Kaszczewski Piotr, Elwertowski Michal, Leszczynski Jerzy, Ostrowski Tomasz, Galazka Zbigniew
Department of General, Endocrine and Vascular Surgery, Medical University of Warsaw, Zwirki i Wigury 61 street, 02-091 Warsaw, Poland.
J Clin Med. 2020 May 7;9(5):1375. doi: 10.3390/jcm9051375.
Carotid flow velocity criteria are well established, with age being a factor influencing measurements. However, there are no volumetric standards for the flow in extracranial arteries. The aim of the study was related to volumetric flow assessment of extracranial arteries in a healthy population >65 years old.
Doppler volumetric measurements of internal carotid (ICA), external carotid (ECA) and vertebral arteries (VA) were performed in 123 healthy volunteers >65 years old and compared with 56 healthy volunteers <65 years old.
The continuous decline in cerebral blood flow (CBF) volume was observed ( < 0.00001). Volumetric reference values were established in study groups: 1., 65-69 years: 898.5 ± 119.1; 2., 70-74 years: 838.5 ± 148.9; 3., 75-79 years: 805.1 ± 99.3; 4., >80 years: 685.7 ± 112.3 (mL/min). Significant differences were observed between groups: 1 and 3.4, as well as 3 and 4 ( = 0.0295, < 0.000001, 0.00446 respectively). CBF volume decreases gradually with age: 28-64 years-6.2 mL/year ( = 0.0019), 65-75 years-11.4 mL/year ( = 0.0121) and >75 years-14.3 mL/year ( = 0.0074). This is a consequence of flow volume decline in ICA ( = 0.00001) and to lesser extent ECA ( = 0.0011). The decrease of peak systolic ( = 0.002) and end diastolic ( = < 0.00001) velocities in ICA and peak systolic velocity in ECA ( = 0.0017) were observed.
CBF decreases with ageing. Volumetric assessment of CBF may play an important additional role in diagnostics of patients with carotid stenosis. Doppler assessment of cerebral flow volume may create an interesting tool for identifying patients with diminished cerebrovascular reserve and higher risk of ischemic symptoms occurrence.
颈动脉血流速度标准已确立,年龄是影响测量结果的一个因素。然而,颅外动脉血流尚无容积标准。本研究的目的是对65岁以上健康人群的颅外动脉血流进行容积评估。
对123名65岁以上的健康志愿者进行颈内动脉(ICA)、颈外动脉(ECA)和椎动脉(VA)的多普勒容积测量,并与56名65岁以下的健康志愿者进行比较。
观察到脑血流量(CBF)容积持续下降(<0.00001)。在研究组中建立了容积参考值:1. 65 - 69岁:898.5±119.1;2. 70 - 74岁:838.5±148.9;3. 75 - 79岁:805.1±99.3;4. 80岁以上:685.7±112.3(mL/min)。组间观察到显著差异:1与3、4组,以及3与4组(分别为=0.0295,<0.000001,0.00446)。CBF容积随年龄逐渐下降:28 - 64岁 - 6.2 mL/年(=0.0019),65 - 75岁 - 11.4 mL/年(=0.0121),75岁以上 - 14.3 mL/年(=0.0074)。这是ICA血流容积下降(=0.00001)以及程度较轻的ECA血流容积下降(=0.0011)的结果。观察到ICA的收缩期峰值(=0.002)和舒张期末期(=<0.00001)速度以及ECA的收缩期峰值速度(=0.0017)下降。
CBF随年龄增长而降低。CBF的容积评估在颈动脉狭窄患者的诊断中可能发挥重要的辅助作用。脑血流容积的多普勒评估可能为识别脑血管储备减少和缺血症状发生风险较高的患者创造一个有趣的工具。