{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:21:30Z","timestamp":1789042890406,"version":"build-2803163510"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Spinal anesthesia-induced hypotension (SAIH) is common in hypertensive patients, yet reliable preoperative markers remain limited. Corrected carotid flow time (CCFT) is a Doppler-derived index influenced by preload and ventricular ejection timing, but its association with SAIH in this population has not been established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate whether preoperative CCFT is independently associated with SAIH in hypertensive patients undergoing spinal anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Single-center prospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>In total, 110 hypertensive adults scheduled for lower abdominal or lower extremity surgery under spinal anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>University hospital, operating room.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions:<\/jats:title>\n                    <jats:p>Preoperative carotid and brachial ultrasound assessments (CCFT, carotid intima-media thickness (CIMT), flow-mediated dilation (FMD), carotid blood flow, and internal jugular vein collapsibility index) were performed. Hemodynamics were recorded for 30\u2009min after spinal injection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures:<\/jats:title>\n                    <jats:p>Primary outcome: SAIH (\u226520% decrease in systolic blood pressure or SBP &lt;90\u2009mmHg sustained for \u22651\u2009minute). Secondary outcomes: hemodynamic trends and discriminative performance of ultrasound parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      SAIH occurred in 54 patients (49.1%). CCFT was shorter in patients who developed hypotension (326.5\u2009\u00b1\u200971.3 vs 437.3\u2009\u00b1\u200982.9\u2009ms,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In the primary multivariable model including CIMT, FMD, and beta-blocker use, CCFT remained independently associated with SAIH (adjusted odds ratio 0.980 per 1-ms increase, 95% confidence interval (CI) 0.973\u20130.988,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). CCFT alone had an area under the curve (AUC) of 0.854 (95% CI 0.785\u20130.924); the 358.5-ms cut-off had 74.1% sensitivity and 87.5% specificity. A clinical model including age, baseline SBP, and beta-blocker use had an AUC of 0.572 (95% CI 0.465\u20130.679); adding CCFT increased the AUC to 0.866 (95% CI 0.799\u20130.932; paired comparison\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Preoperative CCFT was independently associated with SAIH and improved discrimination when added to a parsimonious clinical model. The cohort-derived threshold requires external validation before clinical implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration:<\/jats:title>\n                    <jats:p>\n                      ClinicalTrials.gov (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/\">https:\/\/clinicaltrials.gov\/<\/jats:ext-link>\n                      ), NCT06749184.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10815589261483669","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T04:55:26Z","timestamp":1787374526000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative corrected carotid flow time is associated with spinal anesthesia-induced hypotension in hypertensive patients: A prospective observational study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5709-6504","authenticated-orcid":false,"given":"Mahmut Sami","family":"Tutar","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Sciences, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasan Alp","family":"Mermer","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Sciences, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Aydin","family":"Oner","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Sciences, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Ihsan","family":"Birler","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Sciences, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuf Salih","family":"Mutluay","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Sciences, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammed Halit","family":"Satici","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Sciences, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munise","family":"Yildiz","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Sciences, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betul","family":"Kozanhan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Sciences, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","unstructured":"Carpenter RL Caplan RA Brown DL et al. 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