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首页> 外文期刊>Journal of vascular research >Cerebral hemodynamic response to CO(2) tests in patients with internal carotid artery occlusion: modeling study and in vivo validation.
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Cerebral hemodynamic response to CO(2) tests in patients with internal carotid artery occlusion: modeling study and in vivo validation.

机译：颈内动脉闭塞患者对CO（2）测试的脑血流动力学响应：建模研究和体内验证。

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The aim of this work was to analyze the cerebral hemodynamics in patients with internal carotid artery (ICA) occlusion during CO(2) dynamical tests. The study was performed using an original mathematical model of cerebral hemodynamics. The model includes the circle of Willis, the microvascular circulation in the territories of each cerebral artery, cortical anastomoses, intracranial pressure, the cerebrospinal fluid circulation, the brain venous circulation and two regulation mechanisms: autoregulation and CO(2) reactivity. Model predictions are compared with real data obtained on 20 healthy subjects (group A) and 14 patients with unilateral ICA stenosis (group B) during CO(2) tests. The percent changes in Doppler middle cerebral artery velocity per mm Hg of CO(2) pressure variations (reactivity index, RI) were separately computed during hypocapnia and hypercapnia. In group A, the reactivity index was practically the same in both sides. Patients in group B had a significantly lower CO(2) reactivity in the side ipsilateral to the occlusion (hypocapnia RI: 1.06 +/- 1.6 vs. 2.3 +/- 0.8%/mm Hg; hypercapnia: 0.9 +/- 0.8 vs. 2.4 +/- 1.0%/mm Hg). Our model can explain these results very well, assuming values for the diameter of the communicating arteries in the range reported in the clinical literature. Moreover, computer simulations suggest that patients with a small diameter of both communicating arteries (as low as 0.4-0.5 mm) exhibit a dramatic fall in CO(2) reactivity in the ipsilateral side compared with the contralateral one, with the appearance of paradoxical responses. A decrease in ipsilateral RI reactivity, however, may also depend on the presence of a significant stenosis of the contralateral ICA. Copyright 2000 S. Karger AG, Basel.
机译：这项工作的目的是分析在CO（2）动态测试过程中颈内动脉（ICA）闭塞患者的脑血流动力学。该研究使用脑血流动力学的原始数学模型进行。该模型包括Willis环，每个脑动脉区域的微血管循环，皮质吻合，颅内压，脑脊髓液循环，脑静脉循环和两个调节机制：自调节和CO（2）反应性。将模型预测与在20个健康受试者（A组）和14个CO（2）测试中单侧ICA狭窄患者（B组）中获得的真实数据进行比较。低碳酸血症和高碳酸血症期间，分别计算每毫米汞柱CO（2）压力变化（反应指数，RI）多普勒大脑中动脉速度的变化百分比。在A组中，反应性指数在两侧几乎相同。 B组患者闭塞侧同侧的CO（2）反应性显着降低（低碳酸血症RI：1.06 +/- 1.6 vs. 2.3 +/- 0.8％/ mm Hg;高碳酸血症：0.9 +/- 0.8 vs. 2.4 +/- 1.0％/ mm Hg）。我们的模型可以很好地解释这些结果，假设交流动脉直径的值在临床文献报道的范围内。此外，计算机模拟表明，与两个对侧相比，两个对侧动脉的直径较小（低至0.4-0.5 mm）的患者在同侧的CO（2）反应性方面均出现显着下降，并出现反常反应。但是，同侧RI反应性的降低也可能取决于对侧ICA明显狭窄的存在。版权所有2000 S. Karger AG，巴塞尔。

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