V. Papaioannou, K. Budohoski, Michał M. Placek, Z. Czosnyka, P. Smielewski, M. Czosnyka
{"title":"蛛网膜下腔出血患者平均流速指数、时间常数与临界闭合压的关系","authors":"V. Papaioannou, K. Budohoski, Michał M. Placek, Z. Czosnyka, P. Smielewski, M. Czosnyka","doi":"10.26502/acbr.50170230","DOIUrl":null,"url":null,"abstract":"Background: In patients suffering from Subarachnoid Hemorrhage (SAH), Delayed Cerebral Ischemia (DCI) is partly associated with Vasospasm (VS) and impaired cerebral autoregulation. We investigated the pattern of changes of different Transcranial Doppler (TCD)-derived indices of cerebrovascular dynamics during VS, in patients dichotomized by the presence of DCI. Methods: A retrospective analysis was performed using recordings from 32 SAH patients, diagnosed with VS through bilateral TCD measurements. Patients were divided in 2 groups, depending on development of DCI. Cerebral autoregulation was estimated using the moving correlation coefficient Mxa, calculated from spontaneous fluctuations of Cerebral Blood Flow Velocity (CBFV) and Arterial Blood Pressure (ABP). We also measured cerebral arterial time constant (tau) as the product of resistance (Ra) and Compliance (Ca) and Critical Closing Pressure (CrCP), using two different methods of assessment (CrCPAaslid and CrCPVarsos). Results: In the whole population (N=32), VS caused shortening of tau (ipsilateral to spasm: 0.17 ± 0.08 vs before: 0.25 ± 0.17 sec, p = 0.04), decrease in CrCPAaslid (ipsilateral to spasm: 9.69 ± 23.28 vs before: 27.23 ± 23.31 mmHg, p = 0.01) and interhemispheric asymmetry with lower values on ipsilateral side (p < 0.01). Ipsilateral CrCPAaslid during VS was negatively correlated with Mxa (r =-0.43, p=0.01), whereas CrCPVarsos exhibited positive correlation with tau (r=0.74, p < 0.001). In patients with DCI (N=19), VS caused increase in Mxa (ipsilateral to spasm: 0.36 ± 0.18 vs before: 0.26 ± 0.23, p = 0.04), decrease in CrCPAaslid (ipsilateral to spasm: 6.61 ± 24.5 vs before: 17.24 ± 19.4 mmHg, p = 0.04) and lower values on ipsilateral side (p < 0.01). Arch Clin Biomed Res 2022; 6 (1): 119-133 DOI: 10.26502/acbr.50170230 Archives of Clinical and Biomedical Research Vol. 6 No. 1 – February 2022. [ISSN 2572-9292]. 120 Conclusions: During VS, tau and CrCP were reduced in both temporal and spatial assessments, whereas DCI was associated with loss of autoregulation and vasoparalysis.","PeriodicalId":72279,"journal":{"name":"Archives of clinical and biomedical research","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Relation between Mean Velocity Index, Time Constant and Critical Closing Pressure in Patients with Subarachnoid Hemorrhage\",\"authors\":\"V. Papaioannou, K. Budohoski, Michał M. Placek, Z. Czosnyka, P. Smielewski, M. Czosnyka\",\"doi\":\"10.26502/acbr.50170230\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: In patients suffering from Subarachnoid Hemorrhage (SAH), Delayed Cerebral Ischemia (DCI) is partly associated with Vasospasm (VS) and impaired cerebral autoregulation. We investigated the pattern of changes of different Transcranial Doppler (TCD)-derived indices of cerebrovascular dynamics during VS, in patients dichotomized by the presence of DCI. Methods: A retrospective analysis was performed using recordings from 32 SAH patients, diagnosed with VS through bilateral TCD measurements. Patients were divided in 2 groups, depending on development of DCI. Cerebral autoregulation was estimated using the moving correlation coefficient Mxa, calculated from spontaneous fluctuations of Cerebral Blood Flow Velocity (CBFV) and Arterial Blood Pressure (ABP). We also measured cerebral arterial time constant (tau) as the product of resistance (Ra) and Compliance (Ca) and Critical Closing Pressure (CrCP), using two different methods of assessment (CrCPAaslid and CrCPVarsos). Results: In the whole population (N=32), VS caused shortening of tau (ipsilateral to spasm: 0.17 ± 0.08 vs before: 0.25 ± 0.17 sec, p = 0.04), decrease in CrCPAaslid (ipsilateral to spasm: 9.69 ± 23.28 vs before: 27.23 ± 23.31 mmHg, p = 0.01) and interhemispheric asymmetry with lower values on ipsilateral side (p < 0.01). Ipsilateral CrCPAaslid during VS was negatively correlated with Mxa (r =-0.43, p=0.01), whereas CrCPVarsos exhibited positive correlation with tau (r=0.74, p < 0.001). In patients with DCI (N=19), VS caused increase in Mxa (ipsilateral to spasm: 0.36 ± 0.18 vs before: 0.26 ± 0.23, p = 0.04), decrease in CrCPAaslid (ipsilateral to spasm: 6.61 ± 24.5 vs before: 17.24 ± 19.4 mmHg, p = 0.04) and lower values on ipsilateral side (p < 0.01). Arch Clin Biomed Res 2022; 6 (1): 119-133 DOI: 10.26502/acbr.50170230 Archives of Clinical and Biomedical Research Vol. 6 No. 1 – February 2022. [ISSN 2572-9292]. 