Carotid intima‐media thickness and cerebrovascular reactivity in long‐term type 1 diabetes mellitus

Siró, Péter; Molnár, Csilla; Katona, Éva; Antek, Csaba; Kollár, Ján; Settakis, Georgios; Fülesdi, Béla

doi:10.1002/jcu.20617

Cited by 14 publications

(11 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As a consequence, sudden intraoperative changes of cerebral perfusion pressure and/or carbon-dioxide concentration may challenge the autoregulatory and metabolic regulatory responses and thus may result in critical brain tissue oxygenation. In line with our observations previous studies in humans also demonstrated that sevoflurane at ≤1 MAC concentrations do not affect cerebral autoregulation (2,15,16). In a very recent study Sperna Weiland and co-workers found that sevoflurane does not affect the already impaired cerebral autoregulation in diabetic patients at clinicially applied doses (17).…”

Section: Discussionsupporting

confidence: 92%

Effect of sevoflurane on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity

Juhász

Molnár

Fülesdi

et al. 2019

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Sevoflurane is one of the most frequently used inhaled anesthetics for general anesthesia. Previously it has been reported that at clinically used doses of sevoflurane, cerebral vasoreactivity is maintained. However, there are no data how sevoflurane influences systemic and cerebral circulation in parallel. The aim of our study was to assess systemic and cerebral hemodynamic changes as well as cerebral CO2-reactivity during sevoflurane anesthesia. Methods: 29 patients undergoing general anesthesia were enrolled. Anesthesia was maintained with 1 MAC sevoflurane in 40% oxygen. Ventilatory settings (respiratory rate and tidal volume) were adjusted to reach and maintain 40, 35 and 30 mmHg EtCO2 for 5 minutes respectively. At the end of each period, transcranial Doppler and hemodynamic parameters using applanation tonometry were recorded. Results: Systemic mean arterial pressure significantly decreased during anesthetic induction and remained unchanged during the entire study period. Central aortic and peripherial pulse pressure and augmentation idex as markers of arterial stiffness significantly increased during the anesthetic induction and remained stable at the time points when target CO2 levels were reached. Both cerebral autoregulation and cerebral CO2-reactivity was maintained at 1 MAC sevoflurane. Discussion: Cerebral autoregulation and CO2-reactivity is preserved at 1 MAC sevoflurane. Cerebrovascular effects of anesthetic compounds have to be assessed together with systemic circulatory effects. Key words: sevoflurane; cerebral blood flow, cerebral autoregulation; CO2-reactivity, applanation tonometry; transcranial Doppler The study was registered at http://www.clinicaltrials.gov, identifier: NCT02054143, retrospectively registered.

show abstract

Section: Discussionsupporting

confidence: 92%

Effect of sevoflurane on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity

Juhász

Molnár

Fülesdi

et al. 2019

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Additionally, whyle using some agents, direct cerebral effect has also to be taken Previous reports indicated that sevoflurane between 0.5-1.0 MAC has minimal direct vasodilatory effect on the brain arteries (8,9)and has no systemic hemodynamic effects (cardiac contractility and/or peripheral vascular resistance) at the most frequently used 1 MAC sevoflurane (10). In the present study, during the induction phase, the combination of propofol-fentanyl-rocuronium and adding sevoflurane resulted in a decreased mean arterial pressure (mainly due to the decrease of the Previously it has been demonstrated that cerebral autoregulation and reactivity of the cerebral vessels to induced hypocapnia may be impaired in patients with certain underlying diseases, such as hypertension and diabetes mellitus (11)(12)(13)(14). As a consequence, sudden intraoperative changes of cerebral perfusion pressure and/or carbon-dioxide concentration may challenge the autoregulatory and metabolic regulatory responses and thus may result in critical brain tissue oxygenation.…”

