Moderate correlation between breath-holding and CO 2 inhalation/hyperventilation methods for transcranial doppler evaluation of cerebral vasoreactivity

Diogo C. Haussen, Michael Katsnelson, Abiezer Rodriguez, Nelly Campo, Iszet Campo-Bustillo, Jose G Romano, Sebastian Koch

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Both CO 2 inhalation followed by hyperventilation and breath-holding have been utilized to measure cerebral vasomotor reactivity (VMR) but their correlation has been poorly studied and understood. Methods: A retrospective study was conducted in 143 subjects (62.6 ± 15.8 years old, 64% men) with transcranial Doppler ultrasonography measurement of mean flow velocity (MFV) at baseline, after 30 seconds of breath-holding, and after CO 2 inhalation followed by hyperventilation, in the left and right middle cerebral artery. Breath-holding index (BHI) was calculated as the percentage of MFV increase from baseline per second of apnea. CO 2 inhalation/hyperventilation index (CO 2/HV) was calculated as the percentage of MFV difference between CO 2 inhalation and hyperventilation. Results: There were 75 carotid arteries with >70% stenosis or occlusion, and 18 middle cerebral arteries with >50% stenosis or occlusion. The mean BHI was 0.93 ± 0.7 and 0.89 ± 0.6, whereas the mean CO 2/HV was 61 ± 26% and 60 ± 26%, respectively, on the right and left sides. The correlation between BHI and CO 2/HV was moderate on the right (r = 0.33; p < 0.01) and left sides (r = 0.38; p < 0.01). Multivariate linear regression analysis indicated that age (p = 0.01) and history of stroke (p = 0.007) were associated independently with an impaired VMR on the right as measured by CO 2/HV. No predictors for impaired VMR by CO 2/HV on the left and by BHI on either side were found. Conclusions: CO 2/HV and BHI are only moderately correlated. Further studies are necessary to determine which method more accurately predicts clinical morbidity.

Original languageEnglish
Pages (from-to)554-558
Number of pages5
JournalJournal of Clinical Ultrasound
Volume40
Issue number9
DOIs
StatePublished - Nov 1 2012

Fingerprint

Breath Holding
Hyperventilation
Carbon Monoxide
Inhalation
Pathologic Constriction
Doppler Transcranial Ultrasonography
Middle Cerebral Artery Infarction
Middle Cerebral Artery
Apnea
Carotid Arteries
Linear Models
Retrospective Studies
Stroke
Regression Analysis
Morbidity

Keywords

  • Carbon dioxide
  • Cerebrovascular reactivity
  • Hypercapnia
  • Hypocapnia
  • Transcranial Doppler

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Moderate correlation between breath-holding and CO 2 inhalation/hyperventilation methods for transcranial doppler evaluation of cerebral vasoreactivity. / Haussen, Diogo C.; Katsnelson, Michael; Rodriguez, Abiezer; Campo, Nelly; Campo-Bustillo, Iszet; Romano, Jose G; Koch, Sebastian.

In: Journal of Clinical Ultrasound, Vol. 40, No. 9, 01.11.2012, p. 554-558.

Research output: Contribution to journalArticle

Haussen, Diogo C. ; Katsnelson, Michael ; Rodriguez, Abiezer ; Campo, Nelly ; Campo-Bustillo, Iszet ; Romano, Jose G ; Koch, Sebastian. / Moderate correlation between breath-holding and CO 2 inhalation/hyperventilation methods for transcranial doppler evaluation of cerebral vasoreactivity. In: Journal of Clinical Ultrasound. 2012 ; Vol. 40, No. 9. pp. 554-558.
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abstract = "Background: Both CO 2 inhalation followed by hyperventilation and breath-holding have been utilized to measure cerebral vasomotor reactivity (VMR) but their correlation has been poorly studied and understood. Methods: A retrospective study was conducted in 143 subjects (62.6 ± 15.8 years old, 64{\%} men) with transcranial Doppler ultrasonography measurement of mean flow velocity (MFV) at baseline, after 30 seconds of breath-holding, and after CO 2 inhalation followed by hyperventilation, in the left and right middle cerebral artery. Breath-holding index (BHI) was calculated as the percentage of MFV increase from baseline per second of apnea. CO 2 inhalation/hyperventilation index (CO 2/HV) was calculated as the percentage of MFV difference between CO 2 inhalation and hyperventilation. Results: There were 75 carotid arteries with >70{\%} stenosis or occlusion, and 18 middle cerebral arteries with >50{\%} stenosis or occlusion. The mean BHI was 0.93 ± 0.7 and 0.89 ± 0.6, whereas the mean CO 2/HV was 61 ± 26{\%} and 60 ± 26{\%}, respectively, on the right and left sides. The correlation between BHI and CO 2/HV was moderate on the right (r = 0.33; p < 0.01) and left sides (r = 0.38; p < 0.01). Multivariate linear regression analysis indicated that age (p = 0.01) and history of stroke (p = 0.007) were associated independently with an impaired VMR on the right as measured by CO 2/HV. No predictors for impaired VMR by CO 2/HV on the left and by BHI on either side were found. Conclusions: CO 2/HV and BHI are only moderately correlated. Further studies are necessary to determine which method more accurately predicts clinical morbidity.",
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T1 - Moderate correlation between breath-holding and CO 2 inhalation/hyperventilation methods for transcranial doppler evaluation of cerebral vasoreactivity

