NDLI: Spontaneous fluctuations in cerebral blood flow regulation: contribution of PaCO2.

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Point: Chronic activation of the sympathetic nervous system is the dominant contributor to systemic hypertension.

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Spontaneous fluctuations in cerebral blood flow regulation: contribution of PaCO2.

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Counterpoint: Activation of the intrarenal renin-angiotensin system is the dominant contributor to systemic hypertension.

Rebuttal from Esler, Lambert, and Schlaich.

Rebuttal from Navar.

Comments on Point:Counterpoint: The dominant contributor to systemic hypertension: Chronic activation of the sympathetic nervous system vs. Activation of the intrarenal renin-angiotensin system. Activated intrarenal renin-angiotensin system is correlated with high blood pressure in humans.

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Spontaneous fluctuations in cerebral blood flow regulation: contribution of PaCO2.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Panerai, R. B. Dineen, N. E. Brodie, F. G. Robinson, T. G.
Description	Country affiliation: United kingdom Author Affiliation: Panerai RB ( Medical Physics Group, Department of Cardiovascular Sciences, University of Leicester National Health Service Trust, Leicester, UK. rp9@le.ac.uk)
Abstract	To investigate the temporal variability of dynamic cerebral autoregulation (CA), the transient response of cerebral blood flow to rapid changes in arterial blood pressure, a new approach was introduced to improve the temporal resolution of dynamic CA assessment. Continuous bilateral recordings of cerebral blood flow velocity (transcranial Doppler, middle cerebral artery), end-tidal Pco(2) (Pet(CO(2)), infrared capnograph), and blood pressure (Finapres) were obtained at rest and during breath hold in 30 young subjects (25 ± 6 yr old) and 30 older subjects (64 ± 4 yr old). Time-varying estimates of the autoregulation index [ARI(t)] were obtained with an autoregressive-moving average model with coefficients expanded by orthogonal decomposition. The temporal pattern of ARI(t) varied inversely with Pet(CO(2)), decreasing with hypercapnia. At rest, ARI(t) showed spontaneous fluctuations that were significantly different from noise and significantly correlated with spontaneous fluctuations in Pet(CO(2)) in the majority of recordings (young: 72% and old: 65%). No significant differences were found in ARI(t) due to aging. This new approach to improve the temporal resolution of dynamic CA parameters allows the identification of physiologically meaningful fluctuations in dynamic CA efficiency at rest and in response to changes in arterial CO(2).
File Format	HTM / HTML
ISSN	87507587
e-ISSN	15221601
Journal	Journal of Applied Physiology
Issue Number	6
Volume Number	109
Language	English
Publisher	American Physiological Society
Publisher Date	2010-12-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Physiology Carbon Dioxide Blood Cerebrovascular Circulation Hypercapnia Physiopathology Middle Cerebral Artery Aging Blood Flow Velocity Blood Pressure Capnography Heart Rate Homeostasis Respiratory Rate Time Factors Ultrasonography, Doppler, Transcranial Vascular Resistance
Content Type	Text
Resource Type	Article
Subject	Physiology Physiology (medical) Sports Science

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