Abstract MP15: Arterial Hypertension And Cognitive Disorders: Cerebral Vascular Reserve

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Viktoriia Krotova ◽  
Tetyana Khomazyuk
Keyword(s):  
Blood Flow ◽  
Arterial Hypertension ◽  
Cognitive Disorders ◽  
Maximum Velocity ◽  
Reactivity Index ◽  
Vascular Reserve ◽  
Vasomotor Reactivity ◽  
Average Maximum ◽  
Score Risk ◽  
Cerebral Vascular

The study of functional and restructuring disorders of large and small cerebral vessels that are a target for arterial hypertension (AH) is important for the prognosis of cognitive disorders (CD). The relationship between cerebral vascular reserve and CD in 378 outpatients with controlled AH stage II and low SCORE risk of CVD examined. The median age – 57,3±8,91 years. The average duration of AH was 11,5±6,2 years. SCORE risk of CVD <5 %. All AH patients were examined according to the international recommendations and cognitive functioning was assessed by MoCA scale, blood flow in the middle cerebral artery was investigated by transcranial Doppler (TCD) on the HDI 7, Philips, USA with functional respiratory hypo- and hypercapnic ventilation tests.The integrative index of vasomotor reactivity (IVMR) was calculated for cerebral vascular reserve identification: IVMR=[(V apnea -V hyper )/V 0 ]•100%, V apnea - the average maximum velocity of blood flow after 20s of apnea (cm/s), V hyper - the average maximum velocity of blood flow after 20s of hyperventilation (cm/s), V 0 - the average maximum velocity at rest (cm/s). Non-dementia cognitive disorders were found in 125 (33 %) - 24,32±0,11 points on MOCA scale. The significant decrease in the IVMR was found according to the results of the TCD examination of cerebralvascular reserve testing in patients with AH and CD (44.0±1.2, p<0,001), which indicates the close relationship between the value of IVMR and CD even in patients with controlled AH (rs = +0.54; p<0.001). It is necessary to clarify the cerebral vascular reserve and the vasomotor reactivity index even when controlling AH due to the high risk of the development and progression of cognitive disorders, which worsen the prognosis of cardiovascular events and quality of life.

Abstract 9934: High Mean Arterial Pressure Aggravates Cerebral Hemodynamics After Extracorporeal Resuscitation in Swine

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Yael Levy ◽  
Alice Hutin ◽  
Nicolas Polge ◽  
fanny lidouren ◽  
Matthias Kohlhauer ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiac Arrest ◽  
Oxygen Consumption ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Cerebral Hemodynamics ◽  
Reactivity Index ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Standard Map ◽  
Arterial Blood

Introduction: Extracorporeal cardiopulmonary resuscitation (E-CPR) is used for the treatment of refractory cardiac arrest but the optimal target to reach for mean arterial pressure (MAP) remains to be determined. Hypothesis: We hypothesized that MAP levels modify cerebral hemodynamics during E-CPR. Accordingly, we tested two MAP targets (65-75 vs 80-90 mmHg) in a porcine model of E-CPR. Methods: Pigs were anesthetized and instrumented for the evaluation of cerebral and systemic hemodynamics. They were submitted to 15 min of untreated ventricular fibrillation followed by 30 min of E-CPR. Electric attempts of defibrillation were then delivered until resumption of spontaneous circulation (ROSC). Extracorporeal circulation was initially set to an average flow of 40 ml/kg/min with a standardized volume expansion in both groups. The dose of epinephrine was set to reach either a standard or a high MAP target level (65-75 vs 80-90 mmHg, respectively). Animals were followed during 120 min after ROSC. Results: Six animals were included in both groups. After cardiac arrest, MAP was maintained at the expected level (Figure). During E-CPR, high MAP transiently improved carotid blood flow as compared to standard MAP. This blood flow progressively decreased after ROSC in high vs standard MAP, while intra-cranial pressure increased. Interestingly, this was associated with a significant decrease in cerebral oxygen consumption (26±8 vs 54±6 L O 2 /min/kg at 120 min after ROSC, respectively; p<0.01) (Figure). The pressure reactivity index (PRx), which is the correlation coefficient between arterial blood pressure and intracranial pressure, became positive in high MAP (0.47±0.02) vs standard MAP group (-0.16±0.10), demonstrating altered cerebral autoregulation with high MAP. Conclusion: Increasing MAP above 80 mmHg with epinephrine aggravates cerebral hemodynamics after E-CPR. Figure: Mean arterial pressure (MAP), cerebral blood flow and oxygen consumption (*, p<0.05)

scholarly journals The structural and functional features of the microcirculatory bed in patients with arterial hypertension and type 2 diabetes mellitus

