Central and cerebrovascular effects of leg crossing in humans with sympathetic failure

Mark P M Harms; Wouter Wieling; Willy N J M Colier; Jacques W M Lenders; Niels H Secher; Johannes J van Lieshout; Mark P M Harms; Wouter Wieling; Willy N J M Colier; Jacques W M Lenders; Niels H Secher; Johannes J van Lieshout

doi:10.1042/CS20090038

Central and cerebrovascular effects of leg crossing in humans with sympathetic failure

Mark P M Harms, Wouter Wieling, Willy N J M Colier, Jacques W M Lenders, Niels H Secher, Johannes J van Lieshout, Mark P M Harms, Wouter Wieling, Willy N J M Colier, Jacques W M Lenders, Niels H Secher, Johannes J van Lieshout

9 Citations (Scopus)

Abstract

Leg crossing increases arterial pressure and combats symptomatic orthostatic hypotension in patients with sympathetic failure. This study compared the central and cerebrovascular effects of leg crossing in patients with sympathetic failure and healthy controls. We addressed the relationship between MCA V_mean (middle cerebral artery blood velocity; using transcranial Doppler ultrasound), frontal lobe oxygenation [O₂Hb (oxyhaemoglobin)] and MAP (mean arterial pressure), CO (cardiac output) and TPR (total peripheral resistance) in six patients (aged 37-67 years; three women) and age- and gender-matched controls during leg crossing. In the patients, leg crossing increased MAP from 58 (42-79) to 72 (52-89) comparedwith 84 (70-95) to 90 (74-94) mmHg in the controls. MCA V_mean increased from 55 (38-77) to 63 (45-80) and from 56 (46-77) to 64 (46-80) cm/s respectively (P < 0.05), with a larger rise in O₂Hb [1.12 (0.52-3.27)] in the patients compared with the controls [0.83 (-0.11 to 2.04) μmol/l]. In the control subjects, CO increased 11% (P < 0.05) with no change in TPR. By contrast, in the patients, CO increased 9% (P < 0.05), but also TPR increased by 13% (P < 0.05). In conclusion, leg crossing improves cerebral perfusion and oxygenation both in patients with sympathetic failure and in healthy subjects. However, in healthy subjects, cerebral perfusion and oxygenation were improved by a rise in CO without significant changes in TPR or MAP, whereas in patients with sympathetic failure, cerebral perfusion and oxygenation were improved through a rise in MAP due to increments in both CO and TPR.

Original language	English
Journal	Clinical Science
Volume	118
Issue number	9
Pages (from-to)	573-81
Number of pages	9
ISSN	0143-5221
DOIs	https://doi.org/10.1042/CS20090038 https://doi.org/10.1042/CS20090038
Publication status	Published - 1 May 2010

Access to Document

Cite this

Harms, M. P. M., Wieling, W., Colier, W. N. J. M., Lenders, J. W. M., Secher, N. H., van Lieshout, J. J., Harms, M. P. M., Wieling, W., Colier, W. N. J. M., Lenders, J. W. M., Secher, N. H., & van Lieshout, J. J. (2010). Central and cerebrovascular effects of leg crossing in humans with sympathetic failure. Clinical Science, 118(9), 573-81. https://doi.org/10.1042/CS20090038, https://doi.org/10.1042/CS20090038

Harms, MPM, Wieling, W, Colier, WNJM, Lenders, JWM, Secher, NH, van Lieshout, JJ, Harms, MPM, Wieling, W, Colier, WNJM, Lenders, JWM, Secher, NH & van Lieshout, JJ 2010, 'Central and cerebrovascular effects of leg crossing in humans with sympathetic failure', Clinical Science, vol. 118, no. 9, pp. 573-81. https://doi.org/10.1042/CS20090038, https://doi.org/10.1042/CS20090038

@article{7ce46ac0804411df928f000ea68e967b,

title = "Central and cerebrovascular effects of leg crossing in humans with sympathetic failure",

abstract = "Leg crossing increases arterial pressure and combats symptomatic orthostatic hypotension in patients with sympathetic failure. This study compared the central and cerebrovascular effects of leg crossing in patients with sympathetic failure and healthy controls. We addressed the relationship between MCA Vmean (middle cerebral artery blood velocity; using transcranial Doppler ultrasound), frontal lobe oxygenation [O2Hb (oxyhaemoglobin)] and MAP (mean arterial pressure), CO (cardiac output) and TPR (total peripheral resistance) in six patients (aged 37-67 years; three women) and age- and gender-matched controls during leg crossing. In the patients, leg crossing increased MAP from 58 (42-79) to 72 (52-89) comparedwith 84 (70-95) to 90 (74-94) mmHg in the controls. MCA Vmean increased from 55 (38-77) to 63 (45-80) and from 56 (46-77) to 64 (46-80) cm/s respectively (P < 0.05), with a larger rise in O2Hb [1.12 (0.52-3.27)] in the patients compared with the controls [0.83 (-0.11 to 2.04) μmol/l]. In the control subjects, CO increased 11% (P < 0.05) with no change in TPR. By contrast, in the patients, CO increased 9% (P < 0.05), but also TPR increased by 13% (P < 0.05). In conclusion, leg crossing improves cerebral perfusion and oxygenation both in patients with sympathetic failure and in healthy subjects. However, in healthy subjects, cerebral perfusion and oxygenation were improved by a rise in CO without significant changes in TPR or MAP, whereas in patients with sympathetic failure, cerebral perfusion and oxygenation were improved through a rise in MAP due to increments in both CO and TPR.",

