Lower Blood Pressure Is Not Associated With Decreased Arterial Spin Labeling Estimates of Perfusion in Intracerebral Hemorrhage
Background Subacute ischemic lesions in intracerebral hemorrhage (ICH) have been hypothesized to result from hypoperfusion. Although studies of cerebral blood flow (CBF) indicate modest hypoperfusion in ICH, these investigations have been limited to early time points. Arterial spin labeling (ASL), a...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-06-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.118.010904 |
| _version_ | 1818775055507652608 |
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| author | Ana C. Klahr Jayme C. Kosior Dariush Dowlatshahi Brian H. Buck Christian Beaulieu Laura C. Gioia Hayrapet Kalashyan Alan H. Wilman Thomas Jeerakathil Derek J. Emery Ashfaq Shuaib Kenneth S. Butcher |
| author_facet | Ana C. Klahr Jayme C. Kosior Dariush Dowlatshahi Brian H. Buck Christian Beaulieu Laura C. Gioia Hayrapet Kalashyan Alan H. Wilman Thomas Jeerakathil Derek J. Emery Ashfaq Shuaib Kenneth S. Butcher |
| author_sort | Ana C. Klahr |
| collection | DOAJ |
| description | Background Subacute ischemic lesions in intracerebral hemorrhage (ICH) have been hypothesized to result from hypoperfusion. Although studies of cerebral blood flow (CBF) indicate modest hypoperfusion in ICH, these investigations have been limited to early time points. Arterial spin labeling (ASL), a magnetic resonance imaging technique, can be used to measure CBF without a contrast agent. We assessed CBF in patients with ICH using ASL and tested the hypothesis that CBF is related to systolic blood pressure (SBP). Methods and Results In this cross‐sectional study, patients with ICH were assessed with ASL at 48 hours, 7 days, and/or 30 days after onset. Relative CBF (rCBF; ratio of ipsilateral/contralateral perfusion) was measured in the perihematomal regions, hemispheres, border zones, and the perilesional area in patients with diffusion‐weighted imaging hyperintensities. Twenty‐patients (65% men; mean±SD age, 68.5±12.7 years) underwent imaging with ASL at 48 hours (N=12), day 7 (N=6), and day 30 (N=11). Median (interquartile range) hematoma volume was 13.1 (6.3–19.3) mL. Mean±SD baseline SBP was 185.4±25.5 mm Hg. Mean perihematomal rCBF was 0.9±0.2 at 48 hours at all time points. Baseline SBP and other SBP measurements were not associated with a decrease in rCBF in any of the regions of interest (P≥0.111). rCBF did not differ among time points in any of the regions of interest (P≥0.097). Mean perilesional rCBF was 1.04±0.65 and was unrelated to baseline SBP (P=0.105). Conclusions ASL can be used to measure rCBF in patients with acute and subacute ICH. Perihematomal CBF was not associated with SBP changes at any time point. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00963976. |
| first_indexed | 2024-12-18T10:50:57Z |
| format | Article |
| id | doaj.art-92469126b76c493c810f132a5611bb6c |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-18T10:50:57Z |
| publishDate | 2019-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-92469126b76c493c810f132a5611bb6c2022-12-21T21:10:27ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802019-06-0181110.1161/JAHA.118.010904Lower Blood Pressure Is Not Associated With Decreased Arterial Spin Labeling Estimates of Perfusion in Intracerebral HemorrhageAna C. Klahr0Jayme C. Kosior1Dariush Dowlatshahi2Brian H. Buck3Christian Beaulieu4Laura C. Gioia5Hayrapet Kalashyan6Alan H. Wilman7Thomas Jeerakathil8Derek J. Emery9Ashfaq Shuaib10Kenneth S. Butcher11Division of Neurology University of Alberta Edmonton Alberta CanadaDivision of Neurology University of Alberta Edmonton Alberta CanadaDivision of Neurology University of Ottawa Ottawa Ontario CanadaDivision of Neurology University of Alberta Edmonton Alberta CanadaDepartment of Biomedical Engineering University of Alberta Edmonton Alberta CanadaDivision of