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Published on: January 19, 2020
Changes in Cerebral Hemodynamics in Patients with Hypertension and Post-Covid
Oleksii Khaniukov1, Viktoriia Krotova2, Svitlana Panina1
1Department of Internal Medicine 3, Dnipro State Medical University, Dnipro, Ukraine.
Insights
Patients with hypertension and a history of COVID-19 show reduced cerebral blood flow, indicated by a lower vasomotor reactivity index. This finding highlights the importance of assessing cerebral hemodynamics in these individuals.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Infectious Diseases
Background:
- Hypertension (high blood pressure) is a significant risk factor for cardiovascular and cerebrovascular diseases.
- COVID-19 infection has been linked to various vascular complications, but its long-term effects on cerebral hemodynamics in hypertensive patients require further investigation.
- Assessing cerebrovascular reserve is crucial for understanding brain blood supply and predicting neurological outcomes.
Purpose of the Study:
- To investigate the impact of a history of COVID-19 infection on cerebral hemodynamics in patients with controlled hypertension.
- To compare the vasomotor reactivity index between hypertensive patients with and without a history of COVID-19.
- To determine if COVID-19 history affects the morphofunctional state of cerebral arteries.
Main Methods:
- Ultrasound duplex scanning of head and neck vessels was performed on 73 patients with controlled stage II hypertension.
- Patients were divided into two groups: 36 with hypertension and a history of COVID-19, and a control group with hypertension only.
- Cerebrovascular reserve was assessed using the Lelyuk method, evaluating the middle cerebral artery's response to hypo- and hyperventilation, and calculating the vasomotor reactivity index.
Main Results:
- All patients (100%) exhibited thickening of the intimal-medial complex of the carotid arteries ( > 0.9 mm).
- The vasomotor reactivity index was significantly lower in the COVID-19 history group (35.4 [11.0; 49.2]) compared to the control group (46.7 [26.8; 76.4]), with p=0.002.
- These findings indicate impaired cerebral blood flow in hypertensive patients with a history of COVID-19.
Conclusions:
- A history of COVID-19 infection is associated with impaired cerebral hemodynamics in patients with controlled hypertension.
- Reduced vasomotor reactivity suggests compromised cerebrovascular reserve following COVID-19 infection in this population.
- Measuring the vasomotor reactivity index during head and neck vessel examination is recommended for evaluating cerebral hemodynamics and guiding treatment in hypertensive patients, especially those with a history of COVID-19.
Abstract:
The study results are based on the data of examination of 73 patients with controlled hypertension of the II stage. The 1st study group consisted of patients with hypertension and history of Covid-19 infection (36 patients), the 2nd group - patients with hypertension was the control group. All patients were examined using ultrasound duplex scanning of head and neck vessels. The state of cerebrovascular reserve was studied according to the method of Lelyuk - the morphofunctional state of the middle cerebral artery in hypo- and hyperventilation. The vasomotor reactivity index was calculated. Statistical analysis methods were in accordance with generally accepted international standards. Thickening of the intimal media complex of the carotid arteries during ultrasound scanning of head and neck vessels was observed in 73 (100%) patients (intimal media complex more than 0.9 mm) in the area of maximum visual thickening. The vasomotor reactivity index in patients of the 1st study group was 35.4 (11.0; 49.2), in patients of the 2nd group - 46.7 (26.8; 76.4), which is a statistically significant difference, p=0.002, including the distribution of mean values and their descriptions in terms of the median and interquartile range Me (25%; 75%). Thus, patients with controlled hypertension and the history of Covid-19 infection were shown to have impaired cerebral blood flow, which was manifested by a decrease in the vasomotor reactivity index. When examining the main arteries of the head and neck, the vasomotor reactivity index should be determined to assess the state of cerebral hemodynamics and develop treatment measures.
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