Modeling cerebrovascular responses to assess the impact of the collateral circulation following middle cerebral artery occlusion

IF 1.9 4区 医学 Q3 HEMATOLOGY Microcirculation Pub Date : 2024-02-14 DOI:10.1111/micc.12849
Erin Zhao, Jared Barber, Shomita S. Mathew-Steiner, Savita Khanna, Chandan K. Sen, Julia Arciero
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Abstract

Objective

An improved understanding of the role of the leptomeningeal collateral circulation in blood flow compensation following middle cerebral artery (MCA) occlusion can contribute to more effective treatment development for ischemic stroke. The present study introduces a model of the cerebral circulation to predict cerebral blood flow and tissue oxygenation following MCA occlusion.

Methods

The model incorporates flow regulation mechanisms based on changes in pressure, shear stress, and metabolic demand. Oxygen saturation in cerebral vessels and tissue is calculated using a Krogh cylinder model. The model is used to assess the effects of changes in oxygen demand and arterial pressure on cerebral blood flow and oxygenation after MCA occlusion.

Results

An increase from five to 11 leptomeningeal collateral vessels was shown to increase the oxygen saturation in the region distal to the occlusion by nearly 100%. Post-occlusion, the model also predicted a loss of autoregulation and a decrease in flow to the ischemic territory as oxygen demand was increased; these results were consistent with data from experiments that induced cerebral ischemia.

Conclusions

This study highlights the importance of leptomeningeal collaterals following MCA occlusion and reinforces the idea that lower oxygen demand and higher arterial pressure improve conditions of flow and oxygenation.

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建立脑血管反应模型,评估大脑中动脉闭塞后侧支循环的影响。
目的:进一步了解大脑中动脉(MCA)闭塞后脑侧支循环在血流补偿中的作用有助于缺血性脑卒中更有效的治疗发展。本研究引入了一个脑循环模型来预测大脑中动脉闭塞后的脑血流和组织氧合:该模型结合了基于压力、剪应力和代谢需求变化的血流调节机制。使用 Krogh 气瓶模型计算脑血管和组织中的氧饱和度。该模型用于评估 MCA 闭塞后氧需求和动脉压的变化对脑血流和氧饱和度的影响:结果表明,如果侧支血管从 5 条增加到 11 条,闭塞远端区域的血氧饱和度将提高近 100%。闭塞后,随着氧需求的增加,模型还预测缺血区域会失去自动调节功能,血流量也会减少;这些结果与诱导脑缺血的实验数据一致:这项研究强调了MCA闭塞后左脑膜袢的重要性,并强化了降低需氧量和提高动脉压能改善血流和氧合条件的观点。
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来源期刊
Microcirculation
Microcirculation 医学-外周血管病
CiteScore
5.00
自引率
4.20%
发文量
43
审稿时长
6-12 weeks
期刊介绍: The journal features original contributions that are the result of investigations contributing significant new information relating to the vascular and lymphatic microcirculation addressed at the intact animal, organ, cellular, or molecular level. Papers describe applications of the methods of physiology, biophysics, bioengineering, genetics, cell biology, biochemistry, and molecular biology to problems in microcirculation. Microcirculation also publishes state-of-the-art reviews that address frontier areas or new advances in technology in the fields of microcirculatory disease and function. Specific areas of interest include: Angiogenesis, growth and remodeling; Transport and exchange of gasses and solutes; Rheology and biorheology; Endothelial cell biology and metabolism; Interactions between endothelium, smooth muscle, parenchymal cells, leukocytes and platelets; Regulation of vasomotor tone; and Microvascular structures, imaging and morphometry. Papers also describe innovations in experimental techniques and instrumentation for studying all aspects of microcirculatory structure and function.
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