Comparison of changes in systemic and cerebral hemodynamics in two variants of the active standing test

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Abstract

Justification of methods for diagnosing disorders of systemic and cerebral hemodynamics in humans is an important task of fundamental medicine. The aim of this study was to compare changes in systemic hemodynamics and cerebral circulation in two modifications of the orthostatic test: during active transition to a standing position from a supine position or from a sitting position. In a group of 11 young volunteers of both sexes, blood pressure (BP), heart rate (HR) and stroke volume (SV) were continuously recorded, and changes in the concentration of oxyhemoglobin (OHb) and total hemoglobin (CHb) in the frontal cortex were assessed using infrared spectroscopy. In none of the tests, significant changes in mean BP occurred during verticalization, whereas changes in HR, SV, spectral power and phase synchronization of mean BP and HR oscillations in the low-frequency range (0.06–0.13 Hz) were observed. For most parameters, these changes were more pronounced in the “supine-standing” test than in the “sitting-standing” test. Along with that, an increase in the spectral power of low-frequency oscillations of CHb and OHb in small cerebral vessels, as well as the degree of synchronization of low-frequency oscillations of OHb and mean BP, which can reflect the processes of cerebral circulation control, were observed only in the “supine-standing” test. Thus, both variants of the active orthostatic test provide an assessment of systemic hemodynamics, whereas the “supine-standing” test is more appropriate for assessing cerebral circulation.

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About the authors

R. Yu. Zhedyaev

Institute of Biomedical Problems, RAS

Email: tarasovaos@my.msu.ru
Russian Federation, Moscow

A. S. Borovik

Institute of Biomedical Problems, RAS

Email: tarasovaos@my.msu.ru
Russian Federation, Moscow

O. L. Vinogradova

Institute of Biomedical Problems, RAS

Email: tarasovaos@my.msu.ru
Russian Federation, Moscow

O. S. Tarasova

Institute of Biomedical Problems, RAS; Moscow State University

Author for correspondence.
Email: tarasovaos@my.msu.ru
Russian Federation, Moscow; Moscow

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2. Fig. 1. Spectra of the phase synchronization index of mean arterial pressure (AP) with heart rate (HR) (A), total hemoglobin concentration (CHb, B) and oxyhemoglobin concentration (OHb, B) in different body positions. Blue line – in the lying position, green line – in the sitting position, red line – in the standing position. The peak in the 0.1 Hz region reflects the synchronization of indicators in the low-frequency range, the peak in the 0.25 Hz region corresponds to the respiratory rate.

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3. Fig. 2. Changes in hemodynamic parameters and their variability in two modifications of the active orthostatic test: when moving from a lying position to a standing position or from a sitting position. LF – low-frequency range (0.06–0.13 Hz); CHb – total hemoglobin concentration; OHb – oxyhemoglobin concentration; PSI – phase synchronization index. * – p < 0.05 – statistically significant change in the parameter in the test (one-sided Wilcoxon test); # – p < 0.05 – comparison with the value in the lying-standing test (paired Wilcoxon test).

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