Document Detail

Orthostatic posture affects brain hemodynamics and metabolism in cerebrovascular disease patients with and without coronary artery disease: a positron emission tomography study.
MedLine Citation:
PMID:  15588598     Owner:  NLM     Status:  MEDLINE    
To investigate whether a physiological change in the orthostatic condition is associated with a deterioration of cerebrovascular and metabolic homeostasis in patients with neurocardiovascular compromises, we examined 10 patients with unilateral carotid artery occlusive disease (CVD), 6 CVD patients with coronary artery disease (CVDC), and 10 healthy subjects scanned twice under supine and sitting conditions by positron emission tomography (PET). Repeated measures analysis of variance showed significant reductions in regional cerebral blood flow (rCBF) and cerebral oxygen metabolism (rCMRO2) and tendency of increase in oxygen extraction fraction (OEF) in the affected-side parietal cortex during assuming of upright posture in the CVDC group, and there was a significant OEF increase to maintain rCMRO2 constant during sitting in the CVD counterpart. In this ischemic region, there were negative correlations between changes in OEF and rCBF in the CVD (P < 0.05) and CVDC groups (P < 0.01). Postural reductions in rCBF and CMRO2 in the parietal region were significantly greater in the CVDC group than those in the CVD group. While rCBF remained constant with mean arterial blood pressure (MABP) in healthy subjects, an rCBF reduction was found in the affected parietal cortex in proportion to the upright posture-induced MABP decrease in the CVDC group. These results indicate that patients suffering from both cerebral and coronary artery diseases may be at greater risk of deterioration of local perfusion pressure and metabolic regulation in the hemodynamically susceptible brain region during upright posture.
Yasuomi Ouchi; Etsuji Yoshikawa; Toshihiko Kanno; Masami Futatsubashi; Yoshimoto Sekine; Hiroyuki Okada; Tatsuo Torizuka; Keisei Tanaka
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  NeuroImage     Volume:  24     ISSN:  1053-8119     ISO Abbreviation:  Neuroimage     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2004-12-13     Completed Date:  2005-02-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9215515     Medline TA:  Neuroimage     Country:  United States    
Other Details:
Languages:  eng     Pagination:  70-81     Citation Subset:  IM    
Positron Medical Center, Hamamatsu Medical Center, Hamakita, Japan.
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MeSH Terms
Blood Flow Velocity / physiology
Blood Pressure / physiology
Blood Volume / physiology
Brain / blood supply*,  radionuclide imaging
Brain Ischemia / physiopathology,  radionuclide imaging*
Carotid Artery, Internal / physiopathology,  radionuclide imaging
Carotid Stenosis / physiopathology,  radionuclide imaging*
Cerebral Infarction / physiopathology,  radionuclide imaging
Coronary Disease / physiopathology,  radionuclide imaging*
Image Processing, Computer-Assisted / instrumentation*
Imaging, Three-Dimensional / instrumentation*
Ischemic Attack, Transient / physiopathology,  radionuclide imaging
Magnetic Resonance Imaging / instrumentation
Middle Aged
Oxygen Consumption / physiology
Positron-Emission Tomography / instrumentation*
Posture / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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