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在年轻健康成年人血压短暂降低期间,血管顺应性的快速变化有助于脑血管调节。

Rapid changes in vascular compliance contribute to cerebrovascular adjustments during transient reductions in blood pressure in young, healthy adults.

作者信息

Moir M Erin, Klassen Stephen A, Zamir Mair, Shoemaker J Kevin

机构信息

School of Kinesiology, University of Western Ontario, London, Ontario, Canada.

Department of Applied Mathematics, University of Western Ontario, London, Ontario, Canada.

出版信息

J Appl Physiol (1985). 2020 Jul 1;129(1):27-35. doi: 10.1152/japplphysiol.00272.2020. Epub 2020 May 28.

Abstract

Characterization of dynamic cerebral autoregulation has focused primarily on adjustments in cerebrovascular resistance in response to blood pressure (BP) alterations. However, the role of vascular compliance in dynamic autoregulatory processes remains elusive. The present study examined changes in cerebrovascular compliance and resistance during standing-induced transient BP reductions in nine young, healthy adults (3 women). Brachial artery BP (Finometer) and middle cerebral artery blood velocity (BV; Multigon) waveforms were collected. Beginning 20 beats before standing and continuing 40 beats after standing, individual BP and BV waveforms of every second heartbeat were extracted and input into a four-element modified Windkessel model to calculate indexes of cerebrovascular resistance () and compliance (). Standing elicited a transient reduction in mean BP of 20 ± 9 mmHg. In all participants, a large increase in (165 ± 84%; < 0.001 vs. seated baseline) occurred 2 ± 2 beats following standing. Reductions in occurred 11 ± 3 beats after standing ( vs. delay: < 0.001). The increase in contributed to maintained systolic BV before the decrease in . The present results demonstrate rapid, large but transient increases in that precede reductions in , in response to standing-induced reductions in BP. Therefore, represents a discreet component of cerebrovascular responses during acute decreases in BP and, consequently, dynamic autoregulation. Historically, dynamic cerebral autoregulation has been characterized by adjustments in cerebrovascular resistance following systematic changes in blood pressure. However, with the use of Windkessel modeling approaches, this study revealed rapid and large increases in cerebrovascular compliance that preceded reductions in cerebrovascular resistance following standing-induced blood pressure reductions. Importantly, the rapid cerebrovascular compliance response contributed to preservation of systolic blood velocity during the transient hypotensive phase. These results broaden our understanding of dynamic cerebral autoregulation.

摘要

动态脑自动调节的特征主要集中在脑血管阻力随血压(BP)变化的调整上。然而,血管顺应性在动态自动调节过程中的作用仍不明确。本研究检测了9名年轻健康成年人(3名女性)在站立引起的短暂血压降低过程中脑血管顺应性和阻力的变化。收集肱动脉血压(Finometer)和大脑中动脉血流速度(BV;Multigon)波形。从站立前20个心动周期开始,持续到站立后40个心动周期,每隔一个心跳提取个体血压和BV波形,并输入四元件改良Windkessel模型,以计算脑血管阻力()和顺应性()指标。站立引起平均血压短暂降低20±9 mmHg。在所有参与者中,站立后2±2个心动周期时,(165±84%;与坐位基线相比,P<0.001)大幅增加。站立后11±3个心动周期时降低(与延迟相比:P<0.001)。的增加有助于在降低之前维持收缩期BV。本研究结果表明,响应站立引起的血压降低,在降低之前,迅速、大幅但短暂地增加。因此,代表了急性血压降低期间脑血管反应的一个离散组成部分,从而也是动态自动调节的组成部分。历史上,动态脑自动调节的特征是血压系统性变化后脑血管阻力的调整。然而,通过使用Windkessel建模方法,本研究揭示了站立引起血压降低后,脑血管顺应性迅速大幅增加,先于脑血管阻力降低。重要的是,快速的脑血管顺应性反应有助于在短暂低血压阶段维持收缩期血流速度。这些结果拓宽了我们对动态脑自动调节的理解。

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