The relationship between the state of cerebral blood flow and volemic status in patients with ischemic stroke in the acute period

Abstract

The objective was to assess the relationship between the state of cerebral blood flow and volemic status in patients with acute ischemic stroke using the laboratory and instrumental parameters.Materials and methods. 51 patients with newly diagnosed ischemic stroke confirmed by MSCT/MRI of the brain were examined within less than 24 hours from the onset of the disease, and 20 practically healthy individuals (control group). To determine cerebral blood flow, the hemodynamic parameters of transcranial Doppler imaging were used: blood flow rates (maximum systolic, diastolic, averaged over time), Gosling’s pulsatility index and Purcelo’s index of peripheral resistance in the anterior, posterior, middle and main cerebral arteries from the affected and intact sides. Volemic status was assessed using laboratory (serum sodium and brain natriuretic peptide NT-pro-BNP) and instrumental parameters (echocardiography – end-diastolic volume of the left ventricle, left ventricular ejection fraction, diameter and degree of collapse on inhalation of the inferior vena cava).Results. Deterioration of the state of cerebral blood flow by speed indicators and an increase in the resistance parameters of the vascular wall was noted in the studied affected and intact arteries against the background of violations of the volemic status by the level of brain natriuretic peptide, end-diastolic volume of the left ventricle, diameter of the inferior vena cava, left ventricular ejection fraction and degree of collapse of the inferior vena cava. There is a correlation of vascular wall resistance parameters with laboratory and instrumental indicators of volemia, since both the development of deficiency and volume overload negatively affect cerebral perfusion.Conclusions. The cerebral blood flow parameters are correlated with the volemic status of patients with ischemic stroke in the acute period.