TY - JOUR AU - Ficzere, Andrea AU - Valikovics, Attila AU - Fülesdi, Béla AU - Juhasz, A AU - Czuriga, István AU - Csiba, László TI - Cerebrovascular reactivity in hypertensive patients: A transcranial Doppler study JF - JOURNAL OF CLINICAL ULTRASOUND J2 - J CLIN ULTRASOUND VL - 25 PY - 1997 IS - 7 SP - 383 EP - 389 PG - 7 SN - 0091-2751 DO - 10.1002/(SICI)1097-0096(199709)25:7<383::AID-JCU6>3.0.CO;2-6 UR - https://m2.mtmt.hu/api/publication/1052926 ID - 1052926 AB - PURPOSE: We studied the usefulness of transcranial Doppler sonography for assessing changes in vasoreactivity in patients with hypertension and the hemodynamic consequences of hypertension. METHODS: The study group comprised 25 patients with chronic severe hypertension and 25 age- and sex-matched healthy subjects. Cerebrovascular reserve capacity was assessed by transcranial Doppler recording of the blood flow velocity in both middle cerebral arteries before and 5, 10, 15, and 20 minutes after intravenous injection of 1 g of acetazolamide (Diamox). Blood pressure, blood gases, and other blood parameters were also measured before and after acetazolamide injection. The sizes of the left atrium, left ventricle, and aortic root were measured by echocardiography and correlated with the vasoreactivity after acetazolamide injection. RESULTS: After acetazolamide injection, no significant changes in blood pressure were observed in either group. The mean blood flow velocity in the middle cerebral arteries of hypertensive patients (60.8 +/- 2.6 cm/sec) was not significantly different from that of controls (58.8 +/- 1.9 cm/sec) before acetazolamide injection. Ten minutes after acetazolamide injection, the percentage change in blood flow velocity was significantly lower in the hypertensive group (36.2 +/- 4.5%) than in the controls (52.6 +/- 3.7%). A significant negative correlation (p < 0.05) between decreased vasoreactivity and increased size of the left atrium and aortic root was observed. CONCLUSIONS: Vasoreactivity decreases in hypertensive patients without neurologic deficits or computed tomography abnormalities. Enlargement of the left atrium correlates well with the severity of the impairment in vasoreactivity. Transcranial Doppler sonography can be a sensitive tool in the investigation of vascular impairment caused by hypertension and in the follow-up of hypertensive patients. LA - English DB - MTMT ER - TY - JOUR AU - Fülesdi, Béla AU - Limburg, M AU - Bereczki, Dániel AU - Michels, RPJ AU - Neuwirth, G AU - Legemate, D AU - Valikovics, Attila AU - Csiba, László TI - Impairment of cerebrovascular reactivity in long-term type 1 diabetes JF - DIABETES J2 - DIABETES VL - 46 PY - 1997 IS - 11 SP - 1840 EP - 1845 PG - 6 SN - 0012-1797 DO - 10.2337/diabetes.46.11.1840 UR - https://m2.mtmt.hu/api/publication/1052925 ID - 1052925 AB - The early preclinical detection of cerebrovascular complications in individuals with diabetes is one of the goals of care described in the St. Vincent Declaration. In accordance with this goal, the aim of the present work was to investigate whether altered cerebral microvascular function in patients suffering from type 1 diabetes can be detected with a transcranial Doppler probe after the administration of acetazolamide. A total of 72 type 1 diabetic patients and 40 healthy control subjects entered the study. Patients were divided into two groups: those with long-term diabetes (disease duration of >10 years, n = 37) and those with short-term diabetes (disease duration of < or =10 years, n = 35). Mean blood-flow velocity in the middle cerebral artery (MCAV) was measured at rest and at 5, 10, 15, and 20 min after intravenous administration of 1 g acetazolamide with a transcranial Doppler probe and expressed as the percentage change from the pretest measurement. The percentage increase in MCAV (cerebrovascular reactivity) was calculated at each time point and compared between the groups. Cerebrovascular reserve capacity (CRC), expressed as the maximal percentage increase of the MCAV, was compared between the groups. Additionally, a reproducibility study of CRC was performed in 10 patients, using intraclass correlations. Cerebrovascular reactivity in the long-term diabetes group was lower (means +/- SD: 5 min, 23.4 +/- 15.4%; 10 min, 28.8 +/- 17.0%; 15 min, 30.0 +/- 15.6%; 20 min, 24.2 +/- 17.8%) than that of the control subjects (5 min, 43.5 +/- 23.9%; 10 min, 55.3 +/- 24.0%; 15 min, 56.7 +/- 23.8%; 20 min, 54.8 +/- 25.9%) and the short-term diabetic patients (5 min, 43.6 +/- 25.9%; 10 min, 52.2 +/- 27.7%; 15 min, 55.3 +/- 32.2%; 20 min, 45.8 +/- 35.8%). CRC was lower in the long-term diabetes group than in the control group or the short-term diabetes group. Impairment of cerebrovascular reactivity was associated with retino- and nephropathy and increased levels of fibrinogen. In contrast, CRC was independent from actual glucose, insulin, glycosylated hemoglobin, von Willebrand factor antigen, and alpha-2 macroglobulin levels. Transcranial Doppler measurements of the changes in MCAV after stimulation with acetazolamide can detect altered cerebral microvascular function in patients with diabetes. Cerebrovascular reactivity and reserve capacity are reduced in patients with long-term diabetes. Further prospective studies should delineate the clinical significance of our results. LA - English DB - MTMT ER - TY - JOUR AU - Csépány, Tünde AU - Valikovics, Attila AU - Fülesdi, Béla AU - Kiss, Emese AU - Szegedi, Gyula AU - Csiba, L TI - Cerebral Systemic Lupus Erythematosus. JF - LANCET J2 - LANCET VL - 343 PY - 1994 IS - 8905 SP - 1103 SN - 0140-6736 DO - 10.1016/S0140-6736(94)90216-X UR - https://m2.mtmt.hu/api/publication/1091615 ID - 1091615 N1 - Szerzőségi korrekció található a Lancet 1994 Jun 11;343(8911):1512 oldalon. LA - English DB - MTMT ER -