Effects of arterial hypertension on cerebral hemodynamics: Impact of head-down position on cerebral blood flow (asl–mri) in healthy and hypertensive subjects - 28/02/20
Resumen |
Background |
Hypertension affects cerebrovascular regulation.
Purpose |
To show that cerebral blood flow is altered in hypertensive subjects exposed to dynamic maneuvers: head down tilt (HD).
Study type |
Prospective. Population: 36 subjects (18 normotensive subjects (NT); 53,2±8,8 years/18 Hypertensive subjects (HT); 53,7±8,5 years). Field Strength/Sequence: 1.5T/ASL in supine position and after 4minutes of HD position. DWI/T2*/3D-TOF/FLAIR.
Assessment |
Regions of interest from reconstructed cerebral blood-flow (CBF) maps: sub-cortical nuclear grey matter (Accumbens, amygdala, caudate, hippocampus, pallidum, putamen, thalamus), cortical gray matter (cGM) and white matter (WM). Hemodynamics parameters were monitored. Statistical tests Shapiro and Wilk, Fisher test, univariate and multivariate simple linear regression, Pearson correlation, Student's t-test.
Results |
There was no significant CBF difference between NT and HT group in supine position. After head down tilt, the mean CBF across all structures fell by 5.8% on average in whole study group (n=36) with a decrease of 6.6% and 7.6% respectively in white and gray matter (p<0.001). The largest decreases were observed in Accumbens nuclei (9.6% left sided and 9.2% right sided (p<0.001)). In HT patients, no difference (0/16) in CBF was found after HD, whereas CBF changed significantly in four (4/16) structures in NT (right and left accumbens, putamen and left caudate nucleus as well as in the gray substance). HT had less CBF variation in left caudate nuclei (p=0.039) and cortical gray matter (cGM) (p=0.013). Among HT group, patients with diabetes had a slightest change in CBF (mV_CBF) than the HT subjects only (AccumbensL (p=0.031), Putamen R (p=0.047), white matter (WM) (p=0.015) and gray matter cortical (cGM) (p=0.015)).
Data |
.
Conclusion |
Our study highlights the significant different reaction of CBF to head position between NT and HT subjects. This supports the hypothesis that hypertension is responsible for a deficient cerebral regulation.
El texto completo de este artículo está disponible en PDF.Keywords : ASL, Hypertension, Diabetes, Cerebral auto regulation, Cerebral perfusion, Head down, MRI
Abbreviations : NT, HT, ASL, BP, CBF, GM, HD, TCD, WM
Vol 47 - N° 2
P. 85 - mars 2020 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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