Abstract 066: Adaptive and physiological cerebrovascular changes at high altitudes: a systematic review and meta‐analysis
Introduction moderate altitude, considered over 1,500 meters (about 4921 ft) above sea level (m.a.s.l), is a particular environment due to the lower oxygen pressure that conditions the development of adaptive mechanisms such as cerebrovascular changes expressed in cerebral blood flow (CBF). Several...
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| Formato: | Conference abstract |
| Lenguaje: | inglés |
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2024
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| Acceso en línea: | Enlace permanente (DOI o Handle) |
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| author | Julio A. Chirinos P. Zila-Velasque Pamela Grados‐Espinoza Sebastian Abanto-Urbano Mely Olarte-Durand Martha Isabel Vilca-Salas Paula Moran-Ballon Victor Velásquez‐Rimachi Kateriny Margot Regalado-Rodríguez Carlos Quispe‐Vicuña Fernando Terry Carlos Alva‐Díaz |
| author_browse | Carlos Alva‐Díaz Carlos Quispe‐Vicuña Fernando Terry Julio A. Chirinos Kateriny Margot Regalado-Rodríguez Martha Isabel Vilca-Salas Mely Olarte-Durand P. Zila-Velasque Pamela Grados‐Espinoza Paula Moran-Ballon Sebastian Abanto-Urbano Victor Velásquez‐Rimachi |
| author_facet | Julio A. Chirinos P. Zila-Velasque Pamela Grados‐Espinoza Sebastian Abanto-Urbano Mely Olarte-Durand Martha Isabel Vilca-Salas Paula Moran-Ballon Victor Velásquez‐Rimachi Kateriny Margot Regalado-Rodríguez Carlos Quispe‐Vicuña Fernando Terry Carlos Alva‐Díaz |
| author_sort | Julio A. Chirinos |
| collection | Producción científica |
| description | Introduction moderate altitude, considered over 1,500 meters (about 4921 ft) above sea level (m.a.s.l), is a particular environment due to the lower oxygen pressure that conditions the development of adaptive mechanisms such as cerebrovascular changes expressed in cerebral blood flow (CBF). Several studies have explored changes in CBF in small populations, however, changes at different altitudes, populations and units of measurement have not been described. These characteristics have been associated with cerebrovascular adaptation Methods We systematically searched databases (PubMed‐Medline, Embase, Web of Science, Scopus and Google Scholar) until January 2022 for studies evaluating cerebrovascular changes resulting from exposures at altitudes greater and lower than 1500 m.a.s.l. The Newcastle‐Ottawa scale and RoB‐2 tools was used to assess the risk of bias from observational studies and randomized clinical trials, respectively. A meta‐analysis using a random‐effects model to estimate pooled effects was realized for each outcome and a narrative synthesis when this was not possible. GRADE criteria were used to identify the certainty of evidence for each result. Results We included 58 studies (2 randomized clinical trials and 56 non‐randomized clinical trials) with 1959 patients. Most studies were at low risk of bias. We found that in the middle meningeal artery, altitude higher than 1500 m.a.s.l may reduce autoregulatory index (MD −0.42, 95% CI −0.67 to −0.18, I2 84%, 2 studies, low certainty), cerebral oxygen saturation (MD −5.65, 95% CI −8.63 to −2.67, I2 91%), cerebral oxygen saturation (MD −5.65, 95% CI ‐8.63 to ‐2.67, I2 91%) and cerebral oxygen saturation (MD ‐5.65, 95% CI ‐8.63 to ‐2.67, I2 91%): ‐8.63 to ‐2.67, I2: 91%, 3 studies, low certainty), cerebrovascular resistance (MD: ‐25.04, 95% CI: ‐75.61 to 25.54, I2: 100%, 2 studies, low certainty) and Cerebrovascular Conductance (MD: ‐0.01, 95% CI: ‐0.05 to 0.03, I2: 0%, 2 studies, low certainty). Similarly, in the internal carotid and vertebral artery, altitude may increase global cerebral blood flow (MD 200.82, 95% CI 47.17 to 354.46, I2 70%, 2 studies, low certainty). Conclusion Exposure to altitudes above 1500 m.a.s.l reduces autoregulation and cerebral oxygen saturation but increases overall cerebral blood flow. These changes could indicate cerebrovascular adaptations to lower oxygen pressures, although the evidence is of low certainty due to variability between studies. |
| format | Conference abstract |
| id | openalex:W4406394988 |
| institution | UPeU |
| language | English |
| publishDate | 2024 |
| publishDateRange | 2024 |
| publishDateSort | 2024 |
| record_format | dspace |
