{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T17:38:45Z","timestamp":1788197925630,"version":"build-2803163510"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T00:00:00Z","timestamp":1651536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002920","name":"Research Grants Council, University Grants Committee","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002920","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background and Purpose<\/jats:title><jats:p>Dynamic cerebral autoregulation is impaired after ischemic stroke. External counterpulsation (ECP) augments the cerebral blood flow of patients with ischemic stroke by elevation of blood pressure (BP). We aimed to investigate if cerebral augmentation effects during ECP were associated with impaired dynamic cerebral autoregulation in patients after acute ischemic stroke.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty patients with unilateral ischemic stroke and large artery atherosclerosis in the anterior circulation territory within 7 days from symptom onset and eighteen healthy controls were recruited. We monitored changes in mean flow velocity over both middle cerebral arteries (MCA) by transcranial Doppler (TCD) before, during, and immediately after ECP. Cerebral augmentation index was MCA mean flow velocity increase in percentage during ECP compared with baseline to evaluate the augmentation effects of ECP. Spontaneous arterial BP and cerebral blood flow velocity in both bilateral MCAs were recorded using a servo-controlled plethysmograph and TCD, respectively. Transfer function analysis was used to derive the autoregulatory parameters, including phase difference (PD), and gain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cerebral augmentation index in patients with stroke was significantly higher on both the ipsilateral and contralateral sides than that in controls, while the PD in patients with stroke was significantly lower on both sides than those in controls (all <jats:italic>P<\/jats:italic> &amp;lt; 0.05). The cerebral augmentation index did not correlate with PD and gain on either the ipsilateral or contralateral side of patients with stroke or in controls (all <jats:italic>P<\/jats:italic> &amp;gt; 0.05). The cerebral augmentation index of patients with stroke was significantly related to mean BP change on the ipsilateral side (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> = 0.108, <jats:italic>P<\/jats:italic> = 0.038).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The degree of ECP-induced cerebral augmentation effects as measured by the cerebral augmentation index did not correlate with the magnitude of impaired dynamic cerebral autoregulation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.784836","type":"journal-article","created":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T04:34:41Z","timestamp":1651552481000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Cerebral Augmentation Effect Induced by External Counterpulsation Is Not Related to Impaired Dynamic Cerebral Autoregulation in Ischemic Stroke"],"prefix":"10.3389","volume":"13","author":[{"given":"Li","family":"Xiong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangyan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence Ka Sing","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas W.","family":"Leung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e14982","DOI":"10.14814\/phy2.14982","article-title":"Losing the dogmatic view of cerebral autoregulation","volume":"9","author":"Brassard","year":"2021","journal-title":"Physiol Rep."},{"key":"B2","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1136\/jnnp.72.4.467","article-title":"Dynamic cerebral autoregulation and beat to beat blood pressure control are impaired in acute ischaemic stroke","volume":"72","author":"Eames","year":"2002","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"B3","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1159\/000070118","article-title":"Serial changes in static and dynamic cerebral autoregulation after acute ischaemic stroke","volume":"16","author":"Dawson","year":"2003","journal-title":"Cerebrovasc Dis."},{"key":"B4","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1161\/01.STR.0000014584.17714.2E","article-title":"Effects of induced hypertension on intracranial pressure and flow velocities of the middle cerebral arteries in patients with large hemispheric stroke","volume":"33","author":"Schwarz","year":"2002","journal-title":"Stroke."},{"key":"B5","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.jns.2007.04.033","article-title":"Blood pressure augmentation in acute ischemic stroke","volume":"261","author":"Wityk","year":"2007","journal-title":"J Neurol Sci."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1761","DOI":"10.1016\/S0735-1097(03)00329-2","article-title":"Enhanced external counterpulsation improves endothelial function in patients with symptomatic coronary artery disease","volume":"41","author":"Bonetti","year":"2003","journal-title":"J Am Coll Cardiol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"II16","DOI":"10.1002\/clc.4960251406","article-title":"Current use of enhanced external counterpulsation and patient selection","volume":"25","author":"Lawson","year":"2002","journal-title":"Clin Cardiol."},{"key":"B8","first-page":"20","article-title":"Enhanced external counterpulsation\u2013a therapeutic option for patients with chronic cardiovascular problems","volume":"13","author":"Linnemeier","year":"2002","journal-title":"J Cardiovasc Manag."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1918","DOI":"10.1016\/S0735-1097(03)00428-5","volume":"41","author":"Bonetti","year":"2003","journal-title":"Enhanced external counterpulsation for ischemic heart disease: What's behind the curtain? 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