Section: Discussionmentioning

confidence: 50%

Effect of sevoflurane on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity

Juhász

Molnár

Fülesdi

et al. 2019

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Sevoflurane is one of the most frequently used inhaled anesthetics for general anesthesia. Previously it has been reported that at clinically used doses of sevoflurane, cerebral vasoreactivity is maintained. However, there are no data how sevoflurane influences systemic and cerebral circulation in parallel. The aim of our study was to assess systemic and cerebral hemodynamic changes as well as cerebral CO2-reactivity during sevoflurane anesthesia. Methods: 29 patients undergoing general anesthesia were enrolled. Anesthesia was maintained with 1 MAC sevoflurane in 40% oxygen. Ventilatory settings (respiratory rate and tidal volume) were adjusted to reach and maintain 40, 35 and 30 mmHg EtCO2 for 5 minutes respectively. At the end of each period, transcranial Doppler and hemodynamic parameters using applanation tonometry were recorded. Results: Systemic mean arterial pressure significantly decreased during anesthetic induction and remained unchanged during the entire study period. Central aortic and peripherial pulse pressure and augmentation index as markers of arterial stiffness significantly increased during the anesthetic induction and remained stable at the time points when target CO2 levels were reached. Both cerebral autoregulation and cerebral CO2-reactivity was maintained at 1 MAC sevoflurane. Discussion: Cerebral autoregulation and CO2-reactivity is preserved at 1 MAC sevoflurane. Cerebrovascular effects of anesthetic compounds have to be assessed together with systemic circulatory effects. Doppler Trial Registration: The study was registered at http://www.clinicaltrials.gov, identifier: NCT02054143, retrospectively registered. Date of registration: February 4, 2014.

show abstract

“…An increased cIMT was observed not only in long-standing type 2 diabetic but also in newly detected type 2 diabetic patients (5,8). In type 1 diabetes mellitus (T1DM) cIMT was found to be thicker already in children, adolescents and young adults (3,4,13,20,29,33,39). Increased cIMT within the normal upper limit shows that young women with pGDM have an early sign of vessel involvement (1,9,42).…”

Section: Imtmentioning

confidence: 95%

Preserved structural and functional characteristics of common carotid artery in properly treated normoglycemic women with gestational diabetes mellitus

Vastagh

Horváth²,

Griger

et al. 2011

Acta Physiologica Hungarica

View full text Add to dashboard Cite

Women with gestational diabetes mellitus (GDM) are at high risk of subsequently developing type 2 diabetes mellitus which is an important cardiovascular risk factor. We have evaluated whether preclinical morphological and functional arterial changes are present in GDM. Diameter, intima-media thickness (IMT), intima-media cross-section area (IMCSA) and elasticity features (compliance, distensibility coefficient, circumferential strain, stiffness index (SI) α and β, incremental elastic modulus) of the common carotid arteries (CCA) were studied in the 3rd trimester in 25 women with GDM, and 17 normal pregnant women matched for age and body mass index using an ultrasonographic vessel wall-movement tracking system and applanation tonometry. Mean IMT, IMCSA and SI α tended to be larger, whereas compliance was smaller in women with GDM but none of these differences were significant. Serum glucose (4.99 ± 0.51 vs. 4.79 ± 0.61 mmol/L, p=0.37) and HbA1c (5.33 ± 0.27 vs. 5.36 ± 0.47 mmol/L, p=0.85) proved normoglycemia in both groups. In conclusion, by the combination of methods we applied in this case control study, neither morphological nor functional characteristics of large elastic arteries differ significantly between well-treated normoglycemic women with GDM and non-diabetic pregnant women in the 3rd trimester.

show abstract

Carotid intima‐media thickness and cerebrovascular reactivity in long‐term type 1 diabetes mellitus

Cited by 14 publications

References 21 publications

Effect of sevoflurane on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity

Effect of sevoflurane on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity

Effect of sevoflurane on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity

Preserved structural and functional characteristics of common carotid artery in properly treated normoglycemic women with gestational diabetes mellitus

Contact Info

Product

Resources

About