Cerebral microvascular blood flow and CO2 reactivity in pulmonary arterial hypertension

Cerebral microvascular blood flow and CO2 reactivity in pulmonary arterial hypertension

Author Treptow, Erika Autor UNIFESP Google Scholar
Oliveira, Mayron Faria Autor UNIFESP Google Scholar
Soares, Aline Autor UNIFESP Google Scholar
Ramos, Roberta Pulcheri Autor UNIFESP Google Scholar
Medina, Luiz Autor UNIFESP Google Scholar
Lima, Rita Autor UNIFESP Google Scholar
Alencar, Maria Clara Autor UNIFESP Google Scholar
Ferreira, Eloara Vieira Autor UNIFESP Google Scholar
Ota-Arakaki, Jaquelina Sonoe Autor UNIFESP Google Scholar
Tufik, Sergio Autor UNIFESP Google Scholar
Nery, Luiz Eduardo Autor UNIFESP Google Scholar
Bittencourt, Lia Rita Azeredo Autor UNIFESP Google Scholar
Neder, Jose Alberto Autor UNIFESP Google Scholar
Abstract Hypocapnia and endothelial dysfunction might impair microvascular cerebral blood flow (CBFmicr) and cerebrovascular reactivity to CO2 (CVRCO2). Pulmonary arterial hypertension (PAH) is characteristically associated with chronic alveolar hyperventilation and microvascular endothelial dysfunction. We therefore determined CBFmicr (pre-frontal blood flow index (BFI) by the indocyanine green-near infrared spectroscopy methodology) during hypocapnia and hypercapnia in 25 PAH patients and 10 gender- and age-matched controls. Cerebral BFI was lower in patients than controls at similar transcutaneous PCO2 (PtcCO(2)) levels in both testing conditions. In fact, while BFI increased from hypocapnia to hypercapnia in all controls, it failed to increase in 17/25 (68%) patients. Thus, BFI increased to a lesser extent from hypo to hypercapnia ("Delta") in patients, i.e., they showed lower Delta BFI/Delta PtcCO(2) ratios than controls. In conclusion, CBFmicr and CVRCO2 are lessened in clinically stable, mildly-impaired patients with PAH. These abnormalities might be associated with relevant clinical outcomes (hyperventilation and dyspnea, cognition, cerebrovascular disease) being potentially amenable to pharmacological treatment. (C) 2016 Elsevier B.V. All rights reserved.
Keywords Cerebral blood flow
Carbon dioxide
Pulmonary hypertension
Ventilation
Near-infrared spectroscopy
xmlui.dri2xhtml.METS-1.0.item-coverage Amsterdam
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Grant number FAPESP: 11/52102-6
Date 2016
Published in Respiratory Physiology & Neurobiology. Amsterdam, v. 233, p. 60-65, 2016.
ISSN 1569-9048 (Sherpa/Romeo, impact factor)
Publisher Elsevier Science Bv
Extent 60-65
Origin http://dx.doi.org/10.1016/j.resp.2016.08.001
Access rights Closed access
Type Article
Web of Science ID WOS:000386410600009
URI https://repositorio.unifesp.br/handle/11600/56868

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