{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:41:32Z","timestamp":1791222092251,"version":"4.1.0"},"reference-count":75,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,10,11]]},"abstract":"\n Background<\/jats:title>\n \n Functional cerebrovascular regulatory mechanisms are important for maintaining constant cerebral blood flow and oxygen supply in heathy individuals and are altered in heart failure. We aim to examine whether pulmonary arterial hypertension (\n PAH<\/jats:styled-content>\n ) is associated with abnormal cerebrovascular regulation and lower cerebral oxygenation and their physiological and clinical consequences.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Resting mean flow velocity in the middle cerebral artery mean flow velocity in the middle cerebral artery (\n MCA<\/jats:styled-content>\n v\n mean<\/jats:sub>\n ); transcranial Doppler), cerebral pressure\u2010flow relationship (assessed at rest and during squat\u2010stand maneuvers; analyzed using transfer function analysis), cerebrovascular reactivity to\n CO<\/jats:styled-content>\n 2<\/jats:sub>\n , and central chemoreflex were assessed in 11 patients with PAH and 11 matched healthy controls. Both groups also completed an incremental ramp exercise protocol until exhaustion, during which\n MCA<\/jats:styled-content>\n v\n mean<\/jats:sub>\n , mean arterial pressure, cardiac output (photoplethysmography), end\u2010tidal partial pressure of\n CO<\/jats:styled-content>\n 2<\/jats:sub>\n , and cerebral oxygenation (near\u2010infrared spectroscopy) were measured. Patients were characterized by a significant decrease in resting\n MCA<\/jats:styled-content>\n v\n mean<\/jats:sub>\n (\n P<\/jats:italic>\n <0.01) and higher transfer function gain at rest and during squat\u2010stand maneuvers (both\n P<\/jats:italic>\n <0.05). Cerebrovascular reactivity to\n CO<\/jats:styled-content>\n 2<\/jats:sub>\n was reduced (\n P<\/jats:italic>\n =0.03), whereas central chemoreceptor sensitivity was increased in\n PAH<\/jats:styled-content>\n (\n P<\/jats:italic>\n <0.01), the latter correlating with increased resting ventilation (\n R<\/jats:italic>\n 2<\/jats:sup>\n =0.47;\n P<\/jats:italic>\n <0.05) and the exercise ventilation\/CO\n 2<\/jats:sub>\n production slope (\n \n \n \n \n V<\/mml:mi>\n \u02d9<\/mml:mo>\n <\/mml:mover>\n E<\/mml:mi>\n <\/mml:msub>\n \/<\/mml:mo>\n \n V<\/mml:mi>\n \u02d9<\/mml:mo>\n <\/mml:mover>\n \n CO<\/mml:mtext>\n 2<\/mml:mn>\n <\/mml:msub>\n <\/mml:mrow>\n <\/mml:math>\n slope;\n R<\/jats:italic>\n 2<\/jats:sup>\n =0.62;\n P<\/jats:italic>\n <0.05) during exercise for patients. Exercise\u2010induced increases in\n MCA<\/jats:styled-content>\n v\n mean<\/jats:sub>\n were limited in\n PAH<\/jats:styled-content>\n (\n P<\/jats:italic>\n <0.05). Reduced\n MCA<\/jats:styled-content>\n v\n mean<\/jats:sub>\n contributed to impaired cerebral oxygen delivery and oxygenation (both\n P<\/jats:italic>\n <0.05), the latter correlating with exercise capacity in patients with PAH (\n R<\/jats:italic>\n 2<\/jats:sup>\n =0.52;\n P<\/jats:italic>\n =0.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n These findings provide comprehensive evidence for physiologically and clinically relevant impairments in cerebral hemodynamic regulation and oxygenation in\n PAH<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.006126","type":"journal-article","created":{"date-parts":[[2017,10,13]],"date-time":"2017-10-13T00:10:27Z","timestamp":1507853427000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":54,"title":["Compromised Cerebrovascular Regulation and Cerebral Oxygenation in Pulmonary Arterial Hypertension"],"prefix":"10.1161","volume":"6","author":[{"given":"Simon","family":"Malenfant","sequence":"first","affiliation":[{"name":"Pulmonary Hypertension and Vascular Biology Research Group, Universit\u00e9 Laval, Quebec City, Canada"},{"name":"Quebec Heart and Lung Institute Research Center, Universit\u00e9 Laval, Quebec City, Canada"},{"name":"Department of Kinesiology, Faculty of Medicine, Universit\u00e9 Laval, Quebec City, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrice","family":"Brassard","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute Research Center, Universit\u00e9 Laval, Quebec City, Canada"},{"name":"Department of Kinesiology, Faculty of Medicine, Universit\u00e9 Laval, Quebec City, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myriam","family":"Paquette","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute Research Center, Universit\u00e9 Laval, Quebec City, Canada"},{"name":"Department of Kinesiology, Faculty of Medicine, Universit\u00e9 Laval, Quebec City, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Le Blanc","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute Research Center, Universit\u00e9 Laval, Quebec City, Canada"},{"name":"Department of Kinesiology, Faculty of Medicine, Universit\u00e9 Laval, Quebec City, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Chouinard","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute Research Center, Universit\u00e9 Laval, Quebec City, Canada"},{"name":"Department of Kinesiology, Faculty of Medicine, Universit\u00e9 Laval, Quebec City, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Nadeau","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension and Vascular Biology Research Group, Universit\u00e9 Laval, Quebec City, Canada"},{"name":"Quebec Heart and Lung Institute Research Center, Universit\u00e9 Laval, Quebec City, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip D.","family":"Allan","sequence":"additional","affiliation":[{"name":"Wellington Medical Technology Group, Center for Translational Physiology, University of Otago, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Chieh","family":"Tzeng","sequence":"additional","affiliation":[{"name":"Wellington Medical Technology Group, Center for Translational Physiology, University of Otago, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Simard","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute Research Center, Universit\u00e9 Laval, Quebec City, 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