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. 2023 Aug;13(8):e3155.
doi: 10.1002/brb3.3155. Epub 2023 Jul 21.

Neurovascular coupling in severe aortic valve stenosis

Ana Ovsenik  1   2 , Matej Podbregar  3   4 , Nikola Lakič  5 , Martin Brešar  6   7 , Pavle Boškoski  7 , Ivan Verdenik  8 , Andrej Fabjan  9   10
Affiliations

Neurovascular coupling in severe aortic valve stenosis

Ana Ovsenik et al. Brain Behav. 2023 Aug.

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.

Keywords: aortic stenosis; cerebral blood flow; neurovascular coupling; transcranial Doppler.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Schematic presentation of the visually evoked relative blood flow velocity time course in relation to baseline in PCA. VEFR: visually evoked cerebral blood flow velocity response, PCA: posterior cerebral artery.
FIGURE 2
FIGURE 2
End diastolic VEFR, mean VEFR and peak systolic VEFR in both groups of participants presented as mean ± 2 SE. *Statistical significance computed from repeated‐measures ANOVA. VEFR: visually evoked cerebral blood flow velocity response.
FIGURE 3
FIGURE 3
Visually evoked relative blood flow velocity time courses, averaged over 10 cycles for a sample subject from the aortic stenosis group (solid lines) and the control group (dashed lines). Blue lines represent peak systolic, green lines mean and red lines end diastolic values. The vertical dashed line at 20 s time represents the switch from OFF to the ON phase. PCA: posterior cerebral artery.
FIGURE 4
FIGURE 4
Peak systolic VEFR at each consecutive cycle in both groups of participants displayed as mean ± SD. VEFR: visually evoked cerebral blood flow velocity response.
See this image and copyright information in PMC

References

    1. Aaslid, R. (1987). Visually evoked dynamic blood flow response of the human cerebral circulation. Stroke; A Journal of Cerebral Circulation, 18, 771–775. 10.1161/01.str.18.4.771 - DOI - PubMed
    1. Abdul‐Jawad Altisent, O. , Ferreira‐Gonzalez, I. , Marsal, J. R. , Ribera, A. , Auger, C. , Ortega, G. , Cascant, P. , Urena, M. , Del Blanco, B. G. , Serra, V. , Sureda, C. , Igual, A. , Rovira, A. , González‐Alujas, M. T. , Gonzalez, A. , Puri, R. , Cuellar, H. , Tornos, P. , Rodés‐Cabau, J. , & Garcia‐Dorado, D. (2016). Neurological damage after transcatheter aortic valve implantation compared with surgical aortic valve replacement in intermediate risk patients. Clinical Research in Cardiology, 105, 508–517. 10.1007/s00392-015-0946-9 - DOI - PubMed
    1. Ainslie, P. N. , & Subudhi, A. W. (2014). Cerebral blood flow at high altitude. High Altitude Medicine & Biology, 15, 133–140. 10.1089/ham.2013.1138 - DOI - PubMed
    1. Aires, A. , Andrade, A. , Azevedo, E. , Gomes, F. , Araújo, J. P. , & Castro, P. (2020). Neurovascular coupling impairment in heart failure with reduction ejection fraction. Brain Sciences, 10, 714. 10.3390/brainsci10100714 - DOI - PMC - PubMed
    1. Alosco, M. L. , Gunstad, J. , Jerskey, B. A. , Xu, X. , Clark, U. S. , Hassenstab, J. , Cote, D. M. , Walsh, E. G. , Labbe, D. R. , Hoge, R. , Cohen, R. A. , & Sweet, L. H. (2013). The adverse effects of reduced cerebral perfusion on cognition and brain structure in older adults with cardiovascular disease. Brain and Behavior, 3, 626–636. 10.1002/brb3.171 - DOI - PMC - PubMed

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