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Decreased CSF Dynamics in Treatment-Naive Patients with Essential Hypertension: A Study with Phase-Contrast Cine MR
1From the Department of Medical Imaging (L.M., X. Li, X. Liu, H.C., L.G., X.X., Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, China.
Insights
Hypertension significantly reduces cerebrospinal fluid (CSF) flow dynamics, including forward and reverse flow volumes and velocities. Higher systolic blood pressure correlates with diminished CSF flow, highlighting a critical link between blood pressure and brain fluid circulation.
Area of Science:
- Neuroscience
- Cardiovascular Science
- Medical Imaging
Background:
- Arterial sclerosis from hypertension impairs cerebrospinal fluid (CSF) transport in perivascular spaces.
- The precise impact of hypertension on human CSF flow dynamics remains incompletely understood.
- Essential hypertension is linked to vascular changes affecting fluid dynamics within the central nervous system.
Purpose of the Study:
- To investigate and quantify CSF flow dynamics in individuals with untreated essential hypertension.
- To utilize advanced phase-contrast cine Magnetic Resonance Imaging (MRI) for evaluating CSF circulation.
- To establish the relationship between essential hypertension and alterations in CSF flow parameters.
Main Methods:
- Inclusion of 60 treatment-naive patients with essential hypertension and 60 healthy controls.
- Measurement of key CSF flow parameters: forward/reverse flow volume/peak velocity, average flow, and net flow volume.
- Application of phase-contrast cine MRI for precise assessment of CSF movement and quantification.
Main Results:
- Patients with hypertension exhibited significantly reduced forward flow volume, forward peak velocity, reverse flow volume, reverse peak velocity, and average flow (P < .05).
- Elevated systolic blood pressure was a significant independent determinant, inversely associated with all measured CSF flow parameters (e.g., β = -0.44 mL/mL/mm Hg for forward flow volume).
- These findings indicate a direct correlation between increased blood pressure and impaired CSF circulation.
Conclusions:
- Essential hypertension is associated with significantly decreased cerebrospinal fluid flow dynamics.
- Increasing systolic blood pressure is a strong independent predictor of reduced CSF flow parameters.
- Hypertension-induced vascular changes directly impact CSF circulation, underscoring the importance of blood pressure control for neurological health.
Background And Purpose:
Arterial sclerosis resulting from hypertension slows CSF transportation in the perivascular spaces, showing the intrinsic relationship between the CSF and the blood vasculature. However, the exact effect of hypertension on human CSF flow dynamics remains unclear. The present study aimed to evaluate CSF flow dynamics in treatment-naive patients with essential hypertension using phase-contrast cine MR imaging.
Materials And Methods:
The study included 60 never-treated patients with essential hypertension and 60 subjects without symptomatic atherosclerosis. CSF flow parameters, such as forward flow volume, forward peak velocity, reverse flow volume, reverse peak velocity, average flow, and net flow volume, were measured with phase-contrast cine MR imaging. Differences between the 2 groups were assessed to determine the independent determinants of these CSF flow parameters.
Results:
Forward flow volume, forward peak velocity, reverse flow volume, reverse peak velocity, and average flow in the patients with hypertension significantly decreased (all, P < .05). Increasing systolic blood pressure was significantly associated with lower forward flow volume (β = -0.44 mL/mL/mm Hg; 95% CI, -0.83 to -0.06 mL/mL/mm Hg), forward peak velocity (β = -0.50 cm/s/mm Hg; 95% CI, -0.88 to -0.12 cm/s/mm Hg), reverse flow volume (β = -0.61 mL/mL/mm Hg; 95% CI, -0.97 to -0.26 mL/mL/mm Hg), reverse peak velocity (β = -0.55 cm/s/mm Hg; 95% CI, -0.91-0.18 cm/s/mm Hg), and average flow (β = -0.50 mL/min/mm Hg; 95% CI, -0.93 to -0.08 mL/min/mm Hg).
Conclusions:
The CSF flow dynamics in patients with hypertension are decreased, and increasing systolic blood pressure is strongly associated with lower CSF flow dynamics.
