Induced hypertension during ischemia reduces infarct area after temporary middle cerebral artery occlusion in rats

Chileuitt, L.; Leber, K.; McCalden, T A; Weinstein, Philip

doi:10.1016/0090-3019(95)00453-x

Cited by 28 publications

(17 citation statements)

References 27 publications

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“…26 Our understanding of the mechanisms by which hypertension improved tissue outcome has been limited. Although induced hypertension has reduced infarct size in several studies, [1][2][3]12,43 its impact on cerebral perfusion has been assessed in only a few studies. 1,2,4,16 In ␣-chloralose-anesthetized baboons, a 30% increase in blood pressure enhanced CBF by almost 60% when measured by hydrogen clearance method and partially restored cortical somatosensory evoked potentials.…”

Section: Shin Et Al Induced Hypertension In Acute Focal Ischemiamentioning

confidence: 99%

“…Although improved CBF has been shown during induced hypertension in a few studies, [1][2][3][4]16 the spatiotemporal impact of induced hypertension on collateral CBF, oxygenation, and metabolism in the ischemic core and penumbra is still poorly understood. Recent advances in optical imaging provide a valuable tool to noninvasively monitor CBF, oxygenation, and cerebral metabolic rate of oxygen (CMRO 2 ) with high spatiotemporal resolution.…”

mentioning

confidence: 99%

“…Pharmacologically induced hypertension has similarly been tested to improve cerebral blood flow (CBF) and tissue outcome. [1][2][3][4] Because cerebral autoregulation is impaired after acute ischemic stroke, [5][6][7] CBF passively follows changes in mean arterial pressure (MAP). Although there is general agreement that hypotension during acute stroke is detrimental to perfusion of ischemic brain and tissue outcome, 8 -10 the impact of hypertension is poorly understood.…”

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confidence: 99%

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Mild Induced Hypertension Improves Blood Flow and Oxygen Metabolism in Transient Focal Cerebral Ischemia

Shin

Nakagawa

Jones

et al. 2008

Stroke

132

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Background and Purpose-In focal ischemic cortex, cerebral blood flow autoregulation is impaired, and perfusion passively follows blood pressure variations. Although it is generally agreed that profound hypotension is harmful in acute stroke, the hemodynamic and metabolic impact of increased blood pressure on the ischemic core and penumbra are less well understood. We, therefore, tested whether pharmacologically induced hypertension improves cerebral blood flow and metabolism and tissue outcome in acute stroke using optical imaging with high spatiotemporal resolution. Methods-Cerebral blood flow, oxyhemoglobin, and cerebral metabolic rate of oxygen were measured noninvasively using simultaneous multispectral reflectance imaging and laser speckle flowmetry during distal middle cerebral artery occlusion in mice. Hypertension was induced by phenylephrine infusion starting 10 or 60 minutes after ischemia to raise blood pressure by 30% for the duration of ischemia; control groups received saline infusion. Results-Mild induced hypertension rapidly increased cerebral blood flow, oxyhemoglobin, and cerebral metabolic rate of oxygen in both the core and penumbra and prevented the expansion of cerebral blood flow deficit during 1 hour distal middle cerebral artery occlusion. Induced hypertension also diminished the deleterious effects of periinfarct depolarizations on cerebral blood flow, oxyhemoglobin, and cerebral metabolic rate of oxygen without altering their frequency. Consistent with this, mild induced hypertension reduced infarct volume by 48% without exacerbating tissue swelling when measured 2 days after 1 hour transient distal middle cerebral artery occlusion. Conclusions-Our data suggest that mild induced hypertension increases collateral cerebral blood flow and oxygenation and improves cerebral metabolic rate of oxygen in the core and penumbra, supporting its use as bridging therapy in acute ischemic stroke until arterial recanalization is achieved. (Stroke. 2008;39:1548-1555.)

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Section: Shin Et Al Induced Hypertension In Acute Focal Ischemiamentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Mild Induced Hypertension Improves Blood Flow and Oxygen Metabolism in Transient Focal Cerebral Ischemia

Shin

Nakagawa

Jones

et al. 2008

Stroke

132

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“…Short interruption of oxygen delivery for only 5 minutes will result in neuronal death in corresponding brain regions. A variety of experiments to increase oxygen delivery have been carried out in animal models of ischemia by therapies including manipulation of perfusion pressure (Rossi et al, 2000), improvement of cerebral blood flow (Chileuitt et al, 1996;Ito et al, 2002), and enhancement of blood oxygen-carrying capacity (Bell et al, 2002). Hemoglobinbased oxygen carriers including PEG-Hb would be effective not only as an artificial blood substitutes in the loss of the whole blood but also as a therapeutic agent for the treatment of various diseases induced by hypoxic tissues.…”

Section: Discussionmentioning

confidence: 99%

Attenuated Cerebral Ischemic Injury by Polyethylene Glycol-Conjugated Hemoglobin

Cho¹,

Choi²,

Choi³

et al. 2009

Biomolecules and Therapeutics

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-Polyethylene glycol-conjugated hemoglobin (PEG-Hb) has been proposed as a blood substitute for transfusion due to their plasma expansion and oxygen transport capabilities. The protective effect of PEG-Hb on cerebral hypoxic-ischemic injury was investigated in neonatal hypoxia model and adult rat focal cerebral ischemia model. As intravenously administered 30 min before the onset of hypoxia, PEG-Hb markedly protected cerebral hypoxic injury in a neonatal rat hypoxia model. A similar treatment of PEG-Hb largely reduced the ischemic injury ensuing after 2-h middle cerebral artery occlusion followed by 22-h reperfusion. Consistently, neurological disorder was significantly improved by PEG-Hb. The results indicate that the pharmacological blockade of cerebral ischemic injury by using PEG-Hb may provide a useful strategy for the treatment of cerebral stroke.

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“…Similarly, hypertensive treatment with phenylephrine that increased blood pressure by 65mm Hg reduced infarct volume by 97% in rabbits after one hour of MCAo and 45% in rabbits subjected to two hours of MCAo (Smrcka et al, 1998). Increasing blood pressure through angiotensin was also demonstrated to increase the mean arterial pressure by 40-60% and reduce infarct volume after transient MCAo in rats (Chileuitt et al, 1996). While mild induced hypertension may be neuroprotective, it is important to note that chronic hypertension worsens stroke outcome (Aslanyan et al, 2003;Geeganage et al, 2011;Toyoda et al, 2009), possibly due to inhibition of collateral blood flow.…”

Section: Augmenting Cerebral Blood Flow By Inducing Mild Hypertensionmentioning

confidence: 97%

Understanding and Augmenting Collateral Blood Flow During Ischemic Stroke

Ramakrishnan¹,

Armitage²,

Winship³

2012

Acute Ischemic Stroke

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Induced hypertension during ischemia reduces infarct area after temporary middle cerebral artery occlusion in rats

Cited by 28 publications

References 27 publications

Mild Induced Hypertension Improves Blood Flow and Oxygen Metabolism in Transient Focal Cerebral Ischemia

Mild Induced Hypertension Improves Blood Flow and Oxygen Metabolism in Transient Focal Cerebral Ischemia

Attenuated Cerebral Ischemic Injury by Polyethylene Glycol-Conjugated Hemoglobin

Understanding and Augmenting Collateral Blood Flow During Ischemic Stroke

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