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Blood oxygenation-level dependent cerebrovascular reactivity imaging as strategy to monitor CSF-hemoglobin toxicity.
Thomson, Bart R; Richter, Henning; Akeret, Kevin; Buzzi, Raphael M; Anagnostakou, Vania; van Niftrik, Christiaan H B; Schwendinger, Nina; Kulcsar, Zsolt; Kronen, Peter W; Regli, Luca; Fierstra, Jorn; Schaer, Dominik J; Hugelshofer, Michael.
Afiliación
  • Thomson BR; Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland; Division of Internal Medicine, University Hospital of Zurich, Zurich, Switzerland.
  • Richter H; Clinic for Diagnostic Imaging, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland; Center for Applied Biotechnology and Molecular Medicine (CABMM), University of Zurich, Zurich, Switzerland.
  • Akeret K; Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland.
  • Buzzi RM; Division of Internal Medicine, University Hospital of Zurich, Zurich, Switzerland.
  • Anagnostakou V; Department of Neuroradiology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland; Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA.
  • van Niftrik CHB; Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland.
  • Schwendinger N; Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland.
  • Kulcsar Z; Center for Applied Biotechnology and Molecular Medicine (CABMM), University of Zurich, Zurich, Switzerland; Department of Neuroradiology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland.
  • Kronen PW; Center for Applied Biotechnology and Molecular Medicine (CABMM), University of Zurich, Zurich, Switzerland; Veterinary Anaesthesia Services - International, Winterthur, Switzerland.
  • Regli L; Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland.
  • Fierstra J; Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland.
  • Schaer DJ; Division of Internal Medicine, University Hospital of Zurich, Zurich, Switzerland.
  • Hugelshofer M; Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland; Center for Applied Biotechnology and Molecular Medicine (CABMM), University of Zurich, Zurich, Switzerland. Electronic address: michael.hugelshofer@usz.ch.
J Stroke Cerebrovasc Dis ; 32(3): 106985, 2023 Mar.
Article en En | MEDLINE | ID: mdl-36640721
ABSTRACT

OBJECTIVES:

Cell-free hemoglobin in the cerebrospinal fluid (CSF-Hb) may be one of the main drivers of secondary brain injury after aneurysmal subarachnoid hemorrhage (aSAH). Haptoglobin scavenging of CSF-Hb has been shown to mitigate cerebrovascular disruption. Using digital subtraction angiography (DSA) and blood oxygenation-level dependent cerebrovascular reactivity imaging (BOLD-CVR) the aim was to assess the acute toxic effect of CSF-Hb on cerebral blood flow and autoregulation, as well as to test the protective effects of haptoglobin.

METHODS:

DSA imaging was performed in eight anesthetized and ventilated sheep (mean weight 80.4 kg) at baseline, 15, 30, 45 and 60 minutes after infusion of hemoglobin (Hb) or co-infusion with haptoglobin (HbHaptoglobin) into the left lateral ventricle. Additionally, 10 ventilated sheep (mean weight 79.8 kg) underwent BOLD-CVR imaging to assess the cerebrovascular reserve capacity.

RESULTS:

DSA imaging did not show a difference in mean transit time or cerebral blood flow. Whole-brain BOLD-CVR compared to baseline decreased more in the Hb group after 15 minutes (Hb vs HbHaptoglobin -0.03 ± 0.01 vs -0.01 ± 0.02) and remained diminished compared to HbHaptoglobin group after 30 minutes (Hb vs HbHaptoglobin -0.03 ± 0.01 vs 0.0 ± 0.01), 45 minutes (Hb vs HbHaptoglobin -0.03 ± 0.01 vs 0.01 ± 0.02) and 60 minutes (Hb vs HbHaptoglobin -0.03 ± 0.02 vs 0.01 ± 0.01).

CONCLUSION:

It is demonstrated that CSF-Hb toxicity leads to rapid cerebrovascular reactivity impairment, which is blunted by haptoglobin co-infusion. BOLD-CVR may therefore be further evaluated as a monitoring strategy for CSF-Hb toxicity after aSAH.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hemorragia Subaracnoidea / Haptoglobinas Tipo de estudio: Diagnostic_studies / Screening_studies Límite: Animals Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2023 Tipo del documento: Article País de afiliación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hemorragia Subaracnoidea / Haptoglobinas Tipo de estudio: Diagnostic_studies / Screening_studies Límite: Animals Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2023 Tipo del documento: Article País de afiliación: Suiza