Cargando…
Dynamic Cerebral Autoregulation Is Heterogeneous in Different Subtypes of Acute Ischemic Stroke
BACKGROUND AND PURPOSE: Stroke of large-artery atherosclerosis and small-artery occlusion are two main subtypes of stroke according to TOAST classification. The underlying mechanisms of how these two subtypes affect dynamic cerebral autoregulation (dCA) might be heterogeneous, resulting in varied cl...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966889/ https://www.ncbi.nlm.nih.gov/pubmed/24671155 http://dx.doi.org/10.1371/journal.pone.0093213 |
_version_ | 1782308963862183936 |
---|---|
author | Guo, Zhen-Ni Liu, Jia Xing, Yingqi Yan, Shuo Lv, Cunling Jin, Hang Yang, Yi |
author_facet | Guo, Zhen-Ni Liu, Jia Xing, Yingqi Yan, Shuo Lv, Cunling Jin, Hang Yang, Yi |
author_sort | Guo, Zhen-Ni |
collection | PubMed |
description | BACKGROUND AND PURPOSE: Stroke of large-artery atherosclerosis and small-artery occlusion are two main subtypes of stroke according to TOAST classification. The underlying mechanisms of how these two subtypes affect dynamic cerebral autoregulation (dCA) might be heterogeneous, resulting in varied clinical conditions and outcomes. We therefore studied the pattern of dCA in these two subtypes. METHODS: Forty-one patients with acute unilateral middle cerebral artery (MCA) territory stroke (15 with ipsilateral large-artery atherosclerosis and 26 with small-artery occlusion) and 20 healthy volunteers were enrolled. Non-invasive continuous cerebral blood flow velocity and arterial blood pressure were recorded simultaneously from each subject in supine position using transcranial Doppler on MCA bilaterally and servo-controlled plethysmograph on the middle finger, respectively. Transfer function analysis was applied to derive autoregulatory parameters, gain, phase difference (PD), and slope of step response. RESULTS: In the large-artery atherosclerosis group, PD in affected hemisphere was 42.9±18.5 degree, which is significantly lower than the unaffected hemisphere (72.4±29.9 degree, P<0.01), and the healthy group (P<0.01). However, PD is similar in the unaffected hemisphere and healthy group (P>0.1). In the small-artery occlusion group, PD in the affected hemisphere was similar to that in the contralateral hemisphere (33.8±17.9 vs. 32.6±21.1 degree, P>0.1), both sides were significantly lower than the healthy group (all P<0.001).The results of the slope of step response agree with the findings in PD. CONCLUSIONS: DCA in different subtypes of acute ischemic stroke is heterogeneous, which might be attributed to the varied pathologic changes of cerebral blood vessels. |
format | Online Article Text |
id | pubmed-3966889 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-39668892014-03-31 Dynamic Cerebral Autoregulation Is Heterogeneous in Different Subtypes of Acute Ischemic Stroke Guo, Zhen-Ni Liu, Jia Xing, Yingqi Yan, Shuo Lv, Cunling Jin, Hang Yang, Yi PLoS One Research Article BACKGROUND AND PURPOSE: Stroke of large-artery atherosclerosis and small-artery occlusion are two main subtypes of stroke according to TOAST classification. The underlying mechanisms of how these two subtypes affect dynamic cerebral autoregulation (dCA) might be heterogeneous, resulting in varied clinical conditions and outcomes. We therefore studied the pattern of dCA in these two subtypes. METHODS: Forty-one patients with acute unilateral middle cerebral artery (MCA) territory stroke (15 with ipsilateral large-artery atherosclerosis and 26 with small-artery occlusion) and 20 healthy volunteers were enrolled. Non-invasive continuous cerebral blood flow velocity and arterial blood pressure were recorded simultaneously from each subject in supine position using transcranial Doppler on MCA bilaterally and servo-controlled plethysmograph on the middle finger, respectively. Transfer function analysis was applied to derive autoregulatory parameters, gain, phase difference (PD), and slope of step response. RESULTS: In the large-artery atherosclerosis group, PD in affected hemisphere was 42.9±18.5 degree, which is significantly lower than the unaffected hemisphere (72.4±29.9 degree, P<0.01), and the healthy group (P<0.01). However, PD is similar in the unaffected hemisphere and healthy group (P>0.1). In the small-artery occlusion group, PD in the affected hemisphere was similar to that in the contralateral hemisphere (33.8±17.9 vs. 32.6±21.1 degree, P>0.1), both sides were significantly lower than the healthy group (all P<0.001).The results of the slope of step response agree with the findings in PD. CONCLUSIONS: DCA in different subtypes of acute ischemic stroke is heterogeneous, which might be attributed to the varied pathologic changes of cerebral blood vessels. Public Library of Science 2014-03-26 /pmc/articles/PMC3966889/ /pubmed/24671155 http://dx.doi.org/10.1371/journal.pone.0093213 Text en © 2014 Guo et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Guo, Zhen-Ni Liu, Jia Xing, Yingqi Yan, Shuo Lv, Cunling Jin, Hang Yang, Yi Dynamic Cerebral Autoregulation Is Heterogeneous in Different Subtypes of Acute Ischemic Stroke |
title | Dynamic Cerebral Autoregulation Is Heterogeneous in Different Subtypes of Acute Ischemic Stroke |
title_full | Dynamic Cerebral Autoregulation Is Heterogeneous in Different Subtypes of Acute Ischemic Stroke |
title_fullStr | Dynamic Cerebral Autoregulation Is Heterogeneous in Different Subtypes of Acute Ischemic Stroke |
title_full_unstemmed | Dynamic Cerebral Autoregulation Is Heterogeneous in Different Subtypes of Acute Ischemic Stroke |
title_short | Dynamic Cerebral Autoregulation Is Heterogeneous in Different Subtypes of Acute Ischemic Stroke |
title_sort | dynamic cerebral autoregulation is heterogeneous in different subtypes of acute ischemic stroke |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966889/ https://www.ncbi.nlm.nih.gov/pubmed/24671155 http://dx.doi.org/10.1371/journal.pone.0093213 |
work_keys_str_mv | AT guozhenni dynamiccerebralautoregulationisheterogeneousindifferentsubtypesofacuteischemicstroke AT liujia dynamiccerebralautoregulationisheterogeneousindifferentsubtypesofacuteischemicstroke AT xingyingqi dynamiccerebralautoregulationisheterogeneousindifferentsubtypesofacuteischemicstroke AT yanshuo dynamiccerebralautoregulationisheterogeneousindifferentsubtypesofacuteischemicstroke AT lvcunling dynamiccerebralautoregulationisheterogeneousindifferentsubtypesofacuteischemicstroke AT jinhang dynamiccerebralautoregulationisheterogeneousindifferentsubtypesofacuteischemicstroke AT yangyi dynamiccerebralautoregulationisheterogeneousindifferentsubtypesofacuteischemicstroke |