Dynamic Cerebral Autoregulation in Homozygous Sickle Cell Disease

Yu-Sok Kim; Erfan Nur; Eduard J. van Beers; Jasper Truijen; Shyrin C. A. T. Davis; Bart J. Biemond; Johannes J. van Lieshout

doi:10.1161/STROKEAHA.108.531996

Dynamic Cerebral Autoregulation in Homozygous Sickle Cell Disease

Yu-Sok Kim, Erfan Nur, Eduard J. van Beers, Jasper Truijen, Shyrin C. A. T. Davis, Bart J. Biemond, Johannes J. van Lieshout^*

^*Corresponding author for this work

Hematology/Van Creveldclinic

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background and Purpose-Sickle cell disease (SCD) is associated with cerebral hyperperfusion and an increased risk of stroke. Also, both recurrent microvascular obstruction and chronic hemolysis affect endothelial function, potentially interfering with systemic and cerebral blood flow control. We addressed the question whether cerebrovascular control in patients with SCD is affected and related to hemolysis.

Methods-Systemic and cerebrovascular control were studied in 18 patients with SCD and 10 healthy subjects. Dynamic cerebral autoregulation was evaluated by transfer function analysis assessing the relationship between mean cerebral blood flow velocity and mean arterial pressure.

Results-Normal baroreflex sensitivity and postural cardiovascular reflex responses indicated integrity of systemic cardiovascular control. In the low- (0.07 to 0.15 Hz) frequency region, mean arterial pressure variability was comparable for both groups, but a larger mean cerebral blood flow velocity variability in SCD (6.1 [4.6 to 7.0] versus 4.2 [2.6 to 5.2] [cm.s(-1)](2) . Hz(-1); P

Conclusions-In patients with SCD, dynamic cerebral autoregulation is impaired but appears unrelated to hemolysis. (Stroke. 2009; 40: 808-814.)

Original language	English
Pages (from-to)	808-814
Number of pages	7
Journal	Stroke
Volume	40
Issue number	3
DOIs	https://doi.org/10.1161/STROKEAHA.108.531996
Publication status	Published - Mar 2009

Keywords

baroreflex sensitivity
brain circulation
cerebral blood flow
hemodynamics
transcranial Doppler
BLOOD-FLOW
PULMONARY-HYPERTENSION
TRANSCRANIAL DOPPLER
NITRIC-OXIDE
ARTERY DIAMETER
HUMANS
VELOCITY
EXERCISE
STROKE
PRESSURE

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title = "Dynamic Cerebral Autoregulation in Homozygous Sickle Cell Disease",

abstract = "Background and Purpose-Sickle cell disease (SCD) is associated with cerebral hyperperfusion and an increased risk of stroke. Also, both recurrent microvascular obstruction and chronic hemolysis affect endothelial function, potentially interfering with systemic and cerebral blood flow control. We addressed the question whether cerebrovascular control in patients with SCD is affected and related to hemolysis.Methods-Systemic and cerebrovascular control were studied in 18 patients with SCD and 10 healthy subjects. Dynamic cerebral autoregulation was evaluated by transfer function analysis assessing the relationship between mean cerebral blood flow velocity and mean arterial pressure.Results-Normal baroreflex sensitivity and postural cardiovascular reflex responses indicated integrity of systemic cardiovascular control. In the low- (0.07 to 0.15 Hz) frequency region, mean arterial pressure variability was comparable for both groups, but a larger mean cerebral blood flow velocity variability in SCD (6.1 [4.6 to 7.0] versus 4.2 [2.6 to 5.2] [cm.s(-1)](2) . Hz(-1); PConclusions-In patients with SCD, dynamic cerebral autoregulation is impaired but appears unrelated to hemolysis. (Stroke. 2009; 40: 808-814.)",

keywords = "baroreflex sensitivity, brain circulation, cerebral blood flow, hemodynamics, transcranial Doppler, BLOOD-FLOW, PULMONARY-HYPERTENSION, TRANSCRANIAL DOPPLER, NITRIC-OXIDE, ARTERY DIAMETER, HUMANS, VELOCITY, EXERCISE, STROKE, PRESSURE",

author = "Yu-Sok Kim and Erfan Nur and {van Beers}, {Eduard J.} and Jasper Truijen and Davis, {Shyrin C. A. T.} and Biemond, {Bart J.} and {van Lieshout}, {Johannes J.}",

year = "2009",

month = mar,

doi = "10.1161/STROKEAHA.108.531996",

language = "English",

volume = "40",

pages = "808--814",

journal = "Stroke",

issn = "0039-2499",

publisher = "Lippincott Williams & Wilkins",

number = "3",

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T1 - Dynamic Cerebral Autoregulation in Homozygous Sickle Cell Disease

