Advertisement

Transcranial Doppler evaluation of cerebral blood flow in patients with paroxysmal atrial fibrillation

  • 36 Accesses

  • 17 Citations

Abstract

Cerebral blood flow was measured by transcranial Dopplersonography (TCD) in 15 patients during and after an attack of paroxysmal atrial fibrillation. During the attack the mean flow velocity (MFV) was reduced significantly in the middle cerebral artery (p<0.05) and nonsignificantly in the other arteries. The pulsatility index (PI) was reduced in all the arteries but not significantly. During the fibrillation phase the MFV and PI tended to decrease as the heart rate increased. None of the patients showed clinical signs of cerebral ischemia during the attacks. The absence of such signs despite the reduced cerebral blood flow in atrial fibrillation is probably due to the activation of mechanisms of autoregulation.

Sommario

Il flusso ematico cerebrale, valutato con Doppler Transcranico (TCD), è stato misurato in 15 pazienti durante e dopo un episodio di fibrillazione atriale parossistica. Durante l'attacco di fibrillazione la Mean Flow Velocity (MFV) è risultata ridotta in modo significativo nella cerebrale media (p<0.05), mentre si è ridotta in modo non significativo nelle altre arterie.

I valori dell'indice di pulsatilità (PI) sono risultati ridotti in tutte le arterie ma non significativamente. La correlazione tra la velocità di flusso, il PI e la frequenza cardiaca durante la fase di fibrillazione ha mostrato una tendenza alla riduzione della MFV e del PI con l'aumentare della frequenza. Durante gli episodi di fibrillazione atriale nessuno dei pazienti ha manifestato segni clinici di ischemia cerebrale.

I risultati indicano che, in corso di fibrillazione atriale, si verifica una riduzione di flusso cerebrale che non si accompagna a sintomi di ischemia cerebrale verosimilmente per l'attivazione dei meccanismi di autiregolazione.

This is a preview of subscription content, log in to check access.

We’re sorry, something doesn't seem to be working properly.

Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

References

  1. [1]

    Aaslid R., Markwalder T.M., Nornes H.:Noninvasive Transcranial Doppler ultrasound recording of flow velocity in basal arteries. J. Neurosurg. 57:769–774, 1982.

  2. [2]

    Aaslid R.:Transcranial Dopplersonography. New York: Springer Werlag, 1986.

  3. [3]

    Adams R.D.:Vascular diseases of the brain. Am. Rev. Med. 4:213–252, 1953.

  4. [4]

    Arnolds B.J., von Reutern G.M.:Transcranial Doppler sonography. Examination technique and normal reference values. Ultrasound Med. Biol. 12:112–115, 1986.

  5. [5]

    Benchimol A., Baldi J., Desser K.:The effects of ventricular tachycardia on carotid artery blood flow velocity. Stroke 6:60–67, 1974.

  6. [6]

    Bishop C.C.R., Powell S., Rutt D., Browwse N.L.:Transcranial Doppler measurement of middle cerebral artery blood flow velocity: A validation study. Stroke 17:913–915, 1986.

  7. [7]

    Friberg L., Olesen J., Iversen H.H., Sperling B.:Migraine pain associated with middle cerebral artery dilatation: reversal by sumatriptan. Lancet 338:13–17, 1991.

  8. [8]

    Godtfredsen J.:Atrial fibrillation. Etiology, course and prognosis. A follow-up study of 1,212 cases. Copenhagen: Munksgaard, 1975.

  9. [9]

    Goldberg E.:Treatment of cardiac emergencies. St. Louis: CV Mosby, 86, 1974.

  10. [10]

    Halperin J.L., Hart R.G.:Atrial fibrillation and stroke: New ideas, persisting dilemmas. Stroke 19:937–941, 1988.

  11. [11]

    Hart G.R., Easton J.D., Sherman D.G.:Duration of nonvalvular atrial fibrillation and stroke the Framinghan study. Stroke 14:827, 1983.

  12. [12]

    Kanne W.B., Abbott R.D., Savage D.D., McNamara P.M.:Epidemiologic features of chronic atrial fibrillation the Framingham study. N. Engl. J. Med. 306:1018–22, 1982.

  13. [13]

    Lavy S., Stern S., Melamed E., et al.:Effect of chronic atrial fibrillation on regional cerebral blood flow. Stroke 11:35–38, 1980.

  14. [14]

    Petersen P.P., Godtfredsen J.:Embolic Complication in Paroxysmal atrial fibrillation. Stroke 17:622–626, 1986.

  15. [15]

    Sand B.J., Rose H.B., Barker W.P.:Effect of cardiac dysrythmia on cerebral perfusion. Arch. Surg. 111:787–791, 1976.

  16. [16]

    Wolf P.A., Dawber T.R., Thamer Jr. H.E., Kannel W.S.:Epidemiologic assessment of chronic atrial fibrillation and risk of stroke: the Framingham study. Neurology 28:973–977, 1978.

  17. [17]

    Wolf P.A., Kannel W.S., McGee D.L., et al.:Duration of atrial fibrillation and imminence of stroke: the Framingham study. Stroke 14:664–667, 1983.

Download references

Author information

Correspondence to Dr. R. Totaro.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Totaro, R., Corridoni, C., Marini, C. et al. Transcranial Doppler evaluation of cerebral blood flow in patients with paroxysmal atrial fibrillation. Ital J Neuro Sci 14, 451–454 (1993). https://doi.org/10.1007/BF02339175

Download citation

Key Words

  • Paroxysmal atrial fibrillation
  • transcranial Doppler
  • flow velocity
  • middle cerebral artery