Assessment of dynamic cerebral autoregulation in humans: Is reproducibility dependent on blood pressure variability?
Journal
PLoS ONE
Journal Volume
15
Journal Issue
1
Date Issued
2020
Author(s)
Elting J.W.
Sanders M.L.
Panerai R.B.
Aries M.
Bor-Seng-Shu E.
Caicedo A.
Chacon M.
Gommer E.D.
van Huffel S.
Jara J.L.
Kostoglou K.
Mahdi A.
Marmarelis V.Z.
Mitsis G.D.
M?ller M.
Nikolic D.
Nogueira R.C.
Payne S.J.
Puppo C.
Shin D.C.
Simpson D.M.
Tarumi T.
Yelicich B.
Zhang R.
Claassen J.A.H.R.
Abstract
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<0.4) can improve to good (ICC > 0.6) values when cases with low PSD-MABP are removed, and probably also when measurement duration is increased. ? 2020 Elting et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Subjects
adult
article
autoregulation
blood flow velocity
blood pressure variability
bootstrapping
brain blood flow
controlled study
end tidal carbon dioxide tension
female
human
human experiment
intermethod comparison
major clinical study
male
mean arterial pressure
prediction
reproducibility
spectroscopy
aged
arterial pressure
blood pressure
blood pressure measurement
brain circulation
clinical trial
homeostasis
middle aged
middle cerebral artery
multicenter study
normal human
pathophysiology
physiology
procedures
Adult
Aged
Arterial Pressure
Blood Flow Velocity
Blood Pressure
Blood Pressure Determination
Cerebrovascular Circulation
Female
Healthy Volunteers
Homeostasis
Humans
Male
Middle Aged
Middle Cerebral Artery
Reproducibility of Results
Type
journal article