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Daily blood pressure profile and blood–brain barrier permeability in patients with cerebral small vessel disease

Cerebral small vessel disease (CSVD) plays an important role in cognitive impairment, stroke, disability, and death. Hypertension is the main risk factor for CSVD. The use of antihypertensive therapy has not resulted in the expected decrease in CSVD complications, which may be related to the underes...

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Autores principales: Dobrynina, L. A., Shamtieva, K. V., Kremneva, E. I., Zabitova, M. R., Akhmetzyanov, B. M., Gnedovskaya, E. V., Krotenkova, M. V.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9095696/
https://www.ncbi.nlm.nih.gov/pubmed/35545641
http://dx.doi.org/10.1038/s41598-022-11172-1
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author Dobrynina, L. A.
Shamtieva, K. V.
Kremneva, E. I.
Zabitova, M. R.
Akhmetzyanov, B. M.
Gnedovskaya, E. V.
Krotenkova, M. V.
author_facet Dobrynina, L. A.
Shamtieva, K. V.
Kremneva, E. I.
Zabitova, M. R.
Akhmetzyanov, B. M.
Gnedovskaya, E. V.
Krotenkova, M. V.
author_sort Dobrynina, L. A.
collection PubMed
description Cerebral small vessel disease (CSVD) plays an important role in cognitive impairment, stroke, disability, and death. Hypertension is the main risk factor for CSVD. The use of antihypertensive therapy has not resulted in the expected decrease in CSVD complications, which may be related to the underestimation of significance of daily blood pressure profile for blood–brain barrier (BBB) permeability. 53 patients with CSVD of varying severity (mean age 60.08 ± 6.8 years, 69.8% women, subjects with treated long-standing hypertension vs. normotensive subjects − 84.8% vs. 15.2%) and 17 healthy volunteers underwent ambulatory blood pressure monitoring (ABPM) and MRI, including T1-weighted dynamic contrast-enhanced magnetic resonance imaging for assessing BBB permeability. Most of ABPM parameters in CSVD patients did not differ from controls, but were associated with the severity of white matter hyperintensity (WMH) and the total CSVD score. BBB permeability in normal-appearing white matter (NAWM) and grey matter (GM) was significantly higher in CSVD patients, and the severity of BBB permeability remained similar in patients with different stages of WMH. Among BBB permeability parameters, the area under the curve, corresponding to an increase in the contrast transit time in NAWM, had the greatest number of correlations with deviations of ABPM parameters. BBB permeability in CSVD is a universal mechanism of NAWM and GM damage associated with a slight increase in ABPM parameters. It is obvious that the treatment of hypertension in patients with not severe WMH should be more aggressive and carried out under the control of ABPM.
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spelling pubmed-90956962022-05-13 Daily blood pressure profile and blood–brain barrier permeability in patients with cerebral small vessel disease Dobrynina, L. A. Shamtieva, K. V. Kremneva, E. I. Zabitova, M. R. Akhmetzyanov, B. M. Gnedovskaya, E. V. Krotenkova, M. V. Sci Rep Article Cerebral small vessel disease (CSVD) plays an important role in cognitive impairment, stroke, disability, and death. Hypertension is the main risk factor for CSVD. The use of antihypertensive therapy has not resulted in the expected decrease in CSVD complications, which may be related to the underestimation of significance of daily blood pressure profile for blood–brain barrier (BBB) permeability. 53 patients with CSVD of varying severity (mean age 60.08 ± 6.8 years, 69.8% women, subjects with treated long-standing hypertension vs. normotensive subjects − 84.8% vs. 15.2%) and 17 healthy volunteers underwent ambulatory blood pressure monitoring (ABPM) and MRI, including T1-weighted dynamic contrast-enhanced magnetic resonance imaging for assessing BBB permeability. Most of ABPM parameters in CSVD patients did not differ from controls, but were associated with the severity of white matter hyperintensity (WMH) and the total CSVD score. BBB permeability in normal-appearing white matter (NAWM) and grey matter (GM) was significantly higher in CSVD patients, and the severity of BBB permeability remained similar in patients with different stages of WMH. Among BBB permeability parameters, the area under the curve, corresponding to an increase in the contrast transit time in NAWM, had the greatest number of correlations with deviations of ABPM parameters. BBB permeability in CSVD is a universal mechanism of NAWM and GM damage associated with a slight increase in ABPM parameters. It is obvious that the treatment of hypertension in patients with not severe WMH should be more aggressive and carried out under the control of ABPM. Nature Publishing Group UK 2022-05-11 /pmc/articles/PMC9095696/ /pubmed/35545641 http://dx.doi.org/10.1038/s41598-022-11172-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Dobrynina, L. A.
Shamtieva, K. V.
Kremneva, E. I.
Zabitova, M. R.
Akhmetzyanov, B. M.
Gnedovskaya, E. V.
Krotenkova, M. V.
Daily blood pressure profile and blood–brain barrier permeability in patients with cerebral small vessel disease
title Daily blood pressure profile and blood–brain barrier permeability in patients with cerebral small vessel disease
title_full Daily blood pressure profile and blood–brain barrier permeability in patients with cerebral small vessel disease
title_fullStr Daily blood pressure profile and blood–brain barrier permeability in patients with cerebral small vessel disease
title_full_unstemmed Daily blood pressure profile and blood–brain barrier permeability in patients with cerebral small vessel disease
title_short Daily blood pressure profile and blood–brain barrier permeability in patients with cerebral small vessel disease
title_sort daily blood pressure profile and blood–brain barrier permeability in patients with cerebral small vessel disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9095696/
https://www.ncbi.nlm.nih.gov/pubmed/35545641
http://dx.doi.org/10.1038/s41598-022-11172-1
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