Dynamic Cerebral Autoregulation in Preclinical Atherosclerotic Cardiovascular Disease

Area of Science:

• Cardiovascular Medicine
• Neurology
• Medical Imaging

Background:

• Atherosclerotic cardiovascular disease (ASCVD) impacts various bodily systems, but its effect on cerebral blood flow control is not fully understood.
• Preclinical stages of ASCVD may already influence cerebrovascular regulation and cardiac function.

Purpose of the Study:

• To investigate the association between cardiovascular function and dynamic cerebral autoregulation (dCA) in patients with preclinical ASCVD.
• To explore how ASCVD risk influences the relationship between cardiac function and cerebral blood flow control.

Main Methods:

• 44 participants were stratified into low- and high-ASCVD risk groups based on established criteria.
• Cardiac function was assessed using echocardiography, and beat-to-beat blood pressure and cerebral blood flow velocity were measured.
• Spectral and transfer function analyses were employed to calculate hemodynamic variability and estimate dCA metrics.

Main Results:

• No significant group differences were observed in heart rate, blood pressure, cerebral blood flow velocity variability, or ejection fraction.
• A reduced dCA phase at very low frequency was noted in the high-risk ASCVD group (P=.03).
• Within the high-risk group, dCA phase and E'/A' were negatively correlated with age and positively correlated with each other (r²=.517, P<.01).

Conclusions:

• Advancing age impairs cerebral blood flow control and cardiac diastolic function in high-risk ASCVD patients.
• These impairments are interconnected and likely influenced by ASCVD risk factors.
• The study highlights a potential interplay between cardiac and cerebrovascular dysfunction in preclinical ASCVD.