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Retrograde blood flow in the internal jugular veins of humans with hypertension may have implications for cerebral arterial blood flow

Rodrigues, Jonathan C. L., Strelko, Galina, Warnert, Esther A. H., Burchell, Amy E., Neumann, Sandra, Ratcliffe, Laura E. K., Harris, Ashley D., Chant, Benjamin, Bowles, Ruth, Nightingale, Angus K., Wise, Richard G., Paton, Julian F. R. and Hart, Emma C. 2020. Retrograde blood flow in the internal jugular veins of humans with hypertension may have implications for cerebral arterial blood flow. European Radiology 30 (7) , pp. 3890-3899. 10.1007/s00330-020-06752-6

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Abstract

Objectives To use multi-parametric magnetic resonance imaging (MRI) to test the hypothesis that hypertensives would have higher retrograde venous blood flow (RVBF) in the internal jugular veins (IJV) vs. normotensives, and that this would inversely correlate with arterial inflow and gray matter, white matter, and cerebrospinal fluid volumes. Methods Following local institutional review board approval and written consent, a prospective observational 3-T MRI study of 42 hypertensive patients (53 ± 2 years, BMI 28.2 ± 0.6 kg/m2, ambulatory daytime systolic BP 148 ± 2 mmHg, ambulatory daytime diastolic BP 101 ± 2 mmHg) and 35 normotensive patients (48 ± 2 years, BMI 25.2 ± 0.8 kg/m2, ambulatory daytime systolic BP 119 ± 3 mmHg, ambulatory daytime diastolic BP 90 ± 2 mmHg) was performed. Phase contrast imaging calculated percentage retrograde venous blood flow (%RVBF), brain segmentation estimated regional brain volumes from 3D T1-weighted images, and pseudo-continuous arterial spin labeling measured regional cerebral blood perfusion. Statistical analysis included two-sample equal variance Student’s T tests, two-way analysis of variance with Tukey’s post hoc correction, and permutation-based two-group general linear modeling (p < 0.05). Results In the left IJV, %RVBF was higher in hypertensives (6.1 ± 1.5%) vs. normotensives (1.1 ± 0.3%, p = 0.003). In hypertensives, there was an inverse relationship of %RVBF (permutation-based general linear modeling) to cerebral blood flow in several brain regions, including the left occipital pole and the cerebellar vermis (p < 0.01). Percentage retrograde flow in the left IJV correlated inversely with the total matter volume (gray plus white matter volume) in hypertensives (r = − 0.49, p = 0.004). Conclusion RVBF in the left IJV is greater in hypertensives vs. normotensives and is linked to regional hypoperfusion and brain total matter volume.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Cardiff University Brain Research Imaging Centre (CUBRIC)
Publisher: Springer Verlag (Germany)
ISSN: 0938-7994
Date of Acceptance: 14 February 2020
Last Modified: 12 Aug 2020 14:30
URI: http://orca.cf.ac.uk/id/eprint/134113

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