2005 ◽  
Vol 11 (3) ◽  
pp. 177-180 ◽  
Author(s):  
L. A. Lohankova ◽  
Yu. V. Kotovskaya ◽  
A. S. Milto ◽  
Zh. D. Kobalava
Keyword(s):  
Diabetes Mellitus ◽  
Blood Flow ◽  
Arterial Hypertension ◽  
Control Group ◽  
Microcirculatory Bed ◽  
Type 2 Dm ◽  
Group A ◽  
Functional Features

The structural and functional features of the microcirculatory heel (MCB) were studied in patients with arterial hypertension (AH) in relation to the presence or absence of type 1 diabetes mellitus (DM). Two hundred and twelve patients were examined. These included 110 patients with grades 1 and 2 arterial hypertension (AH) and type 2 DM, 82 patients with AH without type 2 DM, and 20 apparently healthy individuals. Laser Doppler flowmetry (LDF) was used to estimate basal blood flow, the loading test parameters characterizing the structural and functional status of MCB, and the incidence of hemodynamic types of microcirculation. Patients with AH concurrent with type 1 DM were found to have the following microcirculatory features: an increase in perfusion blood flow (microcirculation index, 8,8±1,8 perf. units versus 4,9±0,8 perf, units in patients with AH without DM and 6,7±0,9 perf. units in the control group), a drastic reduction in myogenic activity to 13,2±5,7 % versus 16,7±6,8 and 25,2±6,4 %, respectively, a decrease in vascular resistance, impairment of autoregulation, and low reserve capacities (reserve capillary blood flow was 197,8±31,6 % versus 429,9±82,01 % in the group of AH without DM and 302,8±50,1 % in the control group), a predominance of the hyperemic hemodynamic type (58,8 % in patients with AH and DM, 20,9 % in those with AH without DM, and 20,0 % in the controls). The specific features of the altered microcirculatory bed in patients with AH concurrent with type 2 DM were ascertained. These included the predominance of hyperemic microcirculation, impaired autoregulation. diminished microvascular resistance, and the low reserve capacities of the microcirculatory bed.

scholarly journals Impaired Choroidal Blood Flow in Adolescents with Essential Arterial Hypertension

2019 ◽  
Vol 4 (4) ◽  
pp. 91-95
Author(s):  
Yu. N. Savina ◽  
S. I. Zhukova ◽  
A. V. Korolenko ◽  
D. A. Averyanov
Keyword(s):  
Blood Flow ◽  
Arterial Hypertension ◽  
Children And Adolescents ◽  
Ganglion Cells ◽  
Color Doppler ◽  
Oscillatory Potentials ◽  
Choroidal Blood Flow ◽  
Choroidal Ischemia ◽  
Essential Arterial Hypertension ◽  
Few Data

Arterial hypertension is a problem not only for adults, but also for children, but there are very few data on changes in the organ of vision under the influence of an elevated level of blood pressure in children.The aim of the work is to identify disturbances of the choroidal blood flow in children and adolescents with essential arterial hypertension.Methods. Fifty patients with essential arterial hypertension were examined. The age of patients ranged from 10 to 17 years, the duration of the disease ranged from 2 months to 8 years. All patients underwent color Doppler mapping of the orbital vessels, registration of the oscillatory potentials of the ERG.Results. It was revealed that increased arterial pressure causes retinal and choroidal ischemia, which is accompanied primarily by impaired blood flow in the orbital vessels and is reflected in a decrease in the amplitude and deformation of the peaks of the ERG oscillatory potentials.Conclusion. Hypertension causes and supports retinal and choroidal ischemia, which is accompanied primarily by impaired blood flow in the orbital vessels, functional depression of photoreceptors, ganglion cells and neuroglia of the retina, aggravating the identified changes as the experience of essential hypertension increases. A marker of chorioretinal ischemia is amplitude depression, a change in the shape of the teeth of the oscillatory potentials of the ERG, which indicates a decrease in the functional activity of the retinal ganglion complex.That is, these changes can be considered as a predictor of hypertensive angioretinopathy in children and adolescents with essential arterial hypertension.

scholarly journals Оценка экстракраниального и интракраниального артериального кровобращения у пациентов молодого возраста с артериальной гипертонией, сопровождающейся мигренью или головной болью напряжения

2020 ◽  
pp. 28-36
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Arterial Hypertension ◽  
Flow Resistance ◽  
Posterior Cerebral Artery ◽  
Tension Type Headache ◽  
Left Vertebral Artery ◽  
Hypertensive Disease ◽  
Arterial Blood ◽  
Type Headache

