Publications by authors named "R B Panerai"
Objective: Remote patient monitoring (RPM) beat-to-beat blood pressure (BP) provides an opportunity to measure poststroke BP variability (BPV), which is associated with clinical stroke outcomes. BP sampling interval (SI) influences ambulatory BPV, but RPM BP SI optimisation research is limited. SI and RPM device capabilities require compromises, meaning SI impact requires investigation.
View Article and Find Full Text PDFSubcomponent analysis of the directional sensitivity of dynamic cerebral autoregulation.
Am J Physiol Heart Circ Physiol
January 2025
Article Synopsis
- The study investigates the unknown origin of directional sensitivity (DS) in dynamic cerebral autoregulation (dCA) using measurements from 140 healthy participants, focusing on middle cerebral artery velocity (MCAv) and arterial blood pressure (ABP).
- Results show that MCAv and resistance-area product (RAP) exhibit significant directional sensitivity in response to changes in mean arterial pressure (MAP), while critical closing pressure (CrCP) does not.
- The findings suggest that the directional sensitivity in cerebral blood flow is likely myogenic (related to muscle response) and is primarily mediated by RAP, indicating minimal influence from metabolic factors or sympathetic nervous system control.
Is muscle sympathetic nerve activity associated with cerebral blood velocity? A partial coherence analysis.
Am J Physiol Regul Integr Comp Physiol
December 2024
Article Synopsis
- The study investigates the relationship between muscle sympathetic nervous activity (MSNA) and cerebral blood velocity (CBv) during different physiological conditions in healthy subjects.
- Using methods like transcranial Doppler ultrasound and microneurography, researchers measured changes in MSNA, mean arterial pressure (MAP), and CBv during isometric handgrip exercise and cold pressor test.
- Findings indicate that MSNA significantly influences CBv regulation, revealing that both MAP and MSNA dynamically affect cerebral blood flow at rest and during stress tests.
Introduction: Septic shock, a life-threatening condition, can result in cerebral dysfunction and heightened mortality rates. In these patients, disturbances in cerebral hemodynamics, as reflected by impairment of myogenic cerebral autoregulation (CA), metabolic regulation, expressed by critical closing pressure (CrCP) and reductions in intracranial compliance (ICC), can adversely impact septic shock outcomes. The general recommendation is to maintain a target mean arterial pressure (MAP) of 65 mmHg but the effect of different MAP targets on cerebral hemodynamics in these patients is not clear and optimal targets might be dependent on the status of CA.
View Article and Find Full Text PDFIntroduction: Neurovascular coupling (NVC) is an important mechanism for the regulation of cerebral perfusion during intensive cognitive activity. Thus, it should be examined in terms of its effects on the regulation dynamics of cerebral perfusion and its possible alterations during cognitive impairment. The dynamic dependence of continuous changes in cerebral blood velocity (CBv), which can be measured noninvasively using transcranial Doppler upon fluctuations in arterial blood pressure (ABP) and CO tension, using end-tidal CO (EtCO) as a proxy, can be quantified via data-based dynamic modeling to yield insights into two key regulatory mechanisms: the dynamic cerebral autoregulation (dCA) and dynamic vasomotor reactivity (DVR), respectively.
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