Near-infrared diffuse optical monitoring of cerebral blood flow and oxygenation for the prediction of vasovagal syncope

Ran Cheng; Yu Shang; Siqi Wang; Joyce M. Evans; Abner Rayapati; David C. Randall; Guoqiang Yu

doi:10.1117/1.JBO.19.1.017001

8 January 2014 Near-infrared diffuse optical monitoring of cerebral blood flow and oxygenation for the prediction of vasovagal syncope

Ran Cheng, Yu Shang, Siqi Wang, Joyce M. Evans, Abner Rayapati, David C. Randall, Guoqiang Yu

Author Affiliations +

Funded by: National Institutes of Health, National Institutes of Health (NIH)

Journal of Biomedical Optics, Vol. 19, Issue 1, 017001 (January 2014). https://doi.org/10.1117/1.JBO.19.1.017001

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[HbO ₂ ]/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[HbO ₂ ] , 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.

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Ran Cheng, Yu Shang, Siqi Wang, Joyce M. Evans, Abner Rayapati, David C. Randall, and Guoqiang Yu "Near-infrared diffuse optical monitoring of cerebral blood flow and oxygenation for the prediction of vasovagal syncope," Journal of Biomedical Optics 19(1), 017001 (8 January 2014). https://doi.org/10.1117/1.JBO.19.1.017001

Published: 8 January 2014

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