Dynamic Cerebral Autoregulation in Homozygous Sickle Cell Disease

Sickle cell disease (SCD) is associated with cerebral hyperperfusion and an increased risk of stroke. Also, both recurrent microvascular obstruction and chronic hemolysis affect endothelial function, potentially interfering with systemic and cerebral blood flow control. We addressed the question whe...

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Bibliographic Details
Published in:Stroke (1970) 2009-03, Vol.40 (3), p.808-814
Main Authors: KIM, Yu-Sok, NUR, Erfan, VAN BEERS, Eduard J, TRUIJEN, Jasper, DAVIS, Shyrin C. A. T, BIEMOND, Bart J, VAN LIESHOUT, Johannes J
Format: Article
Language:English
Subjects:
Adult
Anemia, Sickle Cell - diagnostic imaging
Anemia, Sickle Cell - physiopathology
Biological and medical sciences
Blood Cell Count
Blood Pressure - physiology
Cerebral circulation. Blood-brain barrier. Choroid plexus. Cerebrospinal fluid. Circumventricular organ. Meninges
Cerebrovascular Circulation - physiology
Female
Fundamental and applied biological sciences. Psychology
Heart Rate - physiology
Hemodynamics - physiology
Hemolysis - physiology
Homeostasis - physiology
Humans
Male
Medical sciences
Neurology
Ultrasonography, Doppler, Transcranial
Vascular diseases and vascular malformations of the nervous system
Vertebrates: nervous system and sense organs
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Summary:Sickle cell disease (SCD) is associated with cerebral hyperperfusion and an increased risk of stroke. Also, both recurrent microvascular obstruction and chronic hemolysis affect endothelial function, potentially interfering with systemic and cerebral blood flow control. We addressed the question whether cerebrovascular control in patients with SCD is affected and related to hemolysis. Systemic and cerebrovascular control were studied in 18 patients with SCD and 10 healthy subjects. Dynamic cerebral autoregulation was evaluated by transfer function analysis assessing the relationship between mean cerebral blood flow velocity and mean arterial pressure. Normal baroreflex sensitivity and postural cardiovascular reflex responses indicated integrity of systemic cardiovascular control. In the low- (0.07 to 0.15 Hz) frequency region, mean arterial pressure variability was comparable for both groups, but a larger mean cerebral blood flow velocity variability in SCD (6.1 [4.6 to 7.0] versus 4.2 [2.6 to 5.2] [cm x s(-1)](2) x Hz(-1); P
ISSN:0039-2499
1524-4628
DOI:10.1161/STROKEAHA.108.531996