Blood flow response to orthostatic challenge identifies signatures of the failure of static cerebral autoregulation in patients with cerebrovascular disease.
Blood flow response to orthostatic challenge identifies signatures of the failure of static cerebral autoregulation in patients with cerebrovascular disease.
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DOI：
10.1186/s12883-021-02179-8
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发表时间：
2021-04-09
期刊：
影响因子：
2.6
通讯作者：
Delgado-Mederos R
中科院分区：
文献类型：
--
作者：
Gregori-Pla C;Mesquita RC;Favilla CG;Busch DR;Blanco I;Zirak P;Frisk LK;Avtzi S;Maruccia F;Giacalone G;Cotta G;Camps-Renom P;Mullen MT;Martí-Fàbregas J;Prats-Sánchez L;Martínez-Domeño A;Kasner SE;Greenberg JH;Zhou C;Edlow BL;Putt ME;Detre JA;Yodh AG;Durduran T;Delgado-Mederos R
用弥散相关波谱技术研究了急性缺血性卒中(AIS)患者大脑皮质微血管脑血流对不同卧头位置变化的反应。然而，尽管血压是脑血流的主要驱动力，但这些相对的Δ脑血流量变化与相关的全身血压变化之间的关系尚未被研究。收集健康对照组(n = 15例)、无症状性颈内动脉重度狭窄患者(n = 2 7例)和急性缺血性卒中患者(n = 72例)双侧额叶微血管脑血流量的经颅DCs数据。根据短卧位(HOB)操作方案(仰卧位/仰卧位/仰卧位，每个位置5 分钟)测量脑血流量。在亚组(AIS，n = 26；ICA，n = 14；对照组，n = 15)中，在治疗过程中动态测量平均动脉压(MAP)。升高体位后，对照组(p = 0.890)的DCSCBF恢复至基础仰卧值，而颈内动脉狭窄(8.6%[3.1，14.0]，p 0.003)患者则不能恢复至基础仰卧值(9.6%[6.0，13.3]，平均95%CI，p <； 0.001)。AIS患者的MAP未恢复到基线水平(2.6 = [0.5，4.7]，p<0.0 5)，而颈内动脉狭窄患者和对照组的MAP恢复到基线水平。颈动脉血流与MAP相关(AIS6.0%/− 2.4，14.3，p = 0.038；颈内动脉狭窄11.0%/mm Hg[2.4，19.5]，p <； 0.001)。同侧脑血流量和平均动脉压之间的相关性表明，短臂位置的改变可能会导致脑血管疾病患者大脑自动调节功能的缺陷。还需要更多的研究来进一步描述这一现象。网上版载有补充材料，可在10.1186/s12883-021-02179-8查阅。
The cortical microvascular cerebral blood flow response (CBF) to different changes in head-of-bed (HOB) position has been shown to be altered in acute ischemic stroke (AIS) by diffuse correlation spectroscopy (DCS) technique. However, the relationship between these relative ΔCBF changes and associated systemic blood pressure changes has not been studied, even though blood pressure is a major driver of cerebral blood flow. Transcranial DCS data from four studies measuring bilateral frontal microvascular cerebral blood flow in healthy controls (n = 15), patients with asymptomatic severe internal carotid artery stenosis (ICA, n = 27), and patients with acute ischemic stroke (AIS, n = 72) were aggregated. DCS-measured CBF was measured in response to a short head-of-bed (HOB) position manipulation protocol (supine/elevated/supine, 5 min at each position). In a sub-group (AIS, n = 26; ICA, n = 14; control, n = 15), mean arterial pressure (MAP) was measured dynamically during the protocol. After elevated positioning, DCS CBF returned to baseline supine values in controls (p = 0.890) but not in patients with AIS (9.6% [6.0,13.3], mean 95% CI, p < 0.001) or ICA stenosis (8.6% [3.1,14.0], p = 0.003)). MAP in AIS patients did not return to baseline values (2.6 mmHg [0.5, 4.7], p = 0.018), but in ICA stenosis patients and controls did. Instead ipsilesional but not contralesional CBF was correlated with MAP (AIS 6.0%/mmHg [− 2.4,14.3], p = 0.038; ICA stenosis 11.0%/mmHg [2.4,19.5], p < 0.001). The observed associations between ipsilateral CBF and MAP suggest that short HOB position changes may elicit deficits in cerebral autoregulation in cerebrovascular disorders. Additional research is required to further characterize this phenomenon. The online version contains supplementary material available at 10.1186/s12883-021-02179-8.
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影响因子：
6.3
作者：
HEISS, WD;HUBER, M;WIENHARD, K
通讯作者：
WIENHARD, K
影响因子：
3.5
作者：
Kim MN;Edlow BL;Durduran T;Frangos S;Mesquita RC;Levine JM;Greenberg JH;Yodh AG;Detre JA
通讯作者：
Detre JA
影响因子：
5.4
作者：
Durgan DJ;Bryan RM Jr
通讯作者：
Bryan RM Jr
影响因子：
2.9
作者：
Aries, Marcel J.;Elting, Jan Willem;Vroomen, Patrick
通讯作者：
Vroomen, Patrick
影响因子：
4.2
作者：
Asllani, Iris;Slattery, Pamelia;Fafard, Alexander;Pavol, Marykay;Lazar, Ronald M.;Marshall, Randolph S.
通讯作者：
Marshall, Randolph S.