AU - Haussen, Diogo C.

AU - Katsnelson, Michael

AU - Rodriguez, Abiezer

AU - Campo, Nelly

AU - Campo-Bustillo, Iszet

AU - Romano, Jose G

AU - Koch, Sebastian

PY - 2012/11/1

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N2 - Background: Both CO 2 inhalation followed by hyperventilation and breath-holding have been utilized to measure cerebral vasomotor reactivity (VMR) but their correlation has been poorly studied and understood. Methods: A retrospective study was conducted in 143 subjects (62.6 ± 15.8 years old, 64% men) with transcranial Doppler ultrasonography measurement of mean flow velocity (MFV) at baseline, after 30 seconds of breath-holding, and after CO 2 inhalation followed by hyperventilation, in the left and right middle cerebral artery. Breath-holding index (BHI) was calculated as the percentage of MFV increase from baseline per second of apnea. CO 2 inhalation/hyperventilation index (CO 2/HV) was calculated as the percentage of MFV difference between CO 2 inhalation and hyperventilation. Results: There were 75 carotid arteries with >70% stenosis or occlusion, and 18 middle cerebral arteries with >50% stenosis or occlusion. The mean BHI was 0.93 ± 0.7 and 0.89 ± 0.6, whereas the mean CO 2/HV was 61 ± 26% and 60 ± 26%, respectively, on the right and left sides. The correlation between BHI and CO 2/HV was moderate on the right (r = 0.33; p < 0.01) and left sides (r = 0.38; p < 0.01). Multivariate linear regression analysis indicated that age (p = 0.01) and history of stroke (p = 0.007) were associated independently with an impaired VMR on the right as measured by CO 2/HV. No predictors for impaired VMR by CO 2/HV on the left and by BHI on either side were found. Conclusions: CO 2/HV and BHI are only moderately correlated. Further studies are necessary to determine which method more accurately predicts clinical morbidity.

AB - Background: Both CO 2 inhalation followed by hyperventilation and breath-holding have been utilized to measure cerebral vasomotor reactivity (VMR) but their correlation has been poorly studied and understood. Methods: A retrospective study was conducted in 143 subjects (62.6 ± 15.8 years old, 64% men) with transcranial Doppler ultrasonography measurement of mean flow velocity (MFV) at baseline, after 30 seconds of breath-holding, and after CO 2 inhalation followed by hyperventilation, in the left and right middle cerebral artery. Breath-holding index (BHI) was calculated as the percentage of MFV increase from baseline per second of apnea. CO 2 inhalation/hyperventilation index (CO 2/HV) was calculated as the percentage of MFV difference between CO 2 inhalation and hyperventilation. Results: There were 75 carotid arteries with >70% stenosis or occlusion, and 18 middle cerebral arteries with >50% stenosis or occlusion. The mean BHI was 0.93 ± 0.7 and 0.89 ± 0.6, whereas the mean CO 2/HV was 61 ± 26% and 60 ± 26%, respectively, on the right and left sides. The correlation between BHI and CO 2/HV was moderate on the right (r = 0.33; p < 0.01) and left sides (r = 0.38; p < 0.01). Multivariate linear regression analysis indicated that age (p = 0.01) and history of stroke (p = 0.007) were associated independently with an impaired VMR on the right as measured by CO 2/HV. No predictors for impaired VMR by CO 2/HV on the left and by BHI on either side were found. Conclusions: CO 2/HV and BHI are only moderately correlated. Further studies are necessary to determine which method more accurately predicts clinical morbidity.

KW - Carbon dioxide

KW - Cerebrovascular reactivity

KW - Hypercapnia

KW - Hypocapnia

KW - Transcranial Doppler

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