A non-invasive method to assess cerebral perfusion pressure in geriatric patients with suspected cerebrovascular disease

PLoS One. 2015 Mar 19;10(3):e0120146. doi: 10.1371/journal.pone.0120146. eCollection 2015.

Abstract

Background: Cerebral perfusion pressure (CPP) can adversely impact cerebrovascular hemodynamics but cannot be practically measured in most clinical settings. Here, we aimed to establish a representative mathematical model for CPP in geriatric patients with suspected cerebrovascular disease.

Methods: A total of 100 patients (54 males and 46 females between 60-80 years of age) with suspected cerebrovascular disease and no obvious cerebrovascular stenosis were selected for invasive CPP monitoring via catheterization of the middle segment of the common carotid arteries and openings of the vertebral arteries bilaterally. Curves were function-fitted using MATLAB 7.0, and data was statistically processed by SPSS 20.0.

Results: MATLAB 7.0 constructed eighth-order Fourier functions that fit all recorded CPP curves. Since the coefficients of the 100 functions were significantly different, all functions were standardized to derive one representative function. By manipulating the heart rate and maximum/minimum CPP of the representative function, estimated CPP curves can be constructed for patients with differing heart rates, intracranial pressures (ICPs) and blood pressures.

Conclusions: CPP can be well-modeled through an eighth-order Fourier function that can be constructed from a patient's brachial artery blood pressure (BABP), ICP and heart rate. This function is representative of geriatric patients with cerebrovascular disease and can be used in the future study of cerebral hemodynamics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Algorithms*
  • Carotid Artery, Common / physiology
  • Cerebrovascular Circulation / physiology*
  • Cerebrovascular Disorders / physiopathology*
  • Demography
  • Female
  • Geriatric Nursing
  • Heart Rate
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Patients
  • Software
  • Vertebral Artery / physiology

Grants and funding

This study was supported by the Natural Science Foundation of the Yongchuan District of Chongqing Municipality (grant no. Ycstc, 2013nc8031), the Foundation of the Chongqing Health and Family Planning Commission (grant no. 20143001), and the National Natural Science Foundation of China (grant No. 81200899). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.