Effect of Hyper- and Hypocapnia on Cerebral Arterial Compliance in Normal Subjects

被引:28
作者
Carrera, Emmanuel [1 ]
Kim, Dong-Joo [1 ]
Castellani, Gianluca [1 ]
Zweifel, Christian [1 ]
Smielewski, Peter [1 ]
Pickard, John D. [1 ]
Czosnyka, Marek [1 ]
机构
[1] Univ Cambridge, Addenbrookes Hosp, Dept Clin Neurosci, Cambridge CB2 2QQ, England
基金
瑞士国家科学基金会;
关键词
Cerebral arterial compliance; cerebral arterial blood volume; transcranial Doppler; hypocapnia; BLOOD-FLOW VELOCITY; CEREBROVASCULAR REACTIVITY; INTRACRANIAL COMPLIANCE; DOPPLER ULTRASOUND; PULSATILITY INDEX; PRESSURE; HUMANS; CIRCULATION; RESISTANCE; DYNAMICS;
D O I
10.1111/j.1552-6569.2009.00439.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND Changes in partial pressure of carbon dioxide (PaCO2) are associated with a decrease in cerebral blood flow (CBF) during hypocapnia and an increase in CBF during hypercapnia. However, the effects of changes in PaCO2 on cerebral arterial compliance (Ca) are unknown. METHODS We assessed the changes in Ca in 20 normal subjects using monitoring of arterial blood pressure (ABP) and cerebral blood flow velocity (CBFV). Cerebral arterial blood volume (CaBV) was extracted from CBFV. Ca was defined as the ratio between the pulse amplitudes of CaBV (AMP(CaBV)) and ABP (AMP(ABP)). All parameters were recorded during normo-, hyper-, and hypocapnia. RESULTS During hypocapnia, Ca was significantly lower than during normocapnia (.10 +/- .04 vs. .17 +/- .06; P < .001) secondary to a decrease in AMP(CaBV) (1.3 +/- .4 vs. 1.9 +/- .5; P < .001) and a concomitant increase in AMP(ABP) (13.8 +/- 3.4 vs. 11.6 +/- 1.7 mmHg; P < .001). During hypercapnia, there was no change in Ca compared with normocapnia. Ca was inversely correlated with the cerebrovascular resistance during hypo- (R2 = 0.86; P < .001), and hypercapnia (R2 = 0.61; P < .001). CONCLUSION Using a new mathematical model, we have described a reduction of Ca during hypocapnia. Further studies are needed to determine whether Ca may be an independent predictor of outcome in pathological conditions.
引用
收藏
页码:121 / 125
页数:5
相关论文
共 22 条
[1]   Dynamic pressure-flow velocity relationships in the human cerebral circulation [J].
Aaslid, R ;
Lash, SR ;
Bardy, GH ;
Gild, WH ;
Newell, DW .
STROKE, 2003, 34 (07) :1645-1649
[2]   ASSESSMENT OF CEREBRAL AUTOREGULATION DYNAMICS FROM SIMULTANEOUS ARTERIAL AND VENOUS TRANSCRANIAL DOPPLER RECORDINGS IN HUMANS [J].
AASLID, R ;
NEWELL, DW ;
STOOSS, R ;
SORTEBERG, W ;
LINDEGAARD, KF .
STROKE, 1991, 22 (09) :1148-1154
[3]   Quantifying the effect of posture on intracranial physiology in humans by MRI flow studies [J].
Alperin, N ;
Lee, SH ;
Sivaramakrishnan, A ;
Hushek, SG .
JOURNAL OF MAGNETIC RESONANCE IMAGING, 2005, 22 (05) :591-596
[4]   Magnetic resonance imaging-based measurements of cerebrospinal fluid and blood flow as indicators of intracranial compliance in patients with Chiari malformation [J].
Alperin, N ;
Sivaramakrishnan, A ;
Lichtor, T .
JOURNAL OF NEUROSURGERY, 2005, 103 (01) :46-52
[5]   Relationship between transcranial Doppler-determined pulsatility index and cerebrovascular resistance: An experimental study [J].
Czosnyka, M ;
Richards, HK ;
Whitehouse, HE ;
Pickard, JD .
JOURNAL OF NEUROSURGERY, 1996, 84 (01) :79-84
[6]   Carotid stiffness indicates risk of ischemic stroke and TIA in patients with internal carotid artery stenosis - The SMART study [J].
Dijk, JM ;
van der Graaf, Y ;
Grobbee, DE ;
Bots, ML .
STROKE, 2004, 35 (10) :2258-2262
[7]   Can cerebrovascular reactivity be assessed without measuring blood pressure in patients with carotid artery disease? [J].
Dumville, J ;
Panerai, RB ;
Lennard, NS ;
Naylor, AR ;
Evans, DH .
STROKE, 1998, 29 (05) :968-974
[8]   CO2 reactivity testing without blood pressure monitoring? [J].
Hetzel, A ;
Braune, S ;
Guschlbauer, B ;
Dohms, K .
STROKE, 1999, 30 (02) :398-401
[9]   Correlations among critical closing pressure, pulsatility index and cerebrovascular resistance [J].
Hsu, HY ;
Chern, CM ;
Kuo, JS ;
Kuo, TBJ ;
Chen, YT ;
Hu, HH .
ULTRASOUND IN MEDICINE AND BIOLOGY, 2004, 30 (10) :1329-1335
[10]  
Huber P, 1967, Invest Radiol, V2, P17, DOI 10.1097/00004424-196701000-00016