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Relationship Between Cerebral Blood Flow and Blood Pressure in Long-Term Heart Transplant Recipients

Smirl, JD, Haykowsky, MJ, Nelson, MD, Tzeng, Y-C, Marsden, KR, Jones, H and Ainslie, PN (2014) Relationship Between Cerebral Blood Flow and Blood Pressure in Long-Term Heart Transplant Recipients. HYPERTENSION, 64 (6). pp. 1314-1320. ISSN 0194-911X

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Heart transplant recipients are at an increased risk for cerebral hemorrhage and ischemic stroke, yet the exact mechanism for this derangement remains unclear. We hypothesized that alterations in cerebrovascular regulation is principally involved. To test this hypothesis, we studied cerebral pressure-flow dynamics in 8 clinically stable male heart transplant recipients (62 ± 8 years of age and 9 ± 7 years post-transplant, mean + SD), 9 male age-matched controls (63 ± 8 years) and 10 male donor controls (27 ± 5 years). To increase blood pressure variability and improve assessment of the pressure-flow dynamics, subjects performed squat-stand maneuvers at 0.05 and 0.10 Hz. Beat-to-beat blood pressure, middle cerebral artery velocity, and end-tidal carbon dioxide were continuously measured during five minutes of seated rest, and throughout the squat-stand maneuvers. Cardiac baroreceptor sensitivity gain and cerebral pressure-flow responses were assessed with linear transfer function analysis. Heart transplant recipients had reductions in R-R interval power and baroreceptor sensitivity low frequency gain (P<0.01) compared to both control groups; however, these changes were unrelated to transfer function metrics. Thus, in contrast to our hypothesis, the increased risk of cerebrovascular complication after heart transplantation does not appear to be related to alterations in cerebral pressure-flow dynamics. Future research is therefore warranted.

Item Type: Article
Uncontrolled Keywords: 1103 Clinical Sciences, 1102 Cardiovascular Medicine And Haematology
Subjects: R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
Publisher: American Heart Association
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Date Deposited: 08 May 2015 11:36
Last Modified: 04 Sep 2021 14:25
DOI or ID number: 10.1161/HYPERTENSIONAHA.114.04236
URI: https://researchonline.ljmu.ac.uk/id/eprint/1022
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