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Cerebral blood flow velocity progressively decreases with increasing levels of verticalization in healthy adults. A cross-sectional study with an observational design

BACKGROUND: Autoregulation of the cerebral vasculature keeps brain perfusion stable over a range of systemic mean arterial pressures to ensure brain functioning, e.g., in different body positions. Verticalization, i.e., transfer from lying (0°) to upright (70°), which causes systemic blood pressure...

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Autores principales: Deseoe, Julian, Schwarz, Anne, Pipping, Theodor, Lehmann, Aurelia, Veerbeek, Janne M., Luft, Andreas R., Wegener, Susanne, Globas, Christoph, Held, Jeremia P. O.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10149656/
https://www.ncbi.nlm.nih.gov/pubmed/37139076
http://dx.doi.org/10.3389/fneur.2023.1149673
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author Deseoe, Julian
Schwarz, Anne
Pipping, Theodor
Lehmann, Aurelia
Veerbeek, Janne M.
Luft, Andreas R.
Wegener, Susanne
Globas, Christoph
Held, Jeremia P. O.
author_facet Deseoe, Julian
Schwarz, Anne
Pipping, Theodor
Lehmann, Aurelia
Veerbeek, Janne M.
Luft, Andreas R.
Wegener, Susanne
Globas, Christoph
Held, Jeremia P. O.
author_sort Deseoe, Julian
collection PubMed
description BACKGROUND: Autoregulation of the cerebral vasculature keeps brain perfusion stable over a range of systemic mean arterial pressures to ensure brain functioning, e.g., in different body positions. Verticalization, i.e., transfer from lying (0°) to upright (70°), which causes systemic blood pressure drop, would otherwise dramatically lower cerebral perfusion pressure inducing fainting. Understanding cerebral autoregulation is therefore a prerequisite to safe mobilization of patients in therapy. AIM: We measured the impact of verticalization on cerebral blood flow velocity (CBFV) and systemic blood pressure (BP), heart rate (HR) and oxygen saturation in healthy individuals. METHODS: We measured CBFV in the middle cerebral artery (MCA) of the dominant hemisphere in 20 subjects using continuous transcranial doppler ultrasound (TCD). Subjects were verticalized at 0°, −5°, 15°, 30°, 45° and 70° for 3–5 min each, using a standardized Sara Combilizer chair. In addition, blood pressure, heart rate and oxygen saturation were continuously monitored. RESULTS: We show that CBFV progressively decreases in the MCA with increasing degrees of verticalization. Systolic and diastolic BP, as well as HR, show a compensatory increase during verticalization. CONCLUSION: In healthy adults CBFV changes rapidly with changing levels of verticalization. The changes in the circulatory parameters are similar to results regarding classic orthostasis. REGISTRATION: ClinicalTrials.gov, identifier: NCT04573114.
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spelling pubmed-101496562023-05-02 Cerebral blood flow velocity progressively decreases with increasing levels of verticalization in healthy adults. A cross-sectional study with an observational design Deseoe, Julian Schwarz, Anne Pipping, Theodor Lehmann, Aurelia Veerbeek, Janne M. Luft, Andreas R. Wegener, Susanne Globas, Christoph Held, Jeremia P. O. Front Neurol Neurology BACKGROUND: Autoregulation of the cerebral vasculature keeps brain perfusion stable over a range of systemic mean arterial pressures to ensure brain functioning, e.g., in different body positions. Verticalization, i.e., transfer from lying (0°) to upright (70°), which causes systemic blood pressure drop, would otherwise dramatically lower cerebral perfusion pressure inducing fainting. Understanding cerebral autoregulation is therefore a prerequisite to safe mobilization of patients in therapy. AIM: We measured the impact of verticalization on cerebral blood flow velocity (CBFV) and systemic blood pressure (BP), heart rate (HR) and oxygen saturation in healthy individuals. METHODS: We measured CBFV in the middle cerebral artery (MCA) of the dominant hemisphere in 20 subjects using continuous transcranial doppler ultrasound (TCD). Subjects were verticalized at 0°, −5°, 15°, 30°, 45° and 70° for 3–5 min each, using a standardized Sara Combilizer chair. In addition, blood pressure, heart rate and oxygen saturation were continuously monitored. RESULTS: We show that CBFV progressively decreases in the MCA with increasing degrees of verticalization. Systolic and diastolic BP, as well as HR, show a compensatory increase during verticalization. CONCLUSION: In healthy adults CBFV changes rapidly with changing levels of verticalization. The changes in the circulatory parameters are similar to results regarding classic orthostasis. REGISTRATION: ClinicalTrials.gov, identifier: NCT04573114. Frontiers Media S.A. 2023-04-17 /pmc/articles/PMC10149656/ /pubmed/37139076 http://dx.doi.org/10.3389/fneur.2023.1149673 Text en Copyright © 2023 Deseoe, Schwarz, Pipping, Lehmann, Veerbeek, Luft, Wegener, Globas and Held. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Deseoe, Julian
Schwarz, Anne
Pipping, Theodor
Lehmann, Aurelia
Veerbeek, Janne M.
Luft, Andreas R.
Wegener, Susanne
Globas, Christoph
Held, Jeremia P. O.
Cerebral blood flow velocity progressively decreases with increasing levels of verticalization in healthy adults. A cross-sectional study with an observational design
title Cerebral blood flow velocity progressively decreases with increasing levels of verticalization in healthy adults. A cross-sectional study with an observational design
title_full Cerebral blood flow velocity progressively decreases with increasing levels of verticalization in healthy adults. A cross-sectional study with an observational design
title_fullStr Cerebral blood flow velocity progressively decreases with increasing levels of verticalization in healthy adults. A cross-sectional study with an observational design
title_full_unstemmed Cerebral blood flow velocity progressively decreases with increasing levels of verticalization in healthy adults. A cross-sectional study with an observational design
title_short Cerebral blood flow velocity progressively decreases with increasing levels of verticalization in healthy adults. A cross-sectional study with an observational design
title_sort cerebral blood flow velocity progressively decreases with increasing levels of verticalization in healthy adults. a cross-sectional study with an observational design
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10149656/
https://www.ncbi.nlm.nih.gov/pubmed/37139076
http://dx.doi.org/10.3389/fneur.2023.1149673
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