title: Monitoring of hemodynamic change in patients with carotid artery stenosis during the tilt test using wearable near-infrared spectroscopy.
abstract: Transient ischemic attack (TIA) is a major complication in patients with carotid artery stenosis. Patients with severe stenosis sometimes complain of orthostatic dizziness, such as syncope. The purpose of this study was to examine the usefulness of near-infrared spectroscopy (NIRS) for evaluating cerebral circulation in patients with carotid artery stenosis during head-up tilt test (HUTT). Fourteen patients with carotid artery stenosis and nine normal control subjects participated. In addition to blood pressure monitoring, hemoglobin (Hb) values (oxy-Hb, deoxy-Hb, and total Hb) were recorded by a wearable NIRS instrument with a high time resolution during HUTT. Oxy-Hb, which decreased initially when the test table was elevated, subsequently increased in normal volunteers and patients with carotid artery stenosis and did not differ significantly between the two groups. However, the oxy-Hb reduction in the carotid artery stenosis group (-0.02 ± 0.03 a.u.) at 30 s after elevation of the table was significantly larger than in the normal group (0.02 ± 0.02 a.u., P < 0.01). Our results indicate that oxy-Hb reduction in patients with carotid artery stenosis may be related to orthostatic dizziness. We concluded that NIRS monitoring is useful for evaluating cerebral autoregulation in patients with severe carotid artery stenosis.
authors.affiliation: Department of Neurological Surgery, Division of Neurosurgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan. igarashi.takahiro@nihon-u.ac.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Igarashi
authors.affiliation: Department of Neurological Surgery, Division of Neurosurgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.|Department of Neurological Surgery, Division of Optical Brain Engineering, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Sakatani
authors.affiliation: Department of Neurological Surgery, Division of Neurosurgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Fujiwara
authors.affiliation: Department of Neurological Surgery, Division of Neurosurgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Murata
authors.affiliation: Department of Neurological Surgery, Division of Neurosurgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Suma
authors.affiliation: Department of Neuroendovascular Therapy, Sagamihara Kyodo Hospital, Kanagawa, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Shibuya
authors.affiliation: Department of Neurological Surgery, Division of Neurosurgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Teruyasu
authors.initials: T
authors.lastname: Hirayama
authors.affiliation: Department of Neurological Surgery, Division of Neurosurgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Katayama
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D016893:Carotid Stenosis / Q000378:metabolism / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D005260:Female; D006439:Hemodynamics; D006454:Hemoglobins / Q000378:metabolism; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D002546:Ischemic Attack, Transient / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010108:Oxyhemoglobins / Q000378:metabolism; D019265:Spectroscopy, Near-Infrared / Q000379:methods; D018667:Tilt-Table Test / Q000379:methods
chemical_list: D006454:Hemoglobins; D010108:Oxyhemoglobins; C100003:deoxyhemoglobin