Neurovascular coupling in severe aortic valve stenosis
Abstract Objectives Aortic stenosis (AS) is characterized by obstruction of blood outflow from the left ventricle, which can impair target organ perfusion such as the brain. We hypothesized that hemodynamic changes in AS may lead to dysfunction of cerebral blood flow regulatory mechanisms. The aim o...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-08-01
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| Series: | Brain and Behavior |
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| Online Access: | https://doi.org/10.1002/brb3.3155 |
| _version_ | 1827385342223712256 |
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| author | Ana Ovsenik Matej Podbregar Nikola Lakič Martin Brešar Pavle Boškoski Ivan Verdenik Andrej Fabjan |
| author_facet | Ana Ovsenik Matej Podbregar Nikola Lakič Martin Brešar Pavle Boškoski Ivan Verdenik Andrej Fabjan |
| author_sort | Ana Ovsenik |
| collection | DOAJ |
| description | Abstract Objectives Aortic stenosis (AS) is characterized by obstruction of blood outflow from the left ventricle, which can impair target organ perfusion such as the brain. We hypothesized that hemodynamic changes in AS may lead to dysfunction of cerebral blood flow regulatory mechanisms. The aim of our study was to evaluate neurovascular coupling in patients with AS by Transcranial Doppler ultrasonography. Methods Neurovascular coupling was assessed using visually evoked cerebral blood flow velocity responses (VEFR) calculated as relative blood flow velocity changes in the posterior cerebral artery upon visual stimulation. We analyzed peak systolic, mean and end diastolic VEFR in 54 patients with severe AS and 43 controls in 10 consecutive cycles of visual stimulation. Repeated‐measures ANOVA test was used to compare cerebral hemodynamic data by group. Results Patients with AS had significantly higher peak systolic (12.9% ± 5.6% and 10.5% ± 4.5%; p = .009) and mean VEFR (14.4% ± 5.8% and 12.2% ± 4.9%; p = .021) compared to controls, whereas only a tendency for higher end diastolic VEFR was observed (16.7% ± 6.9% and 14.4% ± 6.2%; p = .061). Conclusion We have shown for the first time that patients with severe AS exhibit higher VEFR than controls indicating dysregulation of neurovascular coupling, which can be one of the factors contributing to development of cognitive decline. |
| first_indexed | 2024-03-08T15:25:04Z |
| format | Article |
| id | doaj.art-f0712e56b82a432995dc7ccddb8cb8be |
| institution | Directory Open Access Journal |
| issn | 2162-3279 |
| language | English |
| last_indexed | 2024-03-08T15:25:04Z |
| publishDate | 2023-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Brain and Behavior |
| spelling | doaj.art-f0712e56b82a432995dc7ccddb8cb8be2024-01-10T10:25:35ZengWileyBrain and Behavior2162-32792023-08-01138n/an/a10.1002/brb3.3155Neurovascular coupling in severe aortic valve stenosisAna Ovsenik0Matej Podbregar1Nikola Lakič2Martin Brešar3Pavle Boškoski4Ivan Verdenik5Andrej Fabjan6Faculty of Medicine, Department of BiomedicineUniversity of LjubljanaLjubljanaSloveniaFaculty of Medicine, Department of Internal MedicineUniversity of LjubljanaLjubljanaSloveniaDepartment of Cardiovascular SurgeryUniversity Medical Centre LjubljanaLjubljanaSloveniaJožef Stefan International Postgraduate School Ljubljana SloveniaDepartment of Systems and ControlJožef Stefan InstituteLjubljanaSloveniaDepartment of Obstetrics and Gynaecology, Division for ResearchUniversity Medical Centre LjubljanaLjubljanaSloveniaFaculty of Medicine, Institute for PhysiologyUniversity of LjubljanaLjubljanaSloveniaAbstract Objectives Aortic stenosis (AS) is characterized by obstruction of blood outflow from the left ventricle, which can impair target organ perfusion such as the brain. We hypothesized that hemodynamic changes in AS may lead to dysfunction of cerebral blood flow regulatory mechanisms. The aim of our study was to evaluate neurovascular coupling in patients with AS by Transcranial Doppler ultrasonography. Methods Neurovascular coupling was assessed using visually evoked cerebral blood flow velocity responses (VEFR) calculated as relative blood flow velocity changes in the posterior cerebral artery upon visual stimulation. We analyzed peak systolic, mean and end diastolic VEFR in 54 patients with severe AS and 43 controls in 10 consecutive cycles of visual stimulation. Repeated‐measures ANOVA test was used to compare cerebral hemodynamic data by group. Results Patients with AS had significantly higher peak systolic (12.9% ± 5.6% and 10.5% ± 4.5%; p = .009) and mean VEFR (14.4% ± 5.8% and 12.2% ± 4.9%; p = .021) compared to controls, whereas only a tendency for higher end diastolic VEFR was observed (16.7% ± 6.9% and 14.4% ± 6.2%; p = .061). Conclusion We have shown for the first time that patients with severe AS exhibit higher VEFR than controls indicating dysregulation of neurovascular coupling, which can be one of the factors contributing to development of cognitive decline.https://doi.org/10.1002/brb3.3155aortic stenosiscerebral blood flowneurovascular couplingtranscranial Doppler |
| spellingShingle | Ana Ovsenik Matej Podbregar Nikola Lakič Martin Brešar Pavle Boškoski Ivan Verdenik Andrej Fabjan Neurovascular coupling in severe aortic valve stenosis Brain and Behavior aortic stenosis cerebral blood flow neurovascular coupling transcranial Doppler |
| title | Neurovascular coupling in severe aortic valve stenosis |
| title_full | Neurovascular coupling in severe aortic valve stenosis |
| title_fullStr | Neurovascular coupling in severe aortic valve stenosis |
| title_full_unstemmed | Neurovascular coupling in severe aortic valve stenosis |
| title_short | Neurovascular coupling in severe aortic valve stenosis |
| title_sort | neurovascular coupling in severe aortic valve stenosis |
| topic | aortic stenosis cerebral blood flow neurovascular coupling transcranial Doppler |
| url | https://doi.org/10.1002/brb3.3155 |
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