1. The cerebral blood flow pulsatility will be increased in patients with hypertension. 2. Increased blood flow pulsatility is associated with brain tissue damage.
ID
Bron
Verkorte titel
Aandoening
Hypertension
Cerebral Small Vessel Disease (cSVD)
Ondersteuning
Onderzoeksproduct en/of interventie
Uitkomstmaten
Primaire uitkomstmaten
1. Cerebral blood flow pulsatility index in the small cerebral vessels measured with 7T MRI in hypertensive patients and healthy controls
Achtergrond van het onderzoek
Rationale: Hypertension is a highly prevalent condition. In 2012, hypertension affected 37% of the males and 26% of the females in the Netherlands between 30-70 years. It is a leading cause of morbidity and mortality, and the most important risk for haemorrhagic and ischemic stroke.
Hypertension causes damage in the structure and function of the blood vessels. In target end organs, such as kidneys, heart and brain, it mainly affects the small vessels. The alterations of the vessels lead to functional and structural tissue abnormalities of the end organs. In the brain this structural damage manifests itself clinically either acutely (lacunar stroke) or chronically progressively (cognitive impairment and dementia).
Since hypertension also results in higher arterial stiffness, which results in less effective dampening of the blood wave pulse, this may result in an increase in the blood flow pulsatility. The kinetic energy of the pulse waves is transmitted to the microvascular system, which will lead to damage of the brain tissue, such as tissue damage which is characteristic for cerebral small vessel disease. Therefore, measuring the blood flow in the small intracranial vessels might result in more insight in the relation between cerebral blood flow pulsatility, hypertension and cognitive decline.
Objective: The main objective of this study is to determine the association between cerebral blood flow pulsatility and blood pressure, and the relation with brain tissue damage, using ultra-high-field (7T) MRI.
Study design: The present study is an observational, cross-sectional, high-field (7T) MRI study.
Doel van het onderzoek
1. The cerebral blood flow pulsatility will be increased in patients with hypertension.
2. Increased blood flow pulsatility is associated with brain tissue damage.
Onderzoeksopzet
Baseline
Publiek
Marieke van den Kerkhof
+31433872952
marieke.vanden.kerkhof@mumc.nl
Wetenschappelijk
Marieke van den Kerkhof
+31433872952
marieke.vanden.kerkhof@mumc.nl
Belangrijkste voorwaarden om deel te mogen nemen (Inclusiecriteria)
Criteria for the hypertensive group without known brain damage:
- Age 40-75 years
- Essential hypertension, defined as an ambulant blood pressure of ≥ 130 over 80 mmHg.
Criteria for the hypertensive group with diagnosed brain damage (Fazekas≥2):
- Age 40-75 years
- Essential hypertension, defined as an ambulant blood pressure of ≥ 130 over 80 mmHg.
- Extensive white matter lesions: Fazekas score ≥ 2, indicated on brain MRI.
Criteria for the control (normotensive) group:
- Age 40-75 years
- Normotensive (ambulant blood pressure of < 130 over 80 mmHg).
Belangrijkste redenen om niet deel te kunnen nemen (Exclusiecriteria)
- White coat hypertension
- Inability to stop antihypertensive medication (since this results in an altered blood pressure, not the original blood pressure before the use of medication.)
- Indication of history-taking, physical examination or routine laboratory tests of secondary hypertension
- Chronic renal insufficiency (eGFR<30 mL/min)
- Diabetes mellitus
- Ischemic or valvular heart disease or electrocardiographic evidence of atrial fibrillation
- Transient ischemic attacks and ischemic or hemorrhagic stroke
- Obstructive sleep apnea syndrome
- Systemic inflammation, such as active rheumatoid arthritis
- Body Mass Index > 32 kg/m²
- Inability to provide informed consent
- Any contraindication for MRI: metallic implants, pacemaker, claustrophobia, pregnancy, tattoos in the head/neck region, permanent make-up.
- Contraindications for the gadolinium-containing contrast agent: allergic reaction, eGFR<30 mL/min
Opzet
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| Register | ID |
|---|---|
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