Церебральная вазомоторная реактивность у пациентов в остром периоде ишемического инсульта

Aim. To estimate the cerebrovascular reactivity in the acute period of ischemic stroke and its association with clinicoinstrumental data. Materials and methods. The time-averaged maximum velocity (TAMX) of blood flow was assessed in 25 patients in the medial cerebral artery from the two sides initially, and at the minutes 1 st, 5 th, 10 th after hypercapnic test (HT) followed by semi-orthostatic test. On the basis of the obtained parameters, reactivity index (RI) was calculated. The data were analyzed in the context of correlation with patients’ neurological, cognitive and functional status as well as MRT data and laboratory indices. Results. On the side of the focus, a significant increase in the average velocity and RI during HT was noted without any rise on the opposite side. A further semi-orthostatic load led to decrease in the velocity from both sides that was more marked contralaterally. The most important determinants of cerebrovascular reactivity (CVR) indices were the level of patients’ education, systolic arterial pressure at admittance to the hospital, lipid spectrum, thickness of “intima-media” complex, amount and sizes of acute ischemic foci. In its turn, CVR indices were associated with a global cognitive status of patients and their functional status at discharge from the hospital. Conclusions. Cerebrovascular reactivity in the acute period of ischemic stroke is more marked on the side of the focus and is determined by complex of parameters associated with common cardiovascular risk. Correlation between CVR, global cognitive status and functional status at discharge from the hospital permits to consider it as one of predictors of the outcome in the acute period of disease.