Yu F X, Ma X, Liu D, Liu Y W, Cai L K, Zhang T T, Ren P L, Qiao P G, Zheng W, Wang Z C
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Zhonghua Yi Xue Za Zhi. 2024 Aug 6;104(30):2817-2822. doi: 10.3760/cma.j.cn112137-20240510-01089.
To investigate the effect of increased cardiac output induced by dobutamine on cerebral blood flow (CBF) in healthy volunteers using magnetic resonance 3D-pseudo-continuous arterial spin labeling technology. A prospective study was conducted on 48 healthy volunteers recruited by handy sampling from June 2021 to January 2022. Physiological parameters before (at rest state) and after (under stress state) dobutamine-induced increase in cardiac output were analyzed. Quantitative CBF maps were generated by using arterial spin labeling difference imaging and proton density weighted reference image processing, and CBF changes under the rest and stress states were compared. Multivariable logistic regression model was used to analyze factors associated with reduced CBF. A total of 48 subjects were included, with an age [ (, )] of 25.0 (24.0, 28.0) years, including 43 men and 5 women. Compared with the rest state, the CBF in the anterior cerebral artery [(36.2±6.9) vs (34.5±6.5) ml·(100 g)·min, =0.006] and the middle cerebral artery perfusion area [(35.8±6.5) vs (34.1±6.4) ml·(100 g)·min, =0.006] decreased under the stress state, however there was no statistically significant change in CBF in the posterior cerebral artery and the vertebral-basilar artery perfusion area (all >0.05). Logistic regression analysis showed that the decrease in CBF in the anterior cerebral artery and middle cerebral artery supply regions during the stress state were correlated with an increase in diastolic blood pressure [ (95%): 0.887 (0.796-0.989) and 0.895 (0.805-0.994), both <0.05]. Dobutamine-induced increase in cardiac output leads to a decrease in CBF in anterior cerebral circulation but has no effect on posterior circulation. The increase in diastolic blood pressure is associated with decreased CBF under the stress state. Changes in CBF should be considered in the context of increased cardiac output.
采用磁共振三维伪连续动脉自旋标记技术，研究多巴酚丁胺诱导的心输出量增加对健康志愿者脑血流量（CBF）的影响。对2021年6月至2022年1月通过方便抽样招募的48名健康志愿者进行前瞻性研究。分析多巴酚丁胺诱导心输出量增加之前（静息状态）和之后（应激状态）的生理参数。通过动脉自旋标记差异成像和质子密度加权参考图像处理生成定量CBF图，并比较静息和应激状态下的CBF变化。采用多变量逻辑回归模型分析与CBF降低相关的因素。共纳入48名受试者，年龄[（，）]为25.0（24.0，28.0）岁，其中男性43名，女性5名。与静息状态相比，应激状态下大脑前动脉的CBF[（36.2±6.9） vs （34.5±6.5）ml·（100g）·min，P = 0.006]和大脑中动脉灌注区的CBF[（35.8±6.5） vs （34.1±6.4）ml·（100g）·min，P = 0.006]降低，然而大脑后动脉和椎基底动脉灌注区的CBF无统计学显著变化（均P>0.05）。逻辑回归分析表明，应激状态下大脑前动脉和大脑中动脉供血区域的CBF降低与舒张压升高相关[（95%置信区间）：0.887（0.796 - 0.989）和0.895（0.805 - 0.994），均P<0.05]。多巴酚丁胺诱导的心输出量增加导致大脑前循环的CBF降低，但对后循环无影响。应激状态下舒张压升高与CBF降低相关。在心输出量增加的情况下应考虑CBF的变化。
