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Long-term hemodynamic changes and blood pressure in atherosclerotic major cerebral artery disease

Hiroshi Yamauchi1, Shinya Kagawa1, Masaaki Takahashi1

  • 11 Division of PET Imaging, Shiga Medical Center Research Institute, Moriyama, Japan.

Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism
|August 19, 2017
PubMed

Insights

Lower systolic blood pressure in patients with major cerebral artery disease is linked to reduced hemodynamic improvement. Maintaining adequate blood pressure is crucial for enhancing cerebral blood flow and collateral pathways.

Area of Science:

  • Neurology
  • Cardiovascular Science
  • Medical Imaging

Background:

  • Cerebral artery disease can compromise blood flow through collateral pathways.
  • Lower blood pressure may impede the development of these crucial collateral pathways, hindering hemodynamic recovery.

Purpose of the Study:

  • To investigate the relationship between blood pressure and hemodynamic status in patients with atherosclerotic internal carotid artery or middle cerebral artery disease.
  • To determine if lower systolic blood pressure affects hemodynamic improvement over time in medically treated patients without ischemic events.

Main Methods:

  • Positron emission tomography (PET) with 15O-gas was used to assess hemodynamic status twice in 89 patients.
  • Correlations were analyzed between baseline and follow-up blood pressure and changes in cerebral blood flow, cerebral blood volume, and oxygen extraction fraction.

Main Results:

  • A positive linear relationship was observed between systolic blood pressure and the degree of hemodynamic improvement.
  • Patients with low systolic blood pressure (<130 mmHg) exhibited hemodynamic deterioration, including decreased cerebral blood flow and increased oxygen extraction fraction.
  • No significant hemodynamic changes were noted in patients with normal systolic blood pressure.

Conclusions:

  • Lower systolic blood pressure is associated with diminished hemodynamic improvement in patients with atherosclerotic internal carotid artery or middle cerebral artery disease.
  • Maintaining adequate systolic blood pressure may be important for promoting collateral growth and hemodynamic recovery in this patient population.

Keywords:
Carotid artery diseaseblood pressurecerebral blood flowmiddle cerebral artery diseasepositron-emission tomography

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