Cerebral vascular shunting and oxygen metabolism in sickle cell disease
Abstract: Patients with sickle cell disease (SCD) are at elevated risk of silent cerebral infarcts and strokes; however, they frequently lack established stroke risk factors (eg, macrovascular arterial steno-occlusion) and the mechanisms underlying such events are incompletely characterized. This st...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | Blood Advances |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2473952924006566 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832595754084990976 |
|---|---|
| author | Alexander K. Song Wesley T. Richerson Megan A. Aumann Spencer L. Waddle R. Sky Jones Samantha Davis Lauren Milner Chelsea Custer L. Taylor Davis Sumit Pruthi Dann Martin Lori C. Jordan Manus J. Donahue |
| author_facet | Alexander K. Song Wesley T. Richerson Megan A. Aumann Spencer L. Waddle R. Sky Jones Samantha Davis Lauren Milner Chelsea Custer L. Taylor Davis Sumit Pruthi Dann Martin Lori C. Jordan Manus J. Donahue |
| author_sort | Alexander K. Song |
| collection | DOAJ |
| description | Abstract: Patients with sickle cell disease (SCD) are at elevated risk of silent cerebral infarcts and strokes; however, they frequently lack established stroke