Dynamic Cerebral Autoregulation in Preclinical Atherosclerotic Cardiovascular Disease

Abstract

Objective: The influence of atherosclerotic cardiovascular disease (ASCVD) on cerebral blood flow control is not well known. The aim of this study was to investigate the association between cardiovascular function and dynamic cerebral autoregulation (dCA) in patients with preclinical ASCVD. Methods: A total of 44 participants aged 26-76 years were divided into low- and high-risk groups according to the China assessment of ASCVD risk. The cardiac function was assessed by echocardiography. The beat-to-beat blood pressure and cerebral blood flow velocity were measured at rest. Spectral and transfer function analyses were used to calculate cerebral and systemic hemodynamic variability and to estimate dCA metrics. Results: There were no group differences in beat-to-beat heart rate, blood pressure, and cerebral blood flow velocity variability nor the ejection fraction, E/A and E’/A’. The dCA phase at very low frequency was reduced in the high-risk group (P = .03). Moreover, the dCA phase and E’/A’ were negatively correlated with age, and dCA phase was positively correlated with E’/A’ within the high-risk group (r2 = .517, P < .01). Conclusions: These findings suggest that advancing age, particularly in the high-risk ASCVD group, impairs cerebral blood flow control and cardiac diastolic function which are correlated with each other and may interplay under the effects of ASCVD risk factors.