Chronic hyperglycemia is associated with vascular gain impairment in microangiopathic lacunar stroke.

IF 2.7 4区 医学 Q3 BIOPHYSICS
Lehel-Barna Lakatos, Martin Müller, Mareike Österreich, Alexander von Hessling, Grzegorz Marek Karwacki, Manuel Bolognese
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引用次数: 0

Abstract

Objective. Chronic hyperglycemia is known to contribute to cerebral microangiopathy via an endothelial dysfunction. We hypothesized that gain, as a marker of vascular compliance or stiffness (as its physical inverse), is associated with an increased HbA1c level.Approach. We conducted a retrospective analysis of 94 consecutive patients (27 females, 67 males; median age 72.5 years, IQR 61-80 years) with isolated acute microangiopathic lacunar infarctions. By selecting this specific patient cohort, we minimized the influence of infarct size on dynamic cerebral autoregulation (dCA). dCA parameters-phase and gain- were assessed using transfer function analysis of spontaneous oscillations in blood pressure (BP) and cerebral blood flow velocity in both middle cerebral arteries. HbA1c levels [normal < 5.7% (39 mmol mol-1), prediabetic 5.7-6.4% (39-46 mmol mol-1), diabetic ⩾6.5% (>46 mmol mol-1)], Fazekas grading for small vessel disease was determined on magnet resonance imaging, and other routine diagnostics parameters were recorded.Main results. Neither phase nor gain differed significantly between the Fazekas grading groups. Among the HbA1c categories, phase remained unchanged, whereas gain progressively increased from the normal HbA1c group to the diabetic group significantly in the very low (0.02-0.07 Hz) frequencies (p= .02) and by trend in the low frequency (0.07-0.20 Hz) range (p= .07), while BP and end-tidal carbon dioxide levels were not different across the groups.Significance. In this cohort of patients with microangiopathic lacunar stroke, higher HbA1c levels were associated with increased vascular gain, suggesting a potential link between long-term glucose dysregulation, increased vascular stiffness, and impaired dCA. This finding provides a mechanistic pathway connecting chronic hyperglycaemia to microangiopathic cerebral infarction.

微血管病变腔隙性卒中患者慢性高血糖与血管增益损害相关。
目的:慢性高血糖可通过内皮功能障碍导致脑微血管病变。我们假设增益,作为血管顺应性或僵硬的标志(作为其物理逆),与HbA1c水平升高有关。方法:我们对94例孤立性急性微血管病变腔隙性梗死患者(27例女性,67例男性,中位年龄72.5岁,IQR 61-80岁)进行了回顾性分析。通过选择这一特定的患者队列,我们将梗死面积对动态脑自动调节(dCA)的影响降至最低。dCA参数-相位和增益-使用传递函数分析的血压和脑血流速度在大脑中动脉的自发振荡评估。HbA1c水平[正常< 5.7% (39 mmol/mol),糖尿病前期5.7 - 6.4% (39 - 46 mmol/mol),糖尿病≥6.5% (>46 mmol/mol)],磁共振成像(MRI)确定小血管疾病Fazekas分级,并记录其他常规诊断参数。主要结果:Fazekas分级组间期和增益均无显著差异。在HbA1c类别中,阶段保持不变,而增益从正常HbA1c组逐渐增加到糖尿病组,在极低频率(0.02-0.07 Hz)范围内显著(p= 0.02),在低频(0.07-0.20 Hz)范围内呈趋势(p= 0.07),而血压和潮末二氧化碳水平在各组之间没有差异。意义:在该微血管病变腔隙性卒中患者队列中,较高的HbA1c水平与血管增益增加相关,提示长期血糖失调、血管僵硬增加和动态大脑自动调节受损之间存在潜在联系。这一发现提供了连接慢性高血糖与微血管病变性脑梗死的机制途径。& # xD; & # xD。
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来源期刊
Physiological measurement
Physiological measurement 生物-工程:生物医学
CiteScore
5.50
自引率
9.40%
发文量
124
审稿时长
3 months
期刊介绍: Physiological Measurement publishes papers about the quantitative assessment and visualization of physiological function in clinical research and practice, with an emphasis on the development of new methods of measurement and their validation. Papers are published on topics including: applied physiology in illness and health electrical bioimpedance, optical and acoustic measurement techniques advanced methods of time series and other data analysis biomedical and clinical engineering in-patient and ambulatory monitoring point-of-care technologies novel clinical measurements of cardiovascular, neurological, and musculoskeletal systems. measurements in molecular, cellular and organ physiology and electrophysiology physiological modeling and simulation novel biomedical sensors, instruments, devices and systems measurement standards and guidelines.
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