Correction for Blood Pressure Improves Correlation between Cerebrovascular Reactivity Assessed by Breath Holding and 6% CO2 Breathing

Prakash, Kiran; Chandran, Dinu S; Khadgawat, Rajesh; Jaryal, Ashok Kumar; Deepak, Kishore Kumar

doi:10.1016/j.jstrokecerebrovasdis.2013.06.003

Cited by 17 publications

(23 citation statements)

References 22 publications

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“…There are studies which have shown that changes in cerebrovascular conductances are a better measure of CVR than the changes in cerebral blood flow velocities. 11,13 An important finding of our study is the significant positive correlation between CVR and SVR after correction for non-endothelium-dependent systemic influences. Very few studies 14,15,16 have explored the correlation between CVR and SVR.…”

Section: Discussionmentioning

confidence: 60%

“…13,19 A flaw with this technique is that hypercapnia also causes a substantial rise in ABP which results in non-endothelium mediated increases in cerebral blood flow culminating in falsely high CVR values. 11,22,23 The CVCi calculation minimizes this influence of increased ABP on the CVR results and increases the probability of detecting true positive cases of endothelial dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…11,13 Unfortunately, very few studies have been carried out in DM patients in which this correction has been applied. 13,24 In the present study, we assessed CVR with and without applying this correction and showed that CVR is better correlated with SVR in type 2 DM when corrected for associated changes in ABP.…”

Section: Discussionmentioning

confidence: 99%

“…11,13,19 The middle cerebral artery blood flow velocity (MCAV) was measured by insonating the right middle cerebral artery with a 2-MHz probe using the MultiDop T2 ultrasound (DWL Elektronische Systeme, Germany). The probe was positioned to record the maximum blood flow velocity (monitoring programme QL software 2.5; DWL Elektronische Systeme) and was stabilized using a head-fixation-band.…”

Section: Assessment Of Cerebrovascular Reactivitymentioning

confidence: 99%

“…Several methods have been advocated for the 'correction' of VR results, which may permit a more accurate assessment of endothelium-dependent changes in the vascular bed. [11][12][13] There are very few studies which have explored the association between endothelial function in the systemic and cerebral circulation and those have reported no relationship between them. [14][15][16] However, none of these studies have taken into account the influence of non-endotheliumdependent systemic effects.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Correlations between endothelial function in the systemic and cerebral circulation and insulin resistance in type 2 diabetes mellitus

Prakash

Chandran

Khadgawat

et al. 2015

Diabetes and Vascular Disease Research

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Insulin resistance is associated with endothelial dysfunction in type 2 diabetes mellitus, which can lead to impaired vascular reactivities of both systemic and cerebral circulations. Appropriate 'correction' of vascular reactivity results for non-endothelium-dependent systemic effects avoids misinterpretation of endothelial function. Therefore, we 'corrected' vascular reactivity results and explored the potential correlations between systemic vascular reactivity, cerebrovascular reactivity and insulin resistance. In 34 patients, 'systemic vascular reactivity' was assessed by quantifying reactive hyperaemia. Cerebrovascular reactivity was assessed by quantifying changes in cerebral blood flow velocity during hypercapnia. To minimize the influence of non-endothelium-dependent systemic effects on vascular reactivity results, 'corrected systemic vascular reactivity' was calculated by normalizing systemic vascular reactivity using the measurements from the contralateral side; and cerebrovascular reactivity results were corrected by calculating percentage and absolute changes in cerebrovascular conductance index ('percent cerebrovascular conductance index' and 'delta cerebrovascular conductance index', respectively). Insulin resistance was estimated by homeostatic model assessment. Correlation between conventional cerebrovascular reactivity and systemic vascular reactivity was not significant. But correlations between 'corrected systemic vascular reactivity' and 'percent cerebrovascular conductance index' (r = 0.51; p = 0.002) and 'corrected systemic vascular reactivity' and 'delta cerebrovascular conductance index' (r = 0.50; p = 0.003) were significant. Among all vascular reactivity parameters, only 'delta cerebrovascular conductance index' was significantly correlated with homeostatic model assessment of insulin resistance (r = −0.38; p = 0.029). In conclusion, endothelial function in the systemic and cerebral circulations is moderately correlated, provided that vascular reactivity estimates are corrected for non-endothelium-dependent influences.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Assessment Of Cerebrovascular Reactivitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Correlations between endothelial function in the systemic and cerebral circulation and insulin resistance in type 2 diabetes mellitus

Prakash

Chandran

Khadgawat

et al. 2015

Diabetes and Vascular Disease Research

Self Cite

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Cerebral Vasoreactivity in Children with Sickle Cell Disease: A Transcranial Doppler Study

Prakash

2019

Journal of Stroke and Cerebrovascular Diseases

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Respiratory challenge MRI: Practical aspects

Moreton

Dani

Goutcher

et al. 2016

NeuroImage: Clinical

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Respiratory challenge MRI is the modification of arterial oxygen (PaO2) and/or carbon dioxide (PaCO2) concentration to induce a change in cerebral function or metabolism which is then measured by MRI. Alterations in arterial gas concentrations can lead to profound changes in cerebral haemodynamics which can be studied using a variety of MRI sequences. Whilst such experiments may provide a wealth of information, conducting them can be complex and challenging. In this paper we review the rationale for respiratory challenge MRI including the effects of oxygen and carbon dioxide on the cerebral circulation. We also discuss the planning, equipment, monitoring and techniques that have been used to undertake these experiments. We finally propose some recommendations in this evolving area for conducting these experiments to enhance data quality and comparison between techniques.

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Correction for Blood Pressure Improves Correlation between Cerebrovascular Reactivity Assessed by Breath Holding and 6% CO2 Breathing

Cited by 17 publications

References 22 publications

Correlations between endothelial function in the systemic and cerebral circulation and insulin resistance in type 2 diabetes mellitus

Correlations between endothelial function in the systemic and cerebral circulation and insulin resistance in type 2 diabetes mellitus

Cerebral Vasoreactivity in Children with Sickle Cell Disease: A Transcranial Doppler Study

Respiratory challenge MRI: Practical aspects

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