120 Conclusions: During VS, tau and CrCP were reduced in both temporal and spatial assessments, whereas DCI was associated with loss of autoregulation and vasoparalysis.\",\"PeriodicalId\":72279,\"journal\":{\"name\":\"Archives of clinical and biomedical research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of clinical and biomedical research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.26502/acbr.50170230\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of clinical and biomedical research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.26502/acbr.50170230","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:在蛛网膜下腔出血(SAH)患者中,延迟性脑缺血(DCI)与血管痉挛(VS)和大脑自动调节功能受损部分相关。我们研究了经颅多普勒(TCD)衍生的不同脑血管动力学指标在VS期间的变化模式,在DCI存在的患者中。方法:回顾性分析32例SAH患者的记录,通过双侧TCD测量诊断为VS。根据DCI的发展情况将患者分为两组。根据脑血流速度(CBFV)和动脉血压(ABP)的自发波动计算的运动相关系数Mxa估计脑自动调节。我们还使用两种不同的评估方法(CrCPAaslid和CrCPVarsos)测量了脑动脉时间常数(tau)作为阻力(Ra)和顺应性(Ca)和临界闭合压(CrCP)的乘积。结果:在所有人群中(N=32), VS引起tau缩短(同侧痉挛:0.17±0.08 VS前:0.25±0.17 sec, p = 0.04), CrCPAaslid降低(同侧痉挛:9.69±23.28 VS前:27.23±23.31 mmHg, p = 0.01)和半球间不对称(同侧较低)(p < 0.01)。VS时同侧crcppaaslid与Mxa呈负相关(r= -0.43, p=0.01),而CrCPVarsos与tau呈正相关(r=0.74, p < 0.001)。在DCI患者(N=19)中,VS导致Mxa升高(同侧痉挛:0.36±0.18 VS前:0.26±0.23,p = 0.04), CrCPAaslid降低(同侧痉挛:6.61±24.5 VS前:17.24±19.4 mmHg, p = 0.04),同侧降低(p < 0.01)。Arch clinn Biomed Res 2022;6 (1): 119-133 DOI: 10.26502/acbr.50170230临床和生物医学研究档案第6卷第1期- 2022年2月。(ISSN 2572 - 9292)。120结论:在VS期间,tau和CrCP在时间和空间评估中都降低,而DCI与自我调节丧失和血管麻痹有关。
Relation between Mean Velocity Index, Time Constant and Critical Closing Pressure in Patients with Subarachnoid Hemorrhage
Background: In patients suffering from Subarachnoid Hemorrhage (SAH), Delayed Cerebral Ischemia (DCI) is partly associated with Vasospasm (VS) and impaired cerebral autoregulation. We investigated the pattern of changes of different Transcranial Doppler (TCD)-derived indices of cerebrovascular dynamics during VS, in patients dichotomized by the presence of DCI. Methods: A retrospective analysis was performed using recordings from 32 SAH patients, diagnosed with VS through bilateral TCD measurements. Patients were divided in 2 groups, depending on development of DCI. Cerebral autoregulation was estimated using the moving correlation coefficient Mxa, calculated from spontaneous fluctuations of Cerebral Blood Flow Velocity (CBFV) and Arterial Blood Pressure (ABP). We also measured cerebral arterial time constant (tau) as the product of resistance (Ra) and Compliance (Ca) and Critical Closing Pressure (CrCP), using two different methods of assessment (CrCPAaslid and CrCPVarsos). Results: In the whole population (N=32), VS caused shortening of tau (ipsilateral to spasm: 0.17 ± 0.08 vs before: 0.25 ± 0.17 sec, p = 0.04), decrease in CrCPAaslid (ipsilateral to spasm: 9.69 ± 23.28 vs before: 27.23 ± 23.31 mmHg, p = 0.01) and interhemispheric asymmetry with lower values on ipsilateral side (p < 0.01). Ipsilateral CrCPAaslid during VS was negatively correlated with Mxa (r =-0.43, p=0.01), whereas CrCPVarsos exhibited positive correlation with tau (r=0.74, p < 0.001). In patients with DCI (N=19), VS caused increase in Mxa (ipsilateral to spasm: 0.36 ± 0.18 vs before: 0.26 ± 0.23, p = 0.04), decrease in CrCPAaslid (ipsilateral to spasm: 6.61 ± 24.5 vs before: 17.24 ± 19.4 mmHg, p = 0.04) and lower values on ipsilateral side (p < 0.01). Arch Clin Biomed Res 2022; 6 (1): 119-133 DOI: 10.26502/acbr.50170230 Archives of Clinical and Biomedical Research Vol. 6 No. 1 – February 2022. [ISSN 2572-9292]. 120 Conclusions: During VS, tau and CrCP were reduced in both temporal and spatial assessments, whereas DCI was associated with loss of autoregulation and vasoparalysis.