Elevated cerebral blood flow in patients with pure autonomic failure
| Autor: | Kaitlyn R Hay, Hakmook Kang, Olivia C. Roman, Cyndya A. Shibao, Yan Yan, Paula Trujillo, Sachin Y. Paranjape, Meher R. Juttukonda, Daniel O. Claassen, Emily M. Garland, Manus J. Donahue, Italo Biaggioni |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Orthostatic intolerance Hemodynamics Blood Pressure 030204 cardiovascular system & hematology Autonomic Nervous System 03 medical and health sciences Orthostatic vital signs Hypotension Orthostatic 0302 clinical medicine Internal medicine medicine Pure Autonomic Failure Humans Pure autonomic failure Endocrine and Autonomic Systems business.industry medicine.disease Hyperintensity Autonomic nervous system Blood pressure Cerebral blood flow Autonomic Nervous System Diseases Cerebrovascular Circulation Cardiology Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Clinical autonomic research : official journal of the Clinical Autonomic Research Society. 31(3) |
| ISSN: | 1619-1560 |
| Popis: | Pure autonomic failure (PAF) results from an impaired peripheral autonomic nervous system, and clinical symptoms present with orthostatic hypotension. While the impact on cardiovascular indices of orthostatic intolerance are well-characterized, more limited information is available regarding cerebral hemodynamic dysfunction in PAF. The objective of this study was to test the hypothesis that cerebral blood flow (CBF) is reduced in PAF, and to quantify the relationship between CBF and clinical indicators of disease severity, including peripheral supine arterial blood pressure. Participants with PAF (n = 17) and age- and sex-matched normotensive healthy controls (n = 17) were examined using established clinical rating scales, cardiovascular autonomic function tests, and 3T MRI measurements of CBF. CBF-weighted images were also used to determine the prevalence of venous hyperintensities from the major dural sinuses as evidence of abnormal capillary flow. Nonparametric tests and general linear models were used to evaluate differences and correlations between study variables. Gray matter CBF was higher in PAF (51.1 ± 13.4 mL/100 g/min) compared to controls (42.9 ± 6.5 mL/100 g/min, p = 0.007). Venous hyperintensities were more prevalent in PAF relative to controls, and the presence and degree of venous hyperintensities was associated with higher mean CBF (p = 0.027). In PAF participants, CBF and supine systolic blood pressure were inversely related (Spearman’s rho = −0.545, p = 0.024). Findings suggest that PAF patients may exhibit elevated CBF and provide evidence that this condition exerts a hemodynamic impact in the central nervous system. |
| Databáze: | OpenAIRE |
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