Enhanced external counterpulsation does not compromise cerebral autoregulation

Marthol, H.; Werner, Dierk; Brown, Clive; Hecht, Mirko; Daniel, Werner G.; Hilz, Max J.

doi:10.1111/j.1600-0404.2004.00352.x

Cited by 13 publications

(8 citation statements)

References 26 publications

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“…Regulation of downstream resistance may be one of several possible mechanisms to preserve a stable cerebral perfusion in response to diastolic augmentation in the MCA. Marthol et al [19] provided evidence that CA is preserved during ECP in healthy subjects using dynamic CA measurements. Here, the regulation of downstream resistance may be one of several possible mechanisms to preserve a stable cerebral perfusion in response to diastolic augmentation in the MCA.…”

Section: Discussionmentioning

confidence: 99%

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Does External Counterpulsation Augment Mean Cerebral Blood Flow in the Healthy Brain? Effects of External Counterpulsation on Middle Cerebral Artery Flow Velocity and Cerebrovascular Regulatory Response in Healthy Subjects

Junge-Huelsing

Liman²,

Brunecker³

et al. 2010

Cerebrovasc Dis

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Background and Purpose:External counterpulsation (ECP) noninvasively improves myocardial and organ perfusion via diastolic augmentation. The effects on cerebral blood flow velocities (CBFV) and hemodynamics are controversial. In this study, the effect of active ECP treatment on CBF in healthy subjects was continuously measured. Methods: In 9 healthy volunteers (mean age 34.1 ± 11.1 years, 4 females), 20-min active ECP treatment was performed. CBFV in the middle cerebral artery were detected via transcranial Doppler. CBFV were registered continuously before, during and after ECP. The protocol was repeated twice. Results: At onset of ECP, immediate changes in CBFV were observed: peak diastolic blood flow velocities increased from baseline to treatment (63 vs. 76 cm/s; p < 0.001) and diastolic blood flow augmentation was maintained throughout ECP. Peak systolic (87 vs. 78 cm/s; p < 0.001) and end-diastolic velocities (40 vs. 28 cm/s; p < 0.001) decreased significantly, while mean CBFV maintained constant (59 vs. 58 cm/s; not significant). The pulsatility index and resistance index as indirect parameters for peripheral vascular resistance increased during ECP (pulsatility index 0.79 vs. 0.89, p < 0.001; resistance index 0.54 vs. 0.64; p < 0.001). Conclusions: ECP did not increase mean CBFV in healthy subjects even though peak diastolic CBFV were significantly augmented. Changes in CBFV and transcranial Doppler waveform characteristics suggest that the mean flow of the middle cerebral artery is maintained stable via cerebrovascular autoregulatory mechanisms.

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Section: Discussionmentioning

confidence: 99%

“…There are limited data on the mechanisms and effects of ECP-induced diastolic flow augmentation on cerebrovascular resistance. Marthol et al [19] assessed the influence of brief ECP on dynamic CA. They found that ECP does not compromise CA in 23 healthy and 12 atherosclerotic subjects.…”

Section: Introductionmentioning

confidence: 99%

Does External Counterpulsation Augment Mean Cerebral Blood Flow in the Healthy Brain? Effects of External Counterpulsation on Middle Cerebral Artery Flow Velocity and Cerebrovascular Regulatory Response in Healthy Subjects

Junge-Huelsing

Liman²,

Brunecker³

et al. 2010

Cerebrovasc Dis

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show abstract

“…After optimising the Doppler signal, the probe was attached to the skull at a fixed angle using a headband with an adjustable positioning system. Respiratory frequency was monitored by means of inductance plethysmography using two calibrated belts attached around the thorax and abdomen (Respitrace Calibrator; Ambulatory Monitoring, Ardsley, NY, USA) [13].…”

Section: Methodsmentioning

confidence: 99%

Altered cerebral regulation in type 2 diabetic patients with cardiac autonomic neuropathy

et al. 2006

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“…In our case series, there was no increase in intravascular peripheral resistance during the IABI procedure. This could imply greater antegrade flow induced by the device without increase of downstream resistance 20,21 …”

Section: Discussionmentioning

confidence: 99%

Transcranial Doppler and Cerebral Augmentation in Acute Ischemic Stroke

Saqqur

Ibrahim²,

Butcher³

et al. 2012

Journal of Neuroimaging

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Enhanced external counterpulsation does not compromise cerebral autoregulation

Abstract: Stable gain and phase values suggest that EECP does not compromise CA and, therefore, does not seem to bear cerebrovascular risks.

Cited by 13 publications

References 26 publications

Does External Counterpulsation Augment Mean Cerebral Blood Flow in the Healthy Brain? Effects of External Counterpulsation on Middle Cerebral Artery Flow Velocity and Cerebrovascular Regulatory Response in Healthy Subjects

Does External Counterpulsation Augment Mean Cerebral Blood Flow in the Healthy Brain? Effects of External Counterpulsation on Middle Cerebral Artery Flow Velocity and Cerebrovascular Regulatory Response in Healthy Subjects

Altered cerebral regulation in type 2 diabetic patients with cardiac autonomic neuropathy

Transcranial Doppler and Cerebral Augmentation in Acute Ischemic Stroke

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