Neurology University of Alberta Edmonton Alberta CanadaDivision of Neurology University of Alberta Edmonton Alberta CanadaDepartment of Biomedical Engineering University of Alberta Edmonton Alberta CanadaDivision of Neurology University of Alberta Edmonton Alberta CanadaDepartment of Radiology and Diagnostic Imaging University of Alberta Edmonton Alberta CanadaDivision of Neurology University of Alberta Edmonton Alberta CanadaDivision of Neurology University of Alberta Edmonton Alberta CanadaBackground Subacute ischemic lesions in intracerebral hemorrhage (ICH) have been hypothesized to result from hypoperfusion. Although studies of cerebral blood flow (CBF) indicate modest hypoperfusion in ICH, these investigations have been limited to early time points. Arterial spin labeling (ASL), a magnetic resonance imaging technique, can be used to measure CBF without a contrast agent. We assessed CBF in patients with ICH using ASL and tested the hypothesis that CBF is related to systolic blood pressure (SBP). Methods and Results In this cross‐sectional study, patients with ICH were assessed with ASL at 48 hours, 7 days, and/or 30 days after onset. Relative CBF (rCBF; ratio of ipsilateral/contralateral perfusion) was measured in the perihematomal regions, hemispheres, border zones, and the perilesional area in patients with diffusion‐weighted imaging hyperintensities. Twenty‐patients (65% men; mean±SD age, 68.5±12.7 years) underwent imaging with ASL at 48 hours (N=12), day 7 (N=6), and day 30 (N=11). Median (interquartile range) hematoma volume was 13.1 (6.3–19.3) mL. Mean±SD baseline SBP was 185.4±25.5 mm Hg. Mean perihematomal rCBF was 0.9±0.2 at 48 hours at all time points. Baseline SBP and other SBP measurements were not associated with a decrease in rCBF in any of the regions of interest (P≥0.111). rCBF did not differ among time points in any of the regions of interest (P≥0.097). Mean perilesional rCBF was 1.04±0.65 and was unrelated to baseline SBP (P=0.105). Conclusions ASL can be used to measure rCBF in patients with acute and subacute ICH. Perihematomal CBF was not associated with SBP changes at any time point. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00963976.https://www.ahajournals.org/doi/10.1161/JAHA.118.010904arterial spin labelingblood pressureintracerebral hemorrhagemagnetic resonance imaging |
| spellingShingle | Ana C. Klahr Jayme C. Kosior Dariush Dowlatshahi Brian H. Buck Christian Beaulieu Laura C. Gioia Hayrapet Kalashyan Alan H. Wilman Thomas Jeerakathil Derek J. Emery Ashfaq Shuaib Kenneth S. Butcher Lower Blood Pressure Is Not Associated With Decreased Arterial Spin Labeling Estimates of Perfusion in Intracerebral Hemorrhage Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease arterial spin labeling blood pressure intracerebral hemorrhage magnetic resonance imaging |
| title | Lower Blood Pressure Is Not Associated With Decreased Arterial Spin Labeling Estimates of Perfusion in Intracerebral Hemorrhage |
| title_full | Lower Blood Pressure Is Not Associated With Decreased Arterial Spin Labeling Estimates of Perfusion in Intracerebral Hemorrhage |
| title_fullStr | Lower Blood Pressure Is Not Associated With Decreased Arterial Spin Labeling Estimates of Perfusion in Intracerebral Hemorrhage |
| title_full_unstemmed | Lower Blood Pressure Is Not Associated With Decreased Arterial Spin Labeling Estimates of Perfusion in Intracerebral Hemorrhage |
| title_short | Lower Blood Pressure Is Not Associated With Decreased Arterial Spin Labeling Estimates of Perfusion in Intracerebral Hemorrhage |
| title_sort | lower blood pressure is not associated with decreased arterial spin labeling estimates of perfusion in intracerebral hemorrhage |
| topic | arterial spin labeling blood pressure intracerebral hemorrhage magnetic resonance imaging |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.118.010904 |
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