Is Dynamic Cerebral Autoregulation Bilaterally Impaired after Unilateral Acute Ischemic Stroke?
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AbstractObjective: Whether dynamic cerebral autoregulation (dCA) is impaired focally in the affected hemisphere or bilaterally in both the affected and nonaffected hemispheres after ischemic stroke remains controversial. We therefore investigated the pattern of dCA in acute ischemic stroke patients with different subtypes.
Methods: Sixty acute ischemic stroke patients with unilateral anterior circulation infarct [30 with large artery atherosclerosis (LAA), 13 with small vessel disease (SVD), and 17 with coexisting LAA and SVD] and 16 healthy controls were enrolled. Spontaneous arterial blood pressure and cerebral blood flow velocity fluctuations in both bilateral middle cerebral arteries using transcranial Doppler were recorded over 10 minutes. Transfer function analysis was applied to obtain autoregulatory parameters, autoregulation index (ARI), phase difference (PD), and gain.
Results: PD was significantly lower on both the ipsilateral and contralateral sides in the LAA group (ipsilateral, 30.74 degrees; contralateral, 29.17 degrees) and the coexisting LAA and SVD group (20.23 degrees; 13.10 degrees) than that in healthy controls (left side, 51.66 degrees; right side, 58.48 degrees) (all P <.05), but there were no significant differences between the 2 sides when compared with each other in all groups. However, in the coexisting LAA and SVD group, phase on both sides was significantly lower when compared with that in the LAA and SVD groups, respectively. The results of ARI were consistent with the findings in PD.
Conclusions: The results indicate that dCA is bilaterally impaired in acute ischemic patients with LAA, and the coexisting SVD may aggravate the bilateral impairment of dCA.
Acceptance Date24/12/2016
All Author(s) ListLi Xiong, Ge Tian, Wenhua Lin, Wei Wang, Lijuan Wang, Thomas Leung, Vincent Mok, Jia Liu, Xiangyan Chen, Ka Sing Wong
Journal nameJournal of Stroke and Cerebrovascular Diseases
Volume Number26
Issue Number5
Pages1081 - 1087
LanguagesEnglish-United Kingdom
KeywordsCerebral autoregulation, cerebral blood flow, blood pressure, acute ischemic stroke
Web of Science Subject CategoriesNeurosciences;Peripheral Vascular Disease;Neurosciences & Neurology;Cardiovascular System & Cardiology

Last updated on 2021-01-03 at 02:36