Point/counterpoint: Cerebrovascular resistance is a flawed concept

Area of Science:

• Neuroscience
• Physiology
• Medical Engineering

Background:

• Cerebral autoregulation is vital for brain health, linking blood pressure and blood flow.
• Cerebrovascular resistance (CVR) is traditionally used but has significant limitations in practice.
• Despite flaws, CVR remains prevalent in scientific literature.

Purpose of the Study:

• To highlight the inaccuracies of the conventional cerebrovascular resistance (CVR) method.
• To introduce and advocate for superior parameters: critical closing pressure (CrCP) and resistance-area product (RAP).
• To demonstrate the advantages of CrCP and RAP using real-world data.

Main Methods:

• A critical review of the principles and application of cerebrovascular resistance (CVR).
• Explanation of the theoretical and practical benefits of critical closing pressure (CrCP) and resistance-area product (RAP).
• Analysis of real-world data to support the efficacy of CrCP and RAP.

Main Results:

• Identified fundamental flaws in the conventional cerebrovascular resistance (CVR) calculations.
• Demonstrated that critical closing pressure (CrCP) and resistance-area product (RAP) provide more accurate assessments.
• Real-world data confirmed the superior performance of CrCP and RAP over CVR.

Conclusions:

• The traditional cerebrovascular resistance (CVR) method for assessing cerebral autoregulation is unreliable.
• Critical closing pressure (CrCP) and resistance-area product (RAP) are more accurate and clinically relevant parameters.
• Adoption of CrCP and RAP is recommended for improved understanding of cerebral blood flow regulation.