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.
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.