The authors studied the state of blood flow in the system of arterial vessels of the head and neck in 30 patients with hypertensive disease (HD) stage I, arterial hypertension (AH), 1st degree – in 26 (86,7 %) and 2nd degree – in 4 (13,3 %) people, with comorbid migraine (M) – in 14 (46,7 %) people and tension-type headache (TTH) – in 16 (53,3 %) people, triplex scanning of extra- and intracranial vessels was performed and measurement of arterial blood pressure was conducted. In patients with AH and comorbid M or TTH, decrease in the velocity and volume parameters of blood flow in the arteries at the extracranial and intracranial level, as well as increase in the indexes of blood flow resistance in comparison with the control, were revealed. In patients with AH and TTH, blood flow in the left vertebral artery and right posterior cerebral artery was lower than in patients with AH and M.

Blood Flow Velocity Profiles in Pulmonary Branch Arteries in Lambs

1995 ◽  
Vol 117 (2) ◽  
pp. 237-241
Author(s):  
H. Katayama ◽  
G. W. Henry ◽  
C. L. Lucas ◽  
B. Ha ◽  
J. I. Ferreiro ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Maximum Velocity ◽  
Left Pulmonary Artery ◽  
Control Group ◽  
Pulsed Doppler Ultrasound ◽  
Right Pulmonary Artery ◽  
Blood Flow Velocities ◽  
The Right

We studied the detailed profiles of blood flow in the right and left pulmonary arteries using 20 MHz pulsed Doppler ultrasound equipment in a lamb model. Fourteen lambs aged four to six weeks were selected. In six lambs, monocrotaline pyrrole was injected parenterally to create pulmonary hypertension (PH group). Eight other lambs served as unaltered controls (control group). The blood flow velocities were sampled in 1mm increments along the anterior—posterior axis of the branch arteries. The maximum velocity of the forward flow in the left pulmonary artery was higher than that in the right pulmonary artery in the control group (71.7 ± 15.9cm/s vs 60.2 ± 13.5; p < 0.05). The fastest backward flow was located at the posterior position of the vessel in the right pulmonary artery in the control group. No significant bias in location was shown in the left pulmonary artery. Using indices of P90, acceleration time, P90*AcT, the velocity waveforms in the PH group were compared with those in the control group. In the left pulmonary artery, every index in the control group showed a significantly greater value that in the PH group. On the other hand, no significant differences were found between either group in the right pulmonary artery.

Abstract P531: Cerebral Blood Flow Analysis Using Flow Wire Measurements and CFD Analysis

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Aichi Chien ◽  
Huy Dinh ◽  
Viktor Szeder ◽  
Fernando Vinuela
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Flow Velocity ◽  
Cfd Simulation ◽  
Cfd Analysis ◽  
Flow Data ◽  
Velocity Data ◽  
Mean Flow ◽  
Good Agreement ◽  
Cerebral Vascular

Introduction: Clinical reports show that cerebral blood flow conditions are indicative of cerebral vascular disease. While methods for characterizing cerebral vascular flow have been extensively reported in the past, comparative analyses between direct flow measurements (DM) and computational flow dynamic (CFD) analysis remain limited. We hypothesize that flow data can be reliably measured both directly and through CFD in normal vessels. Methods: A left heart replicator was used as a realistic cardiac pump which maintained systolic pressure at 120 mmHg and diastolic pressure at 80 mmHg. A stenotic model with 50% stenosis for the ICA was connected to the replicator. A ComboWire was used for DM and recorded flow pressure and velocity. CFD was used to study flow. Results: In areas at the proximal end of the stenosis, the pressure and flow velocity derived from DM and CFD were in good agreement. At the end of systole and diastole, DM pressure were 145.42 mmHg and 73.53 mmHg, respectively. CFD simulation for the same system obtained the pressure at the end of systole and diastole of 147.16 mmHg and 74.64 mmHg, respectively. The velocity data collected from DM was at 15.40 cm/s and 7.74 cm/s for systolic flow and mean flow velocity. CFD measured flow was 17.85 cm/s and 11.37 cm/s, respectively. In areas at the distal end of the stenosis, pressure data showed good agreement between DM and CFD analysis. The DM were 138 and 70.81 mmHg at the end of systole and diastole, respectively; CFD simulation yielded 145.95 and 74.51 mmHg, respectively. Variations in the velocity data were observed at this location (Fig, pink arrows). Conclusion: DM of pressure showed good agreement with CFD simulation in all areas of the vessel. DM of velocity using the flow wire were highly affected by location of the measurement. CFD analysis can provide more consistent flow data for flow information collection along the vasculature.

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