title: Near-infrared diffuse optical monitoring of cerebral blood flow and oxygenation for the prediction of vasovagal syncope.
abstract: Significant drops in arterial blood pressure and cerebral hemodynamics have been previously observed during vasovagal syncope (VVS). Continuous and simultaneous monitoring of these physiological variables during VVS is rare, but critical for determining which variable is the most sensitive parameter to predict VVS. The present study used a novel custom-designed diffuse correlation spectroscopy flow-oximeter and a finger plethysmograph to simultaneously monitor relative changes of cerebral blood flow (rCBF), cerebral oxygenation (i.e., oxygenated/deoxygenated/total hemoglobin concentration: r[HbO2]/r[Hb]/rTHC), and mean arterial pressure (rMAP) during 70 deg head-up tilt (HUT) in 14 healthy adults. Six subjects developed presyncope during HUT. Two-stage physiological responses during HUT were observed in the presyncopal group: slow and small changes in measured variables (i.e., Stage I), followed by rapid and dramatic decreases in rMAP, rCBF, r[HbO2], and rTHC (i.e., Stage II). Compared to other physiological variables, rCBF reached its breakpoint between the two stages earliest and had the largest decrease (76±8%) during presyncope. Our results suggest that rCBF has the best sensitivity for the assessment of VVS. Most importantly, a threshold of ∼50% rCBF decline completely separated the subjects from those without presyncope, suggesting its potential for predicting VVS.
authors.affiliation: University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky 40506.
authors.forename: Ran
authors.initials: R
authors.lastname: Cheng
authors.affiliation: University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky 40506.
authors.forename: Yu
authors.initials: Y
authors.lastname: Shang
authors.affiliation: University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky 40506.
authors.forename: Siqi
authors.initials: S
authors.lastname: Wang
authors.affiliation: University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky 40506.
authors.forename: Joyce M
authors.initials: JM
authors.lastname: Evans
authors.affiliation: University of Kentucky, Department of Psychiatry, Lexington, Kentucky 40509.
authors.forename: Abner
authors.initials: A
authors.lastname: Rayapati
authors.affiliation: University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky 40506cUniversity of Kentucky, Department of Physiology, Lexington, Kentucky 40536.
authors.forename: David C
authors.initials: DC
authors.lastname: Randall
authors.affiliation: University of Kentucky, Department of Biomedical Engineering, Lexington, Kentucky 40506.
authors.forename: Guoqiang
authors.initials: G
authors.lastname: Yu
mesh_terms: D000328:Adult; D062186:Arterial Pressure; D001783:Blood Flow Velocity; D001921:Brain / Q000098:blood supply; D002560:Cerebrovascular Circulation; D005260:Female; D006439:Hemodynamics; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D000860:Hypoxia; D008297:Male; D008875:Middle Aged; D055095:Optics and Photonics; D010092:Oximetry; D010100:Oxygen / Q000032:analysis*; D010991:Plethysmography; D012008:Recurrence; D019265:Spectroscopy, Near-Infrared; D019462:Syncope, Vasovagal / Q000175:diagnosis* / Q000503:physiopathology
chemical_list: D006454:Hemoglobins; C100003:deoxyhemoglobin; D010100:Oxygen