Defining the characteristic relationship between arterial pressure and cerebral flow.
Defining the characteristic relationship between arterial pressure and cerebral flow.
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DOI：
10.1152/japplphysiol.00783.2012
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发表时间：
2012-10
影响因子：
3.3
通讯作者：
C. Tan
中科院分区：
文献类型：
--
作者：
C. Tan
可靠的评估脑血管缓冲压力波动的有效性可能对不良脑血管事件后的治疗时机和结果有重要意义。虽然线性方法可以指示脑自动调节的存在或不存在，但它们不足以描述其特征和有效性。建立一种简单而可靠的方法来可靠地测量脑自动调节的有效性，可以提供一种工具来指导筛选和临床选择，以表征和治疗与脑灌注改变相关的不良脑血管事件。为了测试一种这样的方法的效用，在43名健康志愿者中以0.03至0.08 Hz的六个频率使用30-40 mmHg的振荡下体负压，并且使用投影追踪回归来量化压力-流量关系和自动调节的有效性。投影寻踪回归解释了大部分压力和脑血流波动之间的关系，并揭示了其性质一致的个人和跨不同的研究日。这种关系的性质需要一个自动调节区域，其中缓慢的动脉压波动有效地反调节和两个被动区域，其中压力波动导致流量的平行变化。随着压力波动变快，自动调节的有效性显著降低。这些结果表明动脉压和脑血流量之间的特征关系。此外，在这项研究中使用的方法提供了一种工具，可以提供独特的见解，综合脑血管控制，并可能允许诊断的生理变化受损的脑自动调节。
Reliable assessment of cerebrovascular effectiveness in buffering against pressure fluctuations may have important implications for the timing and the outcome of therapy after adverse cerebrovascular events. Although linear approaches may indicate the presence or absence of cerebral autoregulation, they are inadequate to describe its characteristics and its effectiveness. Establishing a simple yet robust methodology to reliably measure the effectiveness of cerebral autoregulation could provide a tool to guide screening and clinical options to characterize and treat adverse cerebrovascular events associated with alterations in cerebral perfusion. To test the utility of one such methodology, an oscillatory lower body negative pressure of 30-40 mmHg was used at six frequencies from 0.03 to 0.08 Hz in 43 healthy volunteers, and the pressure-flow relation and the effectiveness of autoregulation was quantified using projection pursuit regression. Projection pursuit regression explained the majority of the relationship between pressure and cerebral blood flow fluctuations and revealed its nature consistently across individuals and across separate study days. The nature of this relationship entailed an autoregulatory region wherein slow arterial pressure fluctuations are effectively counterregulated and two passive regions wherein pressure fluctuations resulted in parallel changes in flow. The effectiveness of autoregulation was significantly reduced as pressure fluctuations became faster. These results demonstrate the characteristic relationship between arterial pressure and cerebral blood flow. Furthermore, the methodology utilized in this study provides a tool that can provide unique insight to integrated cerebrovascular control and may allow diagnosis of physiological alterations underlying impaired cerebral autoregulation.