author = "Harms, {Mark P M} and Wouter Wieling and Colier, {Willy N J M} and Lenders, {Jacques W M} and Secher, {Niels H} and {van Lieshout}, {Johannes J} and Harms, {Mark P M} and Wouter Wieling and Colier, {Willy N J M} and Lenders, {Jacques W M} and Secher, {Niels H} and {van Lieshout}, {Johannes J}",

note = "Keywords: Adult; Aged; Autonomic Nervous System Diseases; Blood Flow Velocity; Blood Pressure; Cardiac Output; Cerebrovascular Circulation; Female; Humans; Hypotension, Orthostatic; Leg; Male; Middle Aged; Multiple System Atrophy; Oxygen Consumption; Posture; Pure Autonomic Failure",

year = "2010",

month = may,

day = "1",

doi = "10.1042/CS20090038",

language = "English",

volume = "118",

pages = "573--81",

journal = "Clinical Science",

issn = "0143-5221",

publisher = "Portland Press Ltd.",

number = "9",

}

TY - JOUR

T1 - Central and cerebrovascular effects of leg crossing in humans with sympathetic failure

AU - Harms, Mark P M

AU - Wieling, Wouter

AU - Colier, Willy N J M

AU - Lenders, Jacques W M

AU - Secher, Niels H

AU - van Lieshout, Johannes J

AU - Harms, Mark P M

AU - Wieling, Wouter

AU - Colier, Willy N J M

AU - Lenders, Jacques W M

AU - Secher, Niels H

AU - van Lieshout, Johannes J

N1 - Keywords: Adult; Aged; Autonomic Nervous System Diseases; Blood Flow Velocity; Blood Pressure; Cardiac Output; Cerebrovascular Circulation; Female; Humans; Hypotension, Orthostatic; Leg; Male; Middle Aged; Multiple System Atrophy; Oxygen Consumption; Posture; Pure Autonomic Failure

PY - 2010/5/1

Y1 - 2010/5/1

N2 - Leg crossing increases arterial pressure and combats symptomatic orthostatic hypotension in patients with sympathetic failure. This study compared the central and cerebrovascular effects of leg crossing in patients with sympathetic failure and healthy controls. We addressed the relationship between MCA Vmean (middle cerebral artery blood velocity; using transcranial Doppler ultrasound), frontal lobe oxygenation [O2Hb (oxyhaemoglobin)] and MAP (mean arterial pressure), CO (cardiac output) and TPR (total peripheral resistance) in six patients (aged 37-67 years; three women) and age- and gender-matched controls during leg crossing. In the patients, leg crossing increased MAP from 58 (42-79) to 72 (52-89) comparedwith 84 (70-95) to 90 (74-94) mmHg in the controls. MCA Vmean increased from 55 (38-77) to 63 (45-80) and from 56 (46-77) to 64 (46-80) cm/s respectively (P < 0.05), with a larger rise in O2Hb [1.12 (0.52-3.27)] in the patients compared with the controls [0.83 (-0.11 to 2.04) μmol/l]. In the control subjects, CO increased 11% (P < 0.05) with no change in TPR. By contrast, in the patients, CO increased 9% (P < 0.05), but also TPR increased by 13% (P < 0.05). In conclusion, leg crossing improves cerebral perfusion and oxygenation both in patients with sympathetic failure and in healthy subjects. However, in healthy subjects, cerebral perfusion and oxygenation were improved by a rise in CO without significant changes in TPR or MAP, whereas in patients with sympathetic failure, cerebral perfusion and oxygenation were improved through a rise in MAP due to increments in both CO and TPR.

AB - Leg crossing increases arterial pressure and combats symptomatic orthostatic hypotension in patients with sympathetic failure. This study compared the central and cerebrovascular effects of leg crossing in patients with sympathetic failure and healthy controls. We addressed the relationship between MCA Vmean (middle cerebral artery blood velocity; using transcranial Doppler ultrasound), frontal lobe oxygenation [O2Hb (oxyhaemoglobin)] and MAP (mean arterial pressure), CO (cardiac output) and TPR (total peripheral resistance) in six patients (aged 37-67 years; three women) and age- and gender-matched controls during leg crossing. In the patients, leg crossing increased MAP from 58 (42-79) to 72 (52-89) comparedwith 84 (70-95) to 90 (74-94) mmHg in the controls. MCA Vmean increased from 55 (38-77) to 63 (45-80) and from 56 (46-77) to 64 (46-80) cm/s respectively (P < 0.05), with a larger rise in O2Hb [1.12 (0.52-3.27)] in the patients compared with the controls [0.83 (-0.11 to 2.04) μmol/l]. In the control subjects, CO increased 11% (P < 0.05) with no change in TPR. By contrast, in the patients, CO increased 9% (P < 0.05), but also TPR increased by 13% (P < 0.05). In conclusion, leg crossing improves cerebral perfusion and oxygenation both in patients with sympathetic failure and in healthy subjects. However, in healthy subjects, cerebral perfusion and oxygenation were improved by a rise in CO without significant changes in TPR or MAP, whereas in patients with sympathetic failure, cerebral perfusion and oxygenation were improved through a rise in MAP due to increments in both CO and TPR.

U2 - 10.1042/CS20090038

DO - 10.1042/CS20090038

M3 - Journal article

C2 - 19832700

SN - 0143-5221

VL - 118

SP - 573

EP - 581

JO - Clinical Science

JF - Clinical Science

IS - 9

ER -

Central and cerebrovascular effects of leg crossing in humans with sympathetic failure

Abstract

Access to Document

Fingerprint

Cite this