{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:30:31Z","timestamp":1791487831001,"version":"4.3.4"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,12,19]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Staging of hemodynamic failure (HF) in symptomatic patients with cerebrovascular steno\u2010occlusive disease is required to assess the risk of ischemic stroke. Since the gold standard positron emission tomography\u2010based perfusion reserve is unsuitable as a routine clinical imaging tool, blood oxygenation level\u2013dependent cerebrovascular reactivity (BOLD\u2010CVR) with CO\n                      <jats:sub>2<\/jats:sub>\n                      is a promising surrogate imaging approach. We investigated the accuracy of standardized BOLD\u2010CVR to classify the extent of HF.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Patients with symptomatic unilateral cerebrovascular steno\u2010occlusive disease, who underwent both an acetazolamide challenge (\n                      <jats:sup>15<\/jats:sup>\n                      O\u2010)H\n                      <jats:sub>2<\/jats:sub>\n                      O\u2010positron emission tomography and BOLD\u2010CVR examination, were included. HF staging of vascular territories was assessed using qualitative inspection of the positron emission tomography perfusion reserve images. The optimum BOLD\u2010CVR cutoff points between HF stages 0\u20131\u20132 were determined by comparing the quantitative BOLD\u2010CVR data to the qualitative (\n                      <jats:sup>15<\/jats:sup>\n                      O\u2010)H\n                      <jats:sub>2<\/jats:sub>\n                      O\u2010positron emission tomography classification using the 3\u2010dimensional accuracy index to the randomly assigned training and test data sets with the following determination of a single cutoff for clinical application. In the 2\u2010case scenario, classifying data points as HF 0 or 1\u20132 and HF 0\u20131 or 2, BOLD\u2010CVR showed an accuracy of &gt;0.7 for all vascular territories for HF 1 and HF 2 cutoff points. In particular, the middle cerebral artery territory had an accuracy of 0.79 for HF 1 and 0.83 for HF 2, whereas the anterior cerebral artery had an accuracy of 0.78 for HF 1 and 0.82 for HF 2.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Standardized and clinically accessible BOLD\u2010CVR examinations harbor sufficient data to provide specific cerebrovascular reactivity cutoff points for HF staging across individual vascular territories in symptomatic patients with unilateral cerebrovascular steno\u2010occlusive disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.029491","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T07:03:37Z","timestamp":1702364617000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Hemodynamic Failure Staging With Blood Oxygenation Level\u2013Dependent Cerebrovascular Reactivity and Acetazolamide\u2010Challenged (\n                    <sup>15<\/sup>\n                    O\u2010)H\n                    <sub>2<\/sub>\n                    O\u2010Positron Emission Tomography Across Individual Cerebrovascular Territories"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7246-3421","authenticated-orcid":false,"given":"Martina","family":"Seb\u00f6k","sequence":"first","affiliation":[{"name":"Department of Neurosurgery University Hospital Zurich, University of Zurich Switzerland"},{"name":"Clinical Neuroscience Center University Hospital Zurich, 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