Research Article| Volume 29, ISSUE 6, 104810, June 2020

Download started.


Dynamic Cerebral Autoregulation in Preclinical Atherosclerotic Cardiovascular Disease


      Objective: The influence of atherosclerotic cardiovascular disease (ASCVD) on cerebral blood flow control is not well known. The aim of this study was to investigate the association between cardiovascular function and dynamic cerebral autoregulation (dCA) in patients with preclinical ASCVD. Methods: A total of 44 participants aged 26-76 years were divided into low- and high-risk groups according to the China assessment of ASCVD risk. The cardiac function was assessed by echocardiography. The beat-to-beat blood pressure and cerebral blood flow velocity were measured at rest. Spectral and transfer function analyses were used to calculate cerebral and systemic hemodynamic variability and to estimate dCA metrics. Results: There were no group differences in beat-to-beat heart rate, blood pressure, and cerebral blood flow velocity variability nor the ejection fraction, E/A and E’/A’. The dCA phase at very low frequency was reduced in the high-risk group (P = .03). Moreover, the dCA phase and E’/A’ were negatively correlated with age, and dCA phase was positively correlated with E’/A’ within the high-risk group (r2 = .517, P < .01). Conclusions: These findings suggest that advancing age, particularly in the high-risk ASCVD group, impairs cerebral blood flow control and cardiac diastolic function which are correlated with each other and may interplay under the effects of ASCVD risk factors.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Stroke and Cerebrovascular Diseases
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • DALYs GBD and Collaborators H
        Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.
        Lancet. 2017; 390: 1260-1344
        • Wang W.
        • Jiang B.
        • Sun H.
        • et al.
        Prevalence, incidence, and mortality of stroke in China: results from a nationwide population-based survey of 480 687 adults.
        Circulation. 2017; 135: 759-771
        • Chen W.W.
        • GR
        • Liu R.S.
        China cardiovascular disease report 2017.
        Chin Circula J. 2018; 33: 1-7
        • Liu Y
        • Liu B
        • Li B
        • et al.
        Coronary heart disease concomitant with atherosclerotic cerebrovascular disease.
        AUDT. 2019; 3: 076-080
        • Goff Jr., D.C.
        • Lloyd-Jones D.M.
        • Bennett G.
        • et al.
        2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.
        Circulation. 2014; 129: S49-S73
        • Yang X.
        • Li J.
        • Hu D.
        • et al.
        Predicting the 10-year risks of atherosclerotic cardiovascular disease in Chinese population: the China-PAR Project (prediction for ASCVD risk in China).
        Circulation. 2016; 134: 1430-1440
        • He J.
        • Neal B.
        • Gu D.
        • et al.
        International collaborative study of cardiovascular disease in Asia: design, rationale, and preliminary results.
        Ethn Dis. 2004; 14: 260-268
      1. Oliveira GVD, Soares RN, Volino-Souza M, et al. The association between near-infrared spectroscopy assessment of microvascular reactivity and flow-mediated dilation is disrupted in individuals at high risk for cardiovascular disease. 2019;26: p. e12556.

        • Hagstrom L.
        • Henein M.Y.
        • Karp K.
        • Waldenstrom A.
        Impact of age and sex on normal left heart structure and function.
        Clin Physiol Funct Imaging. 2017; 37: 759-766
        • Xing C.Y.
        • Tarumi T.
        • Meijers R.L.
        • et al.
        Arterial pressure, heart rate, and cerebral hemodynamics across the adult life span.
        Hypertension. 2017; 69: 712-720
        • Xiong L.
        • Liu X.
        • Shang T.
        • et al.
        Impaired cerebral autoregulation: measurement and application to stroke.
        J Neurol Neurosurg Psychiatry. 2017; 88: 520-531
        • Tang X.
        • Zhang D.
        • He L.
        • et al.
        Performance of atherosclerotic cardiovascular risk prediction models in a rural Northern Chinese population: results from the Fangshan Cohort Study.
        Am Heart J. 2019; 211: 34-44
        • Claassen J.A.
        • Meel-van den Abeelen A.S.
        • Simpson D.M.
        • et al.
        Transfer function analysis of dynamic cerebral autoregulation: a white paper from the International Cerebral Autoregulation Research Network.
        J Cereb Blood Flow Metab. 2016; 36: 665-680
        • Galderisi M.
        • Cosyns B.
        • Edvardsen T.
        • et al.
        Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imagi.
        Eur Heart J Cardiovasc Imaging. 2017; 18: 1301-1310
        • Nagueh S.F.
        • Smiseth O.A.
        • Appleton C.P.
        • et al.
        Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association ofCardiovascular Imaging.
        Eur Heart J Cardiovasc Imaging. 2016; 29: 277-314
        • Sharp A.S.P.
        • Tapp R.J.
        • Thom S.A.M.
        • et al.
        Tissue Doppler E/E' ratio is a powerful predictor of primary cardiac events in a hypertensive population: an ASCOT substudy.
        Eur Heart J. 2010; 31: 747
        • Boogers M.J.
        • van Werkhoven J.M.
        • Schuijf J.D.
        • et al.
        Feasibility of diastolic function assessment with cardiac CT: feasibility study in comparison with tissue Doppler imaging.
        JACC Cardiovasc Imaging. 2011; 4: 246-256
        • Zhang R.
        • Zuckerman J.H.
        • Iwasaki K.
        • et al.
        Autonomic neural control of dynamic cerebral autoregulation in humans.
        Circulation. 2002; 106: 1814-1820
        • Zhang R.
        • Zuckerman J.H.
        • Giller C.A.
        • et al.
        Transfer function analysis of dynamic cerebral autoregulation in humans.
        Am J Physiol. 1998; 274: H233-H241
        • Tarumi T.
        • Dunsky D.I.
        • Khan M.A.
        • et al.
        Dynamic cerebral autoregulation and tissue oxygenation in amnestic mild cognitive impairment.
        J Alzheimers Dis. 2014; 41: 765-778
        • Xiong J.
        • Yu X.
        • Yu S.
        • et al.
        Comparison of central and peripheral hemodynamics in association with left ventricular diastolic dysfunction in the community-based elderly Chinese.
        J Am Soc Hypertension. 2017; 11: 366-375
        • Howlett ES
        The impact of age on the cardiovascular system.
        Chin J Cardiovasc Med. 2011; 16: 69-78
        • Mundi S.
        • Massaro M.
        • Scoditti E.
        • et al.
        Endothelial permeability, ldl deposition, and cardiovascular risk factors - a review.
        Cardiovasc Res. 2017; 114: 35
        • Al Rifai M.
        • Greenland P.
        • Blaha M.J.
        • et al.
        Factors of health in the protection against death and cardiovascular disease among adults with subclinical atherosclerosis.
        Am Heart J. 2018; 198: 180-188