Abstract
ABSTRACT: To evaluate maturational differences in the cerebral artery blood flow velocity characteristics, we measured the middle cerebral (MCA) and basilar artery blood flow velocity and time intervals using a real-time imaging pulsed Doppler system in 39 preterm and 25 term infants. Preterm MCA and basilar artery mean Doppler spectral ]area under the curve were 22 and 25% lower than the corresponding term values, with a significant increase during gestation as revealed by regression models. Paradoxically, the mean MCA systolic acceleration and deceleration slopes were U+2248 28 and 18% higher in preterm than in term infants: acceleration 701.2 ± 160 cm/s2 versus 546.4 ± 156.5/s2 (p<0.005), and deceleration 222.2 ± 71.6 cm/s2 versus 188.2 ± 52.2 cm/s2(p<0.05), respectively. Similarly, acceleration and deceleration pressure half times for MCA were about 15 and 18% shorter in the preterm (p<0.01 and p<0.005). Multiple regression models controlling for velocity and frequency terms revealed an inverse relationship between gestational age and MCA acceleration (p<0.005), and a positive relationship between gestational age and MCA acceleration pressure half times (p<0.02). In preterm infants the MCA specific index of pulsatility was about 32% higher (p<0.05) than in the term, which was also inversely related to gestational age in a regression model controlling for velocity terms (p<0.02). However, the basilar artery acceleration and deceleration slopes were not significantly different between term and preterm groups, nor showed a significant gestational age effect in the multiple regression models. The results indicate that despite a lower volume flow, the rate of rise of MCA velocity is much higher in preterm than in the term infants; during maturation the velocity waveforms assume a smoother contour. These hemodynamic characteristics could in part reflect immature vessel wall viscoelastic properties, particularly lack of elastin which could result in a reduced windkessel phenomenon.
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Raju, T., Kim, S. Cerebral Artery Flow Velocity Acceleration and Deceleration Characteristics in Newborn Infants. Pediatr Res 26, 588–589 (1989). https://doi.org/10.1203/00006450-198912000-00014
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DOI: https://doi.org/10.1203/00006450-198912000-00014
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