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The effects of superimposed tilt and lower body negative pressure on anterior and posterior cerebral circulations

机译:倾斜和下身负压叠加对大脑前后循环的影响

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摘要

Steady-state tilt has no effect on cerebrovascular reactivity to increases in the partial pressure of end-tidal carbon dioxide (PETCO2). However, the anterior and posterior cerebral circulations may respond differently to a variety of stimuli that alter central blood volume, including lower body negative pressure (LBNP). Little is known about the superimposed effects of head-up tilt (HUT; decreased central blood volume and intracranial pressure) and headdown tilt (HDT; increased central blood volume and intracranial pressure), and LBNP on cerebral blood flow (CBF) responses. We hypothesized that (a) cerebral blood velocity (CBV; an index of CBF) responses during LBNP would not change with HUT and HDT, and (b) CBV in the anterior cerebral circulation would decrease to a greater extent compared to posterior CBV during LBNP when controlling PETCO2. In 13 male participants, we measured CBV in the anterior (middle cerebral artery, MCAv) and posterior (posterior cerebral artery, PCAv) cerebral circulations using transcranial Doppler ultrasound during LBNP stress (−50 mmHg) in three body positions (45°HUT, supine, 45°HDT). PETCO2 was measured continuously and maintained at constant levels during LBNP through coached breathing. Our main findings were that (a) steady-state tilt had no effect on CBV responses during LBNP in both the MCA (P = 0.077) and PCA (P = 0.583), and (b) despite controlling for PETCO2, both the MCAv and PCAv decreased by the same magnitude during LBNP in HUT (P = 0.348), supine (P = 0.694), and HDT (P = 0.407). Here, we demonstrate that there are no differences in anterior and posterior circulations in response to LBNP in different body positions.
机译:稳态倾斜对潮气末二氧化碳(PETCO2)分压升高的脑血管反应性没有影响。但是,大脑前部和后部的循环可能会对各种改变中央血液量的刺激做出不同的反应,包括下体负压(LBNP)。关于抬头向上倾斜(HUT;中心血容量和颅内压降低)和向下倾斜(HDT;中心血液量和颅内压增加)以及LBNP对脑血流(CBF)反应的叠加影响知之甚少。我们假设(a)LBNP期间的脑血流速度(CBV; CBF指数)不会随着HUT和HDT的变化而改变,并且(b)与LBNP期间的后部CBV相比,大脑前循环中的CBV降低程度更大当控制PETCO2时。在13位男性参与者中,我们使用经颅多普勒超声在三个身体部位(45°HUT,45°HUT,仰卧45°HDT)。连续测量PETCO2并在LBNP期间通过教练呼吸将其维持在恒定水平。我们的主要发现是(a)稳态倾斜对MCA(P = 0.077)和PCA(P = 0.583)的LBNP期间的CBV反应没有影响,并且(b)尽管控制了PETCO2,MCAv和在HUT(P = 0.348),仰卧(P = 0.694)和HDT(P = 0.407)的LBNP期间,PCAv下降幅度相同。在这里,我们证明了在不同身体位置对LBNP的反应,前循环和后循环没有差异。

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