Dynamic pressure-flow velocity relationships in the human cerebral circulation

The pressure-flow velocity relationship in the cerebral circulation is characterized by the critical closing pressure (CCP), which is the pressure at which flow ceases, and the linear slope of a plot between pressure and flow velocity. It has been suggested, but not validated, that CCP can be determ...

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Bibliographic Details
Published in:Stroke (1970) 2003-07, Vol.34 (7), p.1645-1649
Main Authors: AASLID, Rune, LASH, Stephanie R, BARDY, Gust H, GILD, William H, NEWELL, David W
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Blood Flow Velocity - physiology
Blood Pressure - physiology
Brain - blood supply
Brain - physiology
Cerebrovascular Circulation - physiology
Diastole - physiology
Electric Countershock
Female
Forearm - blood supply
Fourier Analysis
Heart Rate
Humans
Hyperemia - physiopathology
Linear Models
Male
Medical sciences
Middle Aged
Middle Cerebral Artery - diagnostic imaging
Middle Cerebral Artery - physiology
Middle Cerebral Artery - physiopathology
Neurology
Radial Artery - physiology
Reproducibility of Results
Ultrasonography, Doppler, Transcranial
Vascular diseases and vascular malformations of the nervous system
Ventricular Fibrillation - physiopathology
Ventricular Fibrillation - therapy
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Summary:The pressure-flow velocity relationship in the cerebral circulation is characterized by the critical closing pressure (CCP), which is the pressure at which flow ceases, and the linear slope of a plot between pressure and flow velocity. It has been suggested, but not validated, that CCP can be determined from arterial blood pressure (ABP) and transcranial Doppler (TCD) recordings during the cardiac cycle. We studied a group of patients in whom ventricular fibrillation (VF) was induced. The time interval before defibrillation enabled calculation of CCP from data in which flow approached zero. These estimates were compared with values calculated before and after fibrillation and during regular heartbeats. TCD velocities and ABP in the radial artery were recorded before, during, and after 28 episodes of VF in 13 patients. CCPs were calculated by 3 different methods: (1) linear extrapolation from data during VF (gold standard); (2) linear extrapolation from normal heartbeat data; and (3) first harmonic Fourier filtering of normal heartbeat data. The CCP during VF calculated from long diastoles was 32.9+/-11 mm Hg (mean+/-SD). The regular heartbeat estimate was 6.0+/-4.3 mm Hg lower (P
ISSN:0039-2499
1524-4628
DOI:10.1161/01.str.0000077927.63758.b6