| Cerebrovascular reserve capacity is impaired in patients with sickle cell disease. | |
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MedLine Citation:
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PMID: 19700663 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Sickle cell disease (SCD) is associated with a high incidence of ischemic stroke. SCD is characterized by hemolytic anemia, resulting in reduced nitric oxide-bioavailability, and by impaired cerebrovascular hemodynamics. Cerebrovascular CO2 responsiveness is nitric oxide dependent and has been related to an increased stroke risk in microvascular diseases. We questioned whether cerebrovascular CO2 responsiveness is impaired in SCD and related to hemolytic anemia. Transcranial Doppler-determined mean cerebral blood flow velocity (V(mean)), near-infrared spectroscopy-determined cerebral oxygenation, and end-tidal CO2 tension were monitored during normocapnia and hypercapnia in 23 patients and 16 control subjects. Cerebrovascular CO2 responsiveness was quantified as Delta% V(mean) and Deltamicromol/L cerebral oxyhemoglobin, deoxyhemoglobin, and total hemoglobin per mm Hg change in end-tidal CO2 tension. Both ways of measurements revealed lower cerebrovascular CO2 responsiveness in SCD patients versus controls (V(mean), 3.7, 3.1-4.7 vs 5.9, 4.6-6.7 Delta% V(mean) per mm Hg, P < .001; oxyhemoglobin, 0.36, 0.14-0.82 vs 0.78, 0.61-1.22 Deltamicromol/L per mm Hg, P = .025; deoxyhemoglobin, 0.35, 0.14-0.67 vs 0.58, 0.41-0.86 Deltamicromol/L per mm Hg, P = .033; total-hemoglobin, 0.13, 0.02-0.18 vs 0.23, 0.13-0.38 Deltamicromol/L per mm Hg, P = .038). Cerebrovascular CO2 responsiveness was not related to markers of hemolytic anemia. In SCD patients, impaired cerebrovascular CO2 responsiveness reflects reduced cerebrovascular reserve capacity, which may play a role in pathophysiology of stroke. |
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Authors:
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Erfan Nur; Yu-Sok Kim; Jasper Truijen; Eduard J van Beers; Shyrin C A T Davis; Dees P Brandjes; Bart J Biemond; Johannes J van Lieshout |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-08-21 |
Journal Detail:
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Title: Blood Volume: 114 ISSN: 1528-0020 ISO Abbreviation: Blood Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-16 Completed Date: 2009-11-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7603509 Medline TA: Blood Country: United States |
Other Details:
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Languages: eng Pagination: 3473-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anemia, Sickle Cell / blood, complications, epidemiology, physiopathology* Blood Flow Velocity Brain Ischemia / blood, epidemiology, etiology, physiopathology* Carbon Dioxide / blood Cerebrovascular Circulation* Female Hemoglobins / analysis Humans Incidence Male Nitric Oxide / blood Oxygen / blood Oxyhemoglobins / analysis Risk Factors Stroke / blood, epidemiology, etiology, physiopathology* |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobins; 0/Oxyhemoglobins; 10102-43-9/Nitric Oxide; 124-38-9/Carbon Dioxide; 7782-44-7/Oxygen; 9008-02-0/deoxyhemoglobin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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