Transcranial Doppler Velocities in a Large, Healthy Population

Tegeler, Charles H.; Crutchfield, Kevin E.; Katsnelson, Michael; Kim, Jong-Yeol; Tang, Rong; Griffin, Leah; Rundek, Tatjana; Evans, Greg

doi:10.1111/j.1552-6569.2012.00711.x

Cited by 131 publications

(111 citation statements)

References 34 publications

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“…This observation is supported by clinical data showing that premenopausal women have improved endothelial function compared with age-matched men (23,59). Furthermore, cerebral blood flow measurements using transcranial laser Doppler show that mean arterial blood flow velocity in brain is higher in healthy women compared with age-matched men (57). A similar observation has also been made in healthy children using MRI, with girls showing enhanced cerebral perfusion compared with boys (56).…”

Section: Discussionsupporting

confidence: 59%

Role of aromatase in sex-specific cerebrovascular endothelial function in mice

Zuloaga

Davis

Zhang

et al. 2014

American Journal of Physiology-Heart and Circulatory Physiology

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Zuloaga KL, Davis CM, Zhang W, Alkayed NJ. Role of aromatase in sex-specific cerebrovascular endothelial function in mice. Am J Physiol Heart Circ Physiol 306: H929 -H937, 2014. First published February 7, 2014 doi:10.1152/ajpheart.00698.2013.-Stroke risk and outcome are strongly modified by estrogen. In addition to ovaries, estrogen is produced locally in peripheral tissue by the enzyme aromatase, and extragonadal synthesis becomes the major source of estrogen after menopause. Aromatase gene deletion in female mice exacerbates ischemic brain damage after stroke. However, it is not clear which cell type is responsible for this effect, since aromatase is expressed in multiple cell types, including cerebrovascular endothelium. We tested the hypothesis that cerebrovascular aromatase contributes to sex differences in cerebrovascular endothelial function. Cerebrocortical microvascular responses to the endothelium-dependent vasodilator ACh were compared between male and female wild-type (WT) and aromatase knockout (ArKO) mice by measuring laser-Doppler perfusion in vivo through a closed cranial window. Additional studies were performed in WT mice treated with the aromatase inhibitor fadrozole or vehicle. WT female mice had significantly greater responses to ACh compared with WT males (P Ͻ 0.001), which was associated with higher aromatase expression in female compared with male cerebral vessels (P Ͻ 0.05). ACh responses were significantly lower in ArKO compared with WT females (P Ͻ 0.05) and in WT females treated with fadrozole versus vehicle (P Ͻ 0.001). Conversely, ACh responses were significantly higher in ArKO versus WT males (P Ͻ 0.05). Levels of phosphorylated endothelial nitric oxide synthase (eNOS) were lower in ArKO versus WT female brains, but were not altered by aromatase deletion in males. We conclude that cerebrovascular endothelial aromatase plays an important and sexually dimorphic role in cerebrovascular function and that aromatase inhibitors in clinical use may have cardiovascular consequences in both males and females.

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Section: Discussionsupporting

confidence: 59%

Role of aromatase in sex-specific cerebrovascular endothelial function in mice

Zuloaga

Davis

Zhang

et al. 2014

American Journal of Physiology-Heart and Circulatory Physiology

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“…In this study, in contrast, we compared septic patients to a control group of critically ill patients to exclude critical illness-related factors (possibly including sedation, nonseptic inflammatory reaction, operation stress or catecholamines administration) that could affect cerebrovascular resistances. Patients from the control group had a similar PI to healthy people of the same age (0.98 ±16 vs. 0.95 ± 17 [30] or 0.97[0.93-1.02] [31]). Interestingly, on the first day, when microcirculation changes are expected to be less severe [29,32], only PI and not RI was found to be statistically higher in septic patients compared with the controls.…”

Section: Discussionmentioning

confidence: 99%

Transcranial doppler assessment of cerebral perfusion in critically ill septic patients: a pilot study

