The impact of cardiac index on cerebral hemodynamics

The impact of cardiac index on cerebral hemodynamics

Current noninvasive testing allows accurate assessment of cerebrovascular hemodynamics. The cardiovascular influence on the noninvasive assessment of cerebrovascular studies has not been defined. This study was designed to determine the effect of cardiac index (CI) on cerebral blood flow velocities,...

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Bibliographic Details
Published in:Stroke (1970) Vol. 24; no. 11; pp. 1686 - 1690
Main Authors: MADHUMITA SAHA, MUPPALA, M. R, CASTALDO, J. E, GEE, W, REED, J. F, MORRIS, D. L
Format: Journal Article
Language:English
Published: Hagerstown, MD Lippincott Williams & Wilkins 01-11-1993
Subjects:
Biological and medical sciences
Blood Pressure
Brain
Cardiac Catheterization
Cardiac Output
Cerebral Arteries
Cerebrovascular Circulation
Echoencephalography
Hemodynamics
Humans
Investigative techniques of hemodynamics
Investigative techniques, diagnostic techniques (general aspects)
Medical sciences
Regional Blood Flow
Retinal Vessels
Retrospective Studies
Doppler ultrasound study
Sonography
Human
Cardiac performance
Catheterization
Right
Exploration
Cardiac index
Circulatory velocity
Blood flow
Ophthalmic artery
Regulation(control)
Blood pressure
Hemodynamics
Monitoring
Plethysmography
Brain (vertebrata)
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Summary:Current noninvasive testing allows accurate assessment of cerebrovascular hemodynamics. The cardiovascular influence on the noninvasive assessment of cerebrovascular studies has not been defined. This study was designed to determine the effect of cardiac index (CI) on cerebral blood flow velocities, ocular pulse amplitude, ophthalmic systolic pressure, and ocular blood flow (OBF) as currently estimated by noninvasive laboratories. Based on a retrospective study of 181 patients, we prospectively evaluated 45 patients undergoing right heart catheterization for hemodynamic monitoring to correlate the relation between CI, transcranial Doppler sonography, and ocular pneumoplethysmography. Patients with hemodynamic instability, severe carotid stenoses, massive cerebral infarct, or sepsis were ineligible for the study. Simultaneous recordings of systemic blood pressure, ophthalmic systolic pressure, heart rate, ocular pulse amplitude, middle cerebral artery blood flow velocities, and cardiac output were obtained on all patients. OBF was calculated from the heart rate and ocular pulse amplitude. The relation between OBF and CI is expressed by the equation CI = 2.36 + 0.61 x OBF (r = .47, P = .0010). The middle cerebral artery peak systolic velocities and CI had a correlation of .36 (P = .0181). The equation, derived from the linear relation between OBF and CI, was then validated on a sample of 15 patients. With the apparent linear relation between OBF and CI, we used the derived equation to predict CI from OBF. The OBF determination predicted CI within 30% in all patients and within 20% in 53.3% of the patients. We demonstrated that OBF and middle cerebral artery systolic velocity decrease with diminishing CI. Our findings suggest that CI may be potentially estimated in selected patients by noninvasive assessment of OBF using ocular pneumoplethysmography.
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ISSN:0039-2499
1524-4628
DOI:10.1161/01.str.24.11.1686