Reduced blood flow and preserved vasoreactivity characterize oxygen hypometabolism due to incomplete infarction in occlusive carotid artery diseases.
Reduced blood flow and preserved vasoreactivity characterize oxygen hypometabolism due to incomplete infarction in occlusive carotid artery diseases.
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闭塞性颈动脉疾病中不完全梗塞导致血流量减少和血管反应性保留是氧代谢低下的特征。
DOI：
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发表时间：
2004
影响因子：
9.3
通讯作者：
Y. Iwasaki
中科院分区：
文献类型：
--
作者：
S. Kuroda;T. Shiga;T. Ishikawa;K. Houkin;Takuhito Narita;C. Katoh;N. Tamaki;Y. Iwasaki
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最近的研究表明，血流动力学受损的患者发生后续中风的风险很高。乙酰唑胺试验广泛用于检测因颈动脉闭塞性疾病导致血流动力学受损的患者。先前的研究表明，对乙酰唑胺反应性受损的患者 PET 中的氧提取分数 (OEF) 增加。然而，由于颈动脉闭塞性疾病导致血流量减少和对乙酰唑胺保留反应性的患者，无论 MRI 表现如何，其潜在的病理生理学尚未确定。本研究旨在使用 (15)O 气体和 (11)C-氟马西尼 (FMZ) PET 来阐明此类患者的血流动力学和代谢参数。
方法
我们的研究纳入了 15 名患者，这些患者在 N-异丙基-p-(123)I-碘苯丙胺 ((123)I-IMP) SPECT 上因闭塞性颈动脉疾病而导致同侧大脑中动脉区域的脑血流量 (CBF) 减少，但对乙酰唑胺的脑血管反应性 (CVR) 保留。我们使用 (15)O 气体 PET 测定了 CBF、脑氧代谢率 (CMRO(2))、脑血容量 (CBV) 和 OEF。还在 5 名患者中测量了 (11)C-FMZ 的结合潜力。所有患者都接受了平均 2.7 年的药物治疗和随访。
结果
(15)O气体PET扫描显示同侧CBF和CMRO(2)分别减少至对侧的80%+/-11%(P<0.0001)和78%+/-8%(P<0.0001)。然而，CBV 和 OEF 之间没有显着差异。 (11)C-FMZ 的同侧结合潜力也显着降低至对侧的 82% +/- 2% (P < 0.05)，与 CBF 和 CMRO 的不对称性非常相似(2)。随访期间，没有患者出现同侧半球进一步缺血性卒中。
结论
我们的结果强烈表明，CBF 减少和 CVR 正常是氧代谢低下的特征，可能是由于缺血相关的神经元损失，即不完全梗死。这种缺血性病变不会影响血流动力学，即使患者接受药物治疗，随后发生缺血性中风的风险也非常低。
UNLABELLED
Recent studies have clarified that hemodynamically compromised patients are at high risk for subsequent stroke. The acetazolamide test is widely used to detect the patients with hemodynamic compromise due to occlusive carotid artery disease. Previous studies have suggested that patients with impaired reactivity to acetazolamide had an increased oxygen extraction fraction (OEF) on PET. However, the underlying pathophysiology has not been defined in patients with reduced blood flow and preserved reactivity to acetazolamide due to carotid occlusive diseases regardless of a normal appearance on MRI. This study aimed to clarify hemodynamic and metabolic parameters in such patients, using (15)O gas and (11)C-flumazenil (FMZ) PET.
METHODS
Our study included 15 patients who had reduced cerebral blood flow (CBF) and preserved cerebrovascular reactivity (CVR) to acetazolamide in the ipsilateral middle cerebral artery territory due to occlusive carotid diseases on N-isopropyl-p-(123)I-iodoamphetamine ((123)I-IMP) SPECT. We determined the CBF, cerebral metabolic rate for oxygen (CMRO(2)), cerebral blood volume (CBV), and OEF using (15)O gas PET. The binding potential for (11)C-FMZ was also measured in 5 patients. All patients were medically treated and followed-up during a mean period of 2.7 y.
RESULTS
(15)O gas PET scans revealed that the ipsilateral CBF and CMRO(2) were reduced to 80% +/- 11% (P < 0.0001) and 78% +/- 8% (P < 0.0001) of the contralateral side, respectively. However, there was no significant side-to-side difference in the CBV and OEF. The ipsilateral binding potential for (11)C-FMZ was also significantly reduced to 82% +/- 2% of the contralateral side (P < 0.05), being very similar to the asymmetry of the CBF and CMRO(2). No patients suffered further ischemic stroke in the ipsilateral hemisphere during the follow-up period.
CONCLUSION
Our results strongly suggest that a reduced CBF and a normal CVR characterize oxygen hypometabolism probably due to ischemia-related neuronal loss-namely, incomplete infarction. Such an ischemic lesion is not hemodynamically compromised and is at very low risk for a subsequent ischemic stroke even if the patient is medically treated.
苯二氮卓类/GABA 受体的细胞调节：花生四烯酸、钙和脑缺血。
DOI：
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发表时间：
1992
期刊：
Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology
影响因子：
--
作者：
Schwartz,RD;Yu,X;Wagner,J;Ehrmann,M;Mileson,BE
通讯作者：
Mileson,BE
影响因子：
14.5
作者：
Derdeyn, CP;Videen, TO;Powers, WJ
通讯作者：
Powers, WJ
DOI：
10.1097/00008506-199904000-00018
发表时间：
1999-04
期刊：
JAMA
影响因子：
--
作者：
R. Grubb;C. Derdeyn;S. M. Fritsch;D. Carpenter;K. Yundt;T. Videen;E. Spitznagel;W. Powers
通讯作者：
R. Grubb;C. Derdeyn;S. M. Fritsch;D. Carpenter;K. Yundt;T. Videen;E. Spitznagel;W. Powers