AU - Kim, Yu-Sok

AU - Nur, Erfan

AU - van Beers, Eduard J.

AU - Truijen, Jasper

AU - Davis, Shyrin C. A. T.

AU - Biemond, Bart J.

AU - van Lieshout, Johannes J.

PY - 2009/3

Y1 - 2009/3

N2 - Background and Purpose-Sickle cell disease (SCD) is associated with cerebral hyperperfusion and an increased risk of stroke. Also, both recurrent microvascular obstruction and chronic hemolysis affect endothelial function, potentially interfering with systemic and cerebral blood flow control. We addressed the question whether cerebrovascular control in patients with SCD is affected and related to hemolysis.Methods-Systemic and cerebrovascular control were studied in 18 patients with SCD and 10 healthy subjects. Dynamic cerebral autoregulation was evaluated by transfer function analysis assessing the relationship between mean cerebral blood flow velocity and mean arterial pressure.Results-Normal baroreflex sensitivity and postural cardiovascular reflex responses indicated integrity of systemic cardiovascular control. In the low- (0.07 to 0.15 Hz) frequency region, mean arterial pressure variability was comparable for both groups, but a larger mean cerebral blood flow velocity variability in SCD (6.1 [4.6 to 7.0] versus 4.2 [2.6 to 5.2] [cm.s(-1)](2) . Hz(-1); PConclusions-In patients with SCD, dynamic cerebral autoregulation is impaired but appears unrelated to hemolysis. (Stroke. 2009; 40: 808-814.)

AB - Background and Purpose-Sickle cell disease (SCD) is associated with cerebral hyperperfusion and an increased risk of stroke. Also, both recurrent microvascular obstruction and chronic hemolysis affect endothelial function, potentially interfering with systemic and cerebral blood flow control. We addressed the question whether cerebrovascular control in patients with SCD is affected and related to hemolysis.Methods-Systemic and cerebrovascular control were studied in 18 patients with SCD and 10 healthy subjects. Dynamic cerebral autoregulation was evaluated by transfer function analysis assessing the relationship between mean cerebral blood flow velocity and mean arterial pressure.Results-Normal baroreflex sensitivity and postural cardiovascular reflex responses indicated integrity of systemic cardiovascular control. In the low- (0.07 to 0.15 Hz) frequency region, mean arterial pressure variability was comparable for both groups, but a larger mean cerebral blood flow velocity variability in SCD (6.1 [4.6 to 7.0] versus 4.2 [2.6 to 5.2] [cm.s(-1)](2) . Hz(-1); PConclusions-In patients with SCD, dynamic cerebral autoregulation is impaired but appears unrelated to hemolysis. (Stroke. 2009; 40: 808-814.)

KW - baroreflex sensitivity

KW - brain circulation

KW - cerebral blood flow

KW - hemodynamics

KW - transcranial Doppler

KW - BLOOD-FLOW

KW - PULMONARY-HYPERTENSION

KW - TRANSCRANIAL DOPPLER

KW - NITRIC-OXIDE

KW - ARTERY DIAMETER

KW - HUMANS

KW - VELOCITY

KW - EXERCISE

KW - STROKE

KW - PRESSURE

U2 - 10.1161/STROKEAHA.108.531996

DO - 10.1161/STROKEAHA.108.531996

M3 - Article

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SN - 0039-2499

VL - 40

SP - 808

EP - 814

JO - Stroke

JF - Stroke

IS - 3

ER -

Dynamic Cerebral Autoregulation in Homozygous Sickle Cell Disease

Abstract

Keywords

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