title: Correction for blood pressure improves correlation between cerebrovascular reactivity assessed by breath holding and 6% CO(2) breathing.
abstract: BACKGROUND
  Changes in cerebral blood flow velocity to hypercapnia are associated with changes in systemic blood pressure (BP). These confounding BP-dependent changes in cerebral blood flow velocity cause misinterpretation of cerebrovascular reactivity (CVR) results. The objective of the study was to determine the relationship between CVR assessed by breath holding and 6% CO2 breathing after correcting for BP-dependent changes in cerebral blood flow velocity.
  
  
  METHODS
  In 33 patients of uncomplicated type 2 diabetes mellitus, CVR was assessed as percentage changes in cerebral blood flow velocity and cerebrovascular conductance index.
  
  
  RESULTS
  Percentage change in cerebral blood flow velocity during breath holding was positively correlated with that of during 6% CO2 breathing (r = .35; P = .0448). CVR during breath holding and 6% CO2 breathing were better correlated when expressed as percentage changes in cerebrovascular conductance index (r = .49; P = .0040). Similarly, breath-holding test results expressed as percentage changes in cerebral blood flow velocity correctly identified only 37.5% of the poor reactors to 6% CO2 breathing. However, when the breath-holding test results were expressed as percentage changes in cerebrovascular conductance index, 62.5% of the poor reactors to 6% CO2 breathing were correctly identified indicating a better agreement between the test results obtained by the 2 methods.
  
  
  CONCLUSIONS
  Cerebrovascular response to breath holding is better correlated with that of 6% CO2 breathing when changes in cerebral blood flow velocity were corrected for associated changes in BP.
authors.affiliation: Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Kiran
authors.initials: K
authors.lastname: Prakash
authors.affiliation: Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Dinu S
authors.initials: DS
authors.lastname: Chandran
authors.affiliation: Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Khadgawat
authors.affiliation: Department of Physiology, All India Institute of Medical Sciences, New Delhi, India. Electronic address: ashok.jaryal@gmail.com.
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Jaryal
authors.affiliation: Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Kishore Kumar
authors.initials: KK
authors.lastname: Deepak
mesh_terms: D062186:Arterial Pressure / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D062485:Breath Holding; D002245:Carbon Dioxide; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000502:physiology
chemical_list: D002245:Carbon Dioxide
keywords: Cerebrovascular reactivity; breath holding; breath-holding index; cerebrovascular conductance index; hypercapnia