Pierrakos

Velissaris

et al. 2013

Ann. Intensive Care

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BackgroundThe aim of this study is to evaluate the feasibility and efficacy of Transcranial Doppler (TCD) in assessing cerebral perfusion changes in septic patients.MethodsUsing TCD, we measured the mean velocity in the middle cerebral artery (VmMCA, cm/sec) and calculated the pulsatility index (PI), resistance index (RI) and cerebral blood flow index (CBFi = 10*MAP/1.47PI) on the first day of patients’ admission or on the first day of sepsis development; measurements were repeated on the second day. Sepsis was defined according to standard criteria.ResultsForty-one patients without any known neurologic deficit treated in our 24-bed Critical Care Unit were assessed (Sepsis Group = 20, Control Group = 21). Examination was feasible in 91% of septic and 85% of non-septic patients (p = 0.89). No difference was found between the two groups in mean age, mean arterial pressure (MAP) or APACHE II score. The pCO2 values were higher in septic patients (46 ± 12 vs. 39 ± 4 mmHg p < 0.01). No statistically significant higher values of VmMCA were found in septic patients (110 ± 34 cm/sec vs. 99 ± 28 cm/sec p = 0.17). Higher values of PI and RI were found in septic patients (1.15 ± 0.25 vs. 0.98 ± 0.16 p < 0.01, 0.64 ± 0.08 vs. 0.59 ± 0.06 p < 0.01, respectively). No statistically significant lower values of CBFi were found in septic patients (497 ± 116 vs. 548 ± 110 p = 0.06).ConclusionsOur results suggest cerebral vasoconstriction in septic compared to non-septic patients. TCD is an efficient and feasible exam to evaluate changes in cerebral perfusion during sepsis.

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“…As anticipated, the arteries in question demonstrate characteristics that are different from both the extracranial and intracranial cerebral blood vessels. The velocities in the MXA are lower than in the carotid and intracranial arteries, while being similar to those of vertebral arteries . Flow velocities measured in the MMA are far lower than those of any other major cerebral artery.…”

Section: Discussionmentioning

confidence: 65%

Ultrasonographic assessment of the maxillary artery and middle meningeal artery in the infratemporal fossa

Lepic

Lepić

Mandić‐Rajčević

2019

J of Clinical Ultrasound

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Purpose To investigate with Doppler ultrasonography the maxillary and middle meningeal arteries in the infratemporal fossa, and describe their hemodynamic characteristics. Methods We included 24 female and 11 male volunteers without vascular diseases, with a median age of 43 years. We used the acoustic window, enlarged by subjects half‐opening their mouth, located below the zygomatic arch, in front of temporo‐mandibular joint, to reach the maxillary and middle meningeal arteries. Results In the 35 subjects, 112 arteries were visualized successfully: 60 maxillary (85.7%), and 52 middle meningeal arteries (74.3%), at a depth of 2.40 and 2.50 cm, respectively. Their blood flow was directed anteriorly and away from the probe. While all the measured hemodynamic characteristics differed significantly between the maxillary and the middle meningeal artery (P < 0.001), there was no significant difference between male and female subjects, nor between the left or the right side. Conclusions The maxillary and middle meningeal arteries can be insonated in the infratemporal fossa through the easily accessible acoustic window below the zygomatic arch, when the patient holds his mouth half open. They can be differentiated by their ultrasonographic characteristics and blood flow features.

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Transcranial Doppler Velocities in a Large, Healthy Population

Cited by 131 publications

References 34 publications

Role of aromatase in sex-specific cerebrovascular endothelial function in mice

Role of aromatase in sex-specific cerebrovascular endothelial function in mice

Transcranial doppler assessment of cerebral perfusion in critically ill septic patients: a pilot study

Ultrasonographic assessment of the maxillary artery and middle meningeal artery in the infratemporal fossa

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