Age-Related Changes in Carotid Artery Flow and Pressure Pulses

Hirata, Kozo; Yaginuma, Toshio; O’Rourke, Michael; Kawakami, Masanobu

doi:10.1161/01.str.0000242289.20381.f4

Cited by 149 publications

(87 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been proposed that the transmission of elevated pulse pressures to the microcirculation, especially in regions with relatively low vascular resistance such as the brain or kidney, are deleterious to the vascular beds of these target organs. 10 Consistent with our hypothesis, we found that increased baPWV was significantly related to an increase in CVRi, and that this was strongly related to a reduction in CBF, in the elderly.…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Association between arterial stiffness and cerebrovascular resistance in the elderly

2009

View full text Add to dashboard Cite

Arterial stiffness is an established cardiovascular risk factor influencing haemodynamic properties in the microcirculation. We tested the hypothesis that increased arterial stiffness is associated with an increase in cerebrovascular resistance in the elderly. Brachialankle pulse wave velocity (baPWV), using arterial tonometry, and anterior cerebral blood flow (aCBF), using extracranial ultrasound, were measured in 26 participants (67-92 years). Non-parametric statistics examined relationships between age, blood pressure, baPWV, cerebrovascular resistance (CVRi) and aCBF. Bivariate analysis suggested that baPWV was the only vascular characteristic associated with CVRi (r s ¼ 0.59; P ¼ 0.002). CVRi was strongly correlated with aCBF (r s ¼ À0.89; Po0.001). Furthermore, compared with participants in the lower three quartiles of baPWV (LO) ; P ¼ 0.09). This study found a positive correlation between baPWV and CVRi in the elderly, suggesting that haemodynamic characteristics associated with arterial aging influence cerebral circulation.

show abstract

Section: Discussionsupporting

confidence: 91%

“…10 The current literature provides indirect evidence of an association between arterial stiffness and CBF. 11,12 Six months of anti-hypertensive treatment resulted in not only a reduced perfusion pressure and increased common carotid distensibility, but also an elevated CBF velocity.…”

Section: Introductionmentioning

confidence: 99%

Association between arterial stiffness and cerebrovascular resistance in the elderly

2009

View full text Add to dashboard Cite

show abstract

“…One possibility is that the CAVI reflects atherosclerosis in systemic large arteries, including the carotid, coronary and peripheral arteries. 8 Moreover, atherosclerosis in large extracranial 17 or intracranial arteries 18 also leads to arteriolosclerosis in small cerebral vessels and to the development of CMBs. Thus, systemic atherosclerosis may have a key role in the occurrence of cerebral arteriolosclerosis and CMBs.…”

Section: Discussionmentioning

confidence: 99%

Stroke patients with cerebral microbleeds on MRI scans have arteriolosclerosis as well as systemic atherosclerosis

et al. 2012

View full text Add to dashboard Cite

Cerebral microbleeds (CMBs) are recognized as a manifestation of arteriolosclerosis in cerebral small vessels. However, little is known regarding whether stroke patients with CMBs often have systemic atherosclerosis. The aim of the present study was to elucidate this issue using the cardio-ankle vascular index (CAVI), a new index of systemic atherosclerosis, in acute ischemic stroke patients. We prospectively studied 105 patients (71 males, median age ¼ 70.0 years) with acute ischemic stroke. All of the patients were examined using T2*-weighted gradient echo magnetic resonance imaging (MRI) to look for and assess the CMBs and using fluid-attenuated inversion recovery to evaluate white matter hyperintensity (WMH). We assigned the patients into CMB and non-CMB groups and compared the clinical characteristics of these groups. The factors associated with CMBs were investigated using multivariate logistic regression analysis. T2*-weighted gradient echo MRI revealed CMBs in 47 patients (44.8%) and no CMBs in 58 patients (55.2%). The CAVI was significantly higher in the CMBs group (10.5 vs. 8.6, Po0.001).In the multivariate logistic regression analysis, CAVI per one point increase (odds ratio (OR), 1.50; 95% confidence interval (CI), 1.12-2.00; P ¼ 0.006), advanced WMH (OR, 4.78; 95% CI, 1.55-14.74; P ¼ 0.006) and impaired kidney function (OR, 3.31; 95% CI, 1.16-9.81; P ¼ 0.031) were independent factors associated with the presence of CMBs. A high CAVI was independently associated with CMBs in patients with acute ischemic stroke. Our results indicated that ischemic stroke patients with CMBs may have cerebral arteriolosclerosis as well as systemic atherosclerosis.

show abstract

“…The fact that the PWV is an indicator of lacunar infarction and white matter lesions (Hashimoto et al 2008a;Henskens et al 2008;Mitchell et al 2011;Wohlfahrt et al 2014) can be considered evidence that aortic stiffening underlies these associations between the increased central pressure and cerebral microvascular damage. In addition, a recent study has found an independent association between the cerebral blood flow pulsatility and white matter lesions (Webb et al 2012), suggesting that the flow as well as pressure pulsations are responsible for microvascular damage in the brain (Hirata et al 2006;Adji et al 2011;Mitchell et al 2011), as in the kidney.…”

Section: Central Hemodynamics and Brainmentioning

confidence: 99%

Central Hemodynamics and Target Organ Damage in Hypertension

Hashimoto

2014

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

Recent advances in technology have enabled the noninvasive evaluation of pulsatile hemodynamics in the central aorta; namely, central pressure and flow measurements. The central blood pressure represents the true load imposed on the heart, kidney and brain, and the central blood flow influences the local flow into these vital organs. An elevation of the central blood pressure has a direct, adverse impact on the target organ and, thus, the cardiovascular prognosis in patients with hypertension. A decrease in the central blood flow can cause organ dysfunction and failure. The central pressure and flow dynamics were conventionally regarded as unidirectional from the heart to the periphery. However, current evidence suggests that it should be recognized as a bidirectional interplay between the central and peripheral arteries. Specifically, the pressure pulse wave is not only transmitted forward to the periphery but also reflected backward to the central aorta. The flow pulse wave is also composed of the forward and reverse components. Aortic stiffening and arteriolar remodeling due to hypertension not only augment the central pressure by increasing the wave reflection but also may alter the central bidirectional flow, inducing hemodynamic damage/dysfunction in susceptible organs. Therefore, central hemodynamic monitoring has the potential to provide a diagnostic and therapeutic basis for preventing systemic target organ damage and for offering personalized therapy suitable for the arterial properties in each patient with hypertension. This brief review will summarize hypothetical mechanisms for the association between the central hemodynamics and hypertensive organ damage in the heart, kidney and brain.

show abstract

Age-Related Changes in Carotid Artery Flow and Pressure Pulses

Cited by 149 publications

References 49 publications

Association between arterial stiffness and cerebrovascular resistance in the elderly

Association between arterial stiffness and cerebrovascular resistance in the elderly

Stroke patients with cerebral microbleeds on MRI scans have arteriolosclerosis as well as systemic atherosclerosis

Central Hemodynamics and Target Organ Damage in Hypertension

Contact Info

Product

Resources

About