Cerebral Pulsatility Index Is Elevated in Patients with Elevated Right Atrial Pressure
| Autor: | Konrad Schlick, Matthew M. Padrick, Stephan A. Mayer, Patrick D. Lyden, Shouri Lahiri, Nestor R Gonzalez, Heather D. Jones, Brenda Rinsky |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Subarachnoid hemorrhage business.industry Surrogate endpoint Atrial Pressure Central venous pressure 030204 cardiovascular system & hematology medicine.disease Cerebral edema Transcranial Doppler 03 medical and health sciences 0302 clinical medicine Internal medicine Anesthesia cardiovascular system Cardiology Medicine Radiology Nuclear Medicine and imaging cardiovascular diseases Neurology (clinical) Elevated right atrial pressure business Hypervolemia 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neuroimaging. 28:95-98 |
| ISSN: | 1051-2284 |
| Popis: | BACKGROUND AND PURPOSE Extracerebral venous congestion can precipitate intracranial hypertension due to obstruction of cerebral blood outflow. Conditions that increase right atrial pressure, such as hypervolemia, are thought to increase resistance to jugular venous outflow and contribute to cerebro-venous congestion. Cerebral pulsatility index (CPI) is considered a surrogate marker of distal cerebrovascular resistance and is elevated with intracranial hypertension. Thus, we sought to test the hypothesis that elevated right atrial pressure is associated with increased CPI compared to normal right atrial pressure. METHODS We retrospectively reviewed 61 consecutive patients with subarachnoid hemorrhage. We calculated CPI from transcranial Doppler studies and correlated these with echocardiographic measures of right atrial pressure. CPIs were compared from patients with elevated and normal right atrial pressure. RESULTS There was a significant difference between CPI obtained from all patients with elevated right atrial pressure compared to those with normal right atrial pressure (P < .0001). This finding was consistent in sensitivity analysis that compared right and left hemispheric CPI from patients with both elevated and normal right atrial pressure. CONCLUSION Patients with elevated right atrial pressure had significantly higher CPI compared to patients with normal right atrial pressure. These findings suggest that cerebro-venous congestion due to impaired jugular venous outflow may increase distal cerebrovascular resistance as measured by CPI. Since elevated CPI is associated with poor outcome in numerous neurological conditions, future studies are needed to elucidate the significance of these results in other populations. |
| Databáze: | OpenAIRE |
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