Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Informativity of dopplerographic evaluation of cerebral venous reactivity in different types of disturbances of venous blood outflow from the brain

Authors: V.P. Kulikov 1, M.L. Dicheskul 1, S.I. Zhestovskaya 2

Company:
1 Altai State Medical University, Ministry of Health of the Russian Federation, prospect Lenina, 40, Barnaul, 656038, Russian Federation;
2 Prof. V.F. Voyno-Yasenetskiy Krasnoyarsk State Medical University, Ministry of Health of the Russian Federation, ul. Partizana Zheleznyaka, 1, Krasnoyarsk, 660022, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

Link: Clinical Physiology of Blood Circulaiton. 2013; (): -

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Abstract

Objective. To compare venous and arterial cerebral response to hypercapnic and orthostatic impact in patients presented with dystonic and congestive-hypoxic variants of cerebral venous insufficiency.

Material and methods. Color duplex scanning was performed at 35 patients presented with mild head injury, i.e. dystonic variant of venous insufficiency (MHI group); at 30 patients presented with cervical spine pathology, vertebral artery syndrome, i.e. congestive-hypoxic variant of venous insufficiency (CSP group); at 45 volunteers without symptoms of venous circulatory failure (control normal group). Response of mean blood velocity (Vmean, cm/sec) to tests with hypercapnia and orthostasis was investigated in middle cerebral artery (MCA) and basal vein (BV) as well as in vertebral artery (VA) and vertebral vein (VV). In order to measure blood flow response to tests the index of reactivity (IR) was calculated as Vmean-under test to initial value-Vmean ratio.

Results. In the presence of hypercapnia Vmean BV and Vmean MCA were increasing but in normal group venous response was significantly greater while in CSP group and MHI group the arteriovenous responsive indexes Vmean did not differ. Cerebral circulation response to orthostasis was characterized by comparable decreasing Vmean BV and Vmean MCA, to the exclusion of MHI group in which venous response was greater than arterial one. In all groups in the presence of hypercapnia Vmean VV did not changed positively, and Vmean VA increased, but in MHI group the increase of Vmean VA was less. In all groups response of Vmean VV when transferring to orthostasis was characterized by manifested increase, while Vmean VA in upright standing posture did not change significantly, to the exclusion of CSP group in which Vmean VA decreased.

Conclusion.
1. In normal group circulation response in basal vein using tests with hypercapnia and orthostasis is unidirectional with circulation response in middle cerebral artery but it is more manifested under hypercapnia and did not differ from it under orthostatic test.
2. In normal group circulation response in vertebral artery and vertebral vein under tests with hypercapnia and orthostasis is of different directions and manifested in increasing of arterial circulation in response to hypercapnia and venous circulation under orthostatic test.
3. In the presence of dystonic variant of venous insufficiency circulation response in basal vein decreased under hypercapnia but prevailed over arterial response under orthostasis.
4. Circulation velocity increase in vertebral artery in response to hypercapnia in the presence of dystonic variant of venous insufficiency was less in comparison with normal group and in case of congestive-hypoxic variant the circulation velocity under orthostasis is slower in comparison with normal group.

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