Assessment of dynamic cerebral autoregulation in humans: Is reproducibility dependent on blood pressure variability?

We tested the influence of blood pressure variability on the reproducibility of dynamic cerebral autoregulation (DCA) estimates. Data were analyzed from the 2nd CARNet bootstrap initiative, where mean arterial blood pressure (MABP), cerebral blood flow velocity (CBFV) and end tidal CO2 were measured...

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Bibliographic Details
Published in:PloS one 2020-01, Vol.15 (1), p.e0227651-e0227651
Main Authors: Elting, Jan Willem, Sanders, Marit L, Panerai, Ronney B, Aries, Marcel, Bor-Seng-Shu, Edson, Caicedo, Alexander, Chacon, Max, Gommer, Erik D, Van Huffel, Sabine, Jara, José L, Kostoglou, Kyriaki, Mahdi, Adam, Marmarelis, Vasilis Z, Mitsis, Georgios D, Müller, Martin, Nikolic, Dragana, Nogueira, Ricardo C, Payne, Stephen J, Puppo, Corina, Shin, Dae C, Simpson, David M, Tarumi, Takashi, Yelicich, Bernardo, Zhang, Rong, Claassen, Jurgen A H R
Format: Article
Language:English
Subjects:
Adult
Aged
Arterial Pressure - physiology
Biology and Life Sciences
Biomedical engineering
Blood flow
Blood Flow Velocity - physiology
Blood pressure
Blood Pressure - physiology
Blood Pressure Determination - methods
Brain research
Carbon dioxide
Cerebral blood flow
Cerebrovascular Circulation - physiology
Correlation analysis
Engineering
Environmental health
Estimates
Female
Flow velocity
Healthy Volunteers
Homeostasis - physiology
Hospitals
Humans
Low frequencies
Male
Medicine and Health Sciences
Methods
Middle Aged
Middle Cerebral Artery - physiopathology
Neurology
Parameters
Physical sciences
Physiology
Power spectral density
Pressure dependence
Prolongation
Reproducibility
Reproducibility of Results
Research and analysis methods
Studies
Very Low Frequencies
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Summary:We tested the influence of blood pressure variability on the reproducibility of dynamic cerebral autoregulation (DCA) estimates. Data were analyzed from the 2nd CARNet bootstrap initiative, where mean arterial blood pressure (MABP), cerebral blood flow velocity (CBFV) and end tidal CO2 were measured twice in 75 healthy subjects. DCA was analyzed by 14 different centers with a variety of different analysis methods. Intraclass Correlation (ICC) values increased significantly when subjects with low power spectral density MABP (PSD-MABP) values were removed from the analysis for all gain, phase and autoregulation index (ARI) parameters. Gain in the low frequency band (LF) had the highest ICC, followed by phase LF and gain in the very low frequency band. No significant differences were found between analysis methods for gain parameters, but for phase and ARI parameters, significant differences between the analysis methods were found. Alternatively, the Spearman-Brown prediction formula indicated that prolongation of the measurement duration up to 35 minutes may be needed to achieve good reproducibility for some DCA parameters. We conclude that poor DCA reproducibility (ICC 0.6) values when cases with low PSD-MABP are removed, and probably also when measurement duration is increased.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0227651