| spelling | openalex:W4406394988Abstract 066: Adaptive and physiological cerebrovascular changes at high altitudes: a systematic review and meta‐analysisJulio A. ChirinosP. Zila-VelasquePamela Grados‐EspinozaSebastian Abanto-UrbanoMely Olarte-DurandMartha Isabel Vilca-SalasPaula Moran-BallonVictor Velásquez‐RimachiKateriny Margot Regalado-RodríguezCarlos Quispe‐VicuñaFernando TerryCarlos Alva‐Díazhigh altitudecerebral blood flowcerebral autoregulationmiddle meningeal arterycerebral oxygen saturationcerebrovascular resistancecerebral venous oxygen saturationcerebral blood volumecerebral oxygen extraction fractionhypoxiahigh-altitude adaptationHigh Altitude and HypoxiaCardiovascular and Diving-Related ComplicationsSpaceflight effects on biologyIntroduction moderate altitude, considered over 1,500 meters (about 4921 ft) above sea level (m.a.s.l), is a particular environment due to the lower oxygen pressure that conditions the development of adaptive mechanisms such as cerebrovascular changes expressed in cerebral blood flow (CBF). Several studies have explored changes in CBF in small populations, however, changes at different altitudes, populations and units of measurement have not been described. These characteristics have been associated with cerebrovascular adaptation Methods We systematically searched databases (PubMed‐Medline, Embase, Web of Science, Scopus and Google Scholar) until January 2022 for studies evaluating cerebrovascular changes resulting from exposures at altitudes greater and lower than 1500 m.a.s.l. The Newcastle‐Ottawa scale and RoB‐2 tools was used to assess the risk of bias from observational studies and randomized clinical trials, respectively. A meta‐analysis using a random‐effects model to estimate pooled effects was realized for each outcome and a narrative synthesis when this was not possible. GRADE criteria were used to identify the certainty of evidence for each result. Results We included 58 studies (2 randomized clinical trials and 56 non‐randomized clinical trials) with 1959 patients. Most studies were at low risk of bias. We found that in the middle meningeal artery, altitude higher than 1500 m.a.s.l may reduce autoregulatory index (MD −0.42, 95% CI −0.67 to −0.18, I2 84%, 2 studies, low certainty), cerebral oxygen saturation (MD −5.65, 95% CI −8.63 to −2.67, I2 91%), cerebral oxygen saturation (MD −5.65, 95% CI ‐8.63 to ‐2.67, I2 91%) and cerebral oxygen saturation (MD ‐5.65, 95% CI ‐8.63 to ‐2.67, I2 91%): ‐8.63 to ‐2.67, I2: 91%, 3 studies, low certainty), cerebrovascular resistance (MD: ‐25.04, 95% CI: ‐75.61 to 25.54, I2: 100%, 2 studies, low certainty) and Cerebrovascular Conductance (MD: ‐0.01, 95% CI: ‐0.05 to 0.03, I2: 0%, 2 studies, low certainty). Similarly, in the internal carotid and vertebral artery, altitude may increase global cerebral blood flow (MD 200.82, 95% CI 47.17 to 354.46, I2 70%, 2 studies, low certainty). Conclusion Exposure to altitudes above 1500 m.a.s.l reduces autoregulation and cerebral oxygen saturation but increases overall cerebral blood flow. These changes could indicate cerebrovascular adaptations to lower oxygen pressures, although the evidence is of low certainty due to variability between studies.Conference abstracthttps://doi.org/10.1161/svin.04.suppl_1.066W4406394988enStroke Vascular and Interventional Neurology2694-57462024-11-01 |
| spellingShingle | high altitude cerebral blood flow cerebral autoregulation middle meningeal artery cerebral oxygen saturation cerebrovascular resistance cerebral venous oxygen saturation cerebral blood volume cerebral oxygen extraction fraction hypoxia high-altitude adaptation High Altitude and Hypoxia Cardiovascular and Diving-Related Complications Spaceflight effects on biology Julio A. Chirinos P. Zila-Velasque Pamela Grados‐Espinoza Sebastian Abanto-Urbano Mely Olarte-Durand Martha Isabel Vilca-Salas Paula Moran-Ballon Victor Velásquez‐Rimachi Kateriny Margot Regalado-Rodríguez Carlos Quispe‐Vicuña Fernando Terry Carlos Alva‐Díaz Abstract 066: Adaptive and physiological cerebrovascular changes at high altitudes: a systematic review and meta‐analysis |
| title | Abstract 066: Adaptive and physiological cerebrovascular changes at high altitudes: a systematic review and meta‐analysis |
| title_full | Abstract 066: Adaptive and physiological cerebrovascular changes at high altitudes: a systematic review and meta‐analysis |
| title_fullStr | Abstract 066: Adaptive and physiological cerebrovascular changes at high altitudes: a systematic review and meta‐analysis |
| title_full_unstemmed | Abstract 066: Adaptive and physiological cerebrovascular changes at high altitudes: a systematic review and meta‐analysis |
| title_short | Abstract 066: Adaptive and physiological cerebrovascular changes at high altitudes: a systematic review and meta‐analysis |
| title_sort | abstract 066 adaptive and physiological cerebrovascular changes at high altitudes a systematic review and meta analysis |
| topic | high altitude cerebral blood flow cerebral autoregulation middle meningeal artery cerebral oxygen saturation cerebrovascular resistance cerebral venous oxygen saturation cerebral blood volume cerebral oxygen extraction fraction hypoxia high-altitude adaptation High Altitude and Hypoxia Cardiovascular and Diving-Related Complications Spaceflight effects on biology |
| topic_facet | high altitude cerebral blood flow cerebral autoregulation middle meningeal artery cerebral oxygen saturation cerebrovascular resistance cerebral venous oxygen saturation cerebral blood volume cerebral oxygen extraction fraction hypoxia high-altitude adaptation High Altitude and Hypoxia Cardiovascular and Diving-Related Complications Spaceflight effects on biology |
| url | https://doi.org/10.1161/svin.04.suppl_1.066 |
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