Time trends, collaterals and cerebral autoregulation efficacy in acute ischemic stroke
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Tipo de documento: | Dissertação |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://hdl.handle.net/10216/134559 |
Resumo: | Background and purposes: Cerebral autoregulation (CA) is crucial for stable blood perfusion pressure and is challenged during acute ischemic stroke. CA's efficacy and collateral arteries may play a key role in penumbral region perfusion during acute phase of ischemia. We aimed to investigate CA parameters in collateral arteries over the first 48 hours post-stroke and compare them between cerebral hemispheres. Methods: We enrolled 46 patients with acute ischemic stroke of the middle cerebral artery territory and monitored cerebral blood flow velocity (CBFV) of the main cerebral arteries with transcranial Doppler. We assessed dynamic CA by projection pursuit regression (PPR) from the spontaneous oscillations of blood pressure and CBFV from within 6 hours until 48 hours of symptom onset. Results: No differences were detected throughout time. Affected middle cerebral artery showed steeper autoregulatory gain (worse dynamic CA) than its contralateral after 48 hours of onset (0.42±0.37 vs 0.37±0.30 cm/s/mmHg, p<0.05). Slight asymmetries were found in CA mostly outside autoregulatory regions. Conclusion: Our findings advance on the knowledge of global CA impairment during acute phase of stroke. Understanding collateral arteries role and physiological mechanisms regarding their CA efficacy can be useful to personalize stroke hemodynamic management and predict stroke clinical outcomes. |
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Time trends, collaterals and cerebral autoregulation efficacy in acute ischemic strokeMedicina clínicaClinical medicineBackground and purposes: Cerebral autoregulation (CA) is crucial for stable blood perfusion pressure and is challenged during acute ischemic stroke. CA's efficacy and collateral arteries may play a key role in penumbral region perfusion during acute phase of ischemia. We aimed to investigate CA parameters in collateral arteries over the first 48 hours post-stroke and compare them between cerebral hemispheres. Methods: We enrolled 46 patients with acute ischemic stroke of the middle cerebral artery territory and monitored cerebral blood flow velocity (CBFV) of the main cerebral arteries with transcranial Doppler. We assessed dynamic CA by projection pursuit regression (PPR) from the spontaneous oscillations of blood pressure and CBFV from within 6 hours until 48 hours of symptom onset. Results: No differences were detected throughout time. Affected middle cerebral artery showed steeper autoregulatory gain (worse dynamic CA) than its contralateral after 48 hours of onset (0.42±0.37 vs 0.37±0.30 cm/s/mmHg, p<0.05). Slight asymmetries were found in CA mostly outside autoregulatory regions. Conclusion: Our findings advance on the knowledge of global CA impairment during acute phase of stroke. Understanding collateral arteries role and physiological mechanisms regarding their CA efficacy can be useful to personalize stroke hemodynamic management and predict stroke clinical outcomes.2021-05-102021-05-10T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttps://hdl.handle.net/10216/134559TID:202850285engNuno Ricardo Sousa Gonçalvesinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-29T14:47:37Zoai:repositorio-aberto.up.pt:10216/134559Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T00:08:36.492302Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Time trends, collaterals and cerebral autoregulation efficacy in acute ischemic stroke |
title |
Time trends, collaterals and cerebral autoregulation efficacy in acute ischemic stroke |
spellingShingle |
Time trends, collaterals and cerebral autoregulation efficacy in acute ischemic stroke Nuno Ricardo Sousa Gonçalves Medicina clínica Clinical medicine |
title_short |
Time trends, collaterals and cerebral autoregulation efficacy in acute ischemic stroke |
title_full |
Time trends, collaterals and cerebral autoregulation efficacy in acute ischemic stroke |
title_fullStr |
Time trends, collaterals and cerebral autoregulation efficacy in acute ischemic stroke |
title_full_unstemmed |
Time trends, collaterals and cerebral autoregulation efficacy in acute ischemic stroke |
title_sort |
Time trends, collaterals and cerebral autoregulation efficacy in acute ischemic stroke |
author |
Nuno Ricardo Sousa Gonçalves |
author_facet |
Nuno Ricardo Sousa Gonçalves |
author_role |
author |
dc.contributor.author.fl_str_mv |
Nuno Ricardo Sousa Gonçalves |
dc.subject.por.fl_str_mv |
Medicina clínica Clinical medicine |
topic |
Medicina clínica Clinical medicine |
description |
Background and purposes: Cerebral autoregulation (CA) is crucial for stable blood perfusion pressure and is challenged during acute ischemic stroke. CA's efficacy and collateral arteries may play a key role in penumbral region perfusion during acute phase of ischemia. We aimed to investigate CA parameters in collateral arteries over the first 48 hours post-stroke and compare them between cerebral hemispheres. Methods: We enrolled 46 patients with acute ischemic stroke of the middle cerebral artery territory and monitored cerebral blood flow velocity (CBFV) of the main cerebral arteries with transcranial Doppler. We assessed dynamic CA by projection pursuit regression (PPR) from the spontaneous oscillations of blood pressure and CBFV from within 6 hours until 48 hours of symptom onset. Results: No differences were detected throughout time. Affected middle cerebral artery showed steeper autoregulatory gain (worse dynamic CA) than its contralateral after 48 hours of onset (0.42±0.37 vs 0.37±0.30 cm/s/mmHg, p<0.05). Slight asymmetries were found in CA mostly outside autoregulatory regions. Conclusion: Our findings advance on the knowledge of global CA impairment during acute phase of stroke. Understanding collateral arteries role and physiological mechanisms regarding their CA efficacy can be useful to personalize stroke hemodynamic management and predict stroke clinical outcomes. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-05-10 2021-05-10T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://hdl.handle.net/10216/134559 TID:202850285 |
url |
https://hdl.handle.net/10216/134559 |
identifier_str_mv |
TID:202850285 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799136011450580992 |