaking cardiac rehabilitation (CR). Repeated measures general linear models were used to determine the association between baseline plasma ceramides and the change in verbal memory performance over 1 year of CR controlling for age and body mass index (BMI). Elevated plasma concentrations of the very long chain ceramides C22:0 and C24:0 have been associated with the development of CAD [9] and with greater verbal memory decline and hippocampal volume loss in patients with mild cognitive impairment [10] and incident Alzheimer’s disease in community dwelling elderly women [11]. The present study evaluated the relationship between plasma concentrations of C22:0 and C24:0 and change in verbal memory performance in CAD subjects undertaking a 1-year cardiac rehabilitation (CR) program
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