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. 2014 Apr 16:3:191.
doi: 10.1186/2193-1801-3-191. eCollection 2014.

Carotid blood flow, cardiovascular and endocrine responses during head-up tilt in patients with acute cerebrovascular diseases

Takahiro Miyake  1 , Takeshi Nakamura  1 , Ken Kouda  1 , Hiroyasu Uenishi  1 , Yoshio Yamamoto  1 , Shinji Kawasaki  1 , Masami Ueno  2 , Fumihiro Tajima  1
Affiliations

Carotid blood flow, cardiovascular and endocrine responses during head-up tilt in patients with acute cerebrovascular diseases

Takahiro Miyake et al. Springerplus. .

Abstract

The purpose of this study was to define common carotid blood flow (CBF), cardiovascular and endocrine responses during head-up tilt (HUT) in patients with acute cerebrovascular diseases (CVD). In 31 male patients with acute CVD (damage of the supratentorial area) and 21 age-matched control male subjects, we measured CBF, mean blood pressure (MBP), heart rate, stroke volume and cardiac output responses before (baseline), during and after HUT. We also measured plasma levels of antidiuretic hormone, adrenaline, noradrenaline, aldosterone and plasma renin activity. After obtaining baseline measurements during 3-minutes horizontal position, HUT was performed for 5 minutes, followed by continuation of recording for 3 more minutes in the horizontal position. During HUT, CBF decreased significantly and equally in both groups. MBP did not change during HUT in both groups. The endocrine responses were also not different between the two groups. The results suggest that damage to the supratentorial area in patients with acute CVD do not alter the CBF, cardiovascular and endocrine responses. In other words, HUT does not predispose patients with acute CVD to serious falls in MBP and CBF at upright posture.

Keywords: Blood pressure; Cardiac output; Duplex ultrasound; Noradrenaline; Stroke volume.

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Figures

Figure 1
Figure 1
Changes in heart rate (HR), stroke volumes (SV), cardiac output (CD), mean blood pressure (MBP) and common carotid blood flow (CBF). (A) HR, (B) SV, (C) CO, (D) MBP, and (E) CBF in patients with acute CVD (n=31) and elderly subjects (n=21) at control (baseline), during a 5-minute 60° head-up tilt (HUT) and recovery. Data are mean ± SD. *P < 0.05, compared with the baseline period.
Figure 2
Figure 2
Changes in adrenaline and noradrenaline. Plasma levels of (A) adrenaline, and (B) noradrenaline in patients with acute CVD (n = 31) and elderly subjects (n = 21) at control (baseline), during a 5-minute 60° head-up tilt (HUT) and at recovery. Data are mean ± SD. *P < 0.05 compared with the baseline period.
Figure 3
Figure 3
Changes in antidiuretic hormone (ADH), aldosterone and plasma reinin activity (PRA). Plasma levels of (A) plasma ADH, (B) aldosterone, and (C) PRA in patients with acute CVD (n = 31) and elderly subjects (n = 21) at control (baseline), during a 5-minute 60° head-up tilt (HUT) and at recovery. Data are mean ± SD. *P < 0.05 compared with the baseline period.
See this image and copyright information in PMC

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