Continuous recording of mean cerebral blood flow velocity (MCBFV) by Doppler ultrasound allows detection of low-frequency (LF) oscillations, which reflect sympathetic activity in the cerebral circulation. To establish whether the sympathetic drive to the cerebral circulation is altered in patients with compensated cirrhosis, and, if so, where alterations take place, LF oscillations of MCBFV, heart rate (RR interval) and systolic arterial pressure (SAP) were analysed in 10 patients with cirrhosis and 10 control subjects during supine rest and on stimulation of carotid baroreceptors using a neck chamber applying sinusoidal suction. Bivariate analysis was used to study the relationship between pairs of oscillations. In the case of a significant association, the delay in the appearance of the oscillation in MCBFV, SAP and RR was calculated. Baroreceptor stimulation induced significant increases in SAP LF and RR LF power in both groups, while MCBFV LF power increased only in controls. During baroreceptor stimulation, the lag phase between SAP LF and MCBFV LF power was significantly lower in cirrhotic patients than in control subjects (0.96 compared with 1.59 rad; P<0.01), indicating altered sympathetic regulation of the cerebral circulation. The baroreflex arc was intact, as indicated by the similar pattern of RR-SAP interval in patients and controls. Plasma noradrenaline levels increased significantly in both groups in response to head-up tilt. These results indicate that patients with cirrhosis have an altered sympathetic regulation of the cerebral circulation that is characterized by an inadequate response of resistance microvessels, despite adequate baroreceptor function.
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Research Article|
June 07 2002
Impaired sympathetic regulation of cerebral blood flow in patients with cirrhosis of the liver
Alfonso LAGI;
Alfonso LAGI
*Divisione di Medicina Interna I, Santa Maria Nuova Hospital, Firenze, Italy
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Giacomo LAFFI;
Giacomo LAFFI
†Department of Internal Medicine, University of Florence School of Medicine, viale Morgagni 85, 50134 Firenze, Italy
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Simone CENCETTI;
Simone CENCETTI
*Divisione di Medicina Interna I, Santa Maria Nuova Hospital, Firenze, Italy
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Giuseppe BARLETTA;
Giuseppe BARLETTA
‡Noninvasive Cardiology Section, Azienda Ospedaliera Careggi, Firenze, Italy
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Marco FOSCHI;
Marco FOSCHI
†Department of Internal Medicine, University of Florence School of Medicine, viale Morgagni 85, 50134 Firenze, Italy
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Francesco VIZZUTTI;
Francesco VIZZUTTI
†Department of Internal Medicine, University of Florence School of Medicine, viale Morgagni 85, 50134 Firenze, Italy
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Renzo BANDINELLI;
Renzo BANDINELLI
§Laboratorio di Analisi Chimico-Cliniche, Azienda Ospedaliera Careggi, Firenze, Italy
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Pietro PANTALEO;
Pietro PANTALEO
†Department of Internal Medicine, University of Florence School of Medicine, viale Morgagni 85, 50134 Firenze, Italy
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Cristina TOSTI GUERRA;
Cristina TOSTI GUERRA
†Department of Internal Medicine, University of Florence School of Medicine, viale Morgagni 85, 50134 Firenze, Italy
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Paolo GENTILINI;
Paolo GENTILINI
†Department of Internal Medicine, University of Florence School of Medicine, viale Morgagni 85, 50134 Firenze, Italy
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Giorgio LA VILLA
†Department of Internal Medicine, University of Florence School of Medicine, viale Morgagni 85, 50134 Firenze, Italy
Correspondence: Dr Giorgio La Villa (e-mail g.lavilla@dmi.unifi.it).
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Publisher: Portland Press Ltd
Received:
October 20 2001
Revision Received:
February 08 2002
Accepted:
March 25 2002
Online ISSN: 1470-8736
Print ISSN: 0143-5221
The Biochemical Society and the Medical Research Society © 2002
2002
Clin Sci (Lond) (2002) 103 (1): 43–51.
Article history
Received:
October 20 2001
Revision Received:
February 08 2002
Accepted:
March 25 2002
Citation
Alfonso LAGI, Giacomo LAFFI, Simone CENCETTI, Giuseppe BARLETTA, Marco FOSCHI, Francesco VIZZUTTI, Renzo BANDINELLI, Pietro PANTALEO, Cristina TOSTI GUERRA, Paolo GENTILINI, Giorgio LA VILLA; Impaired sympathetic regulation of cerebral blood flow in patients with cirrhosis of the liver. Clin Sci (Lond) 1 July 2002; 103 (1): 43–51. doi: https://doi.org/10.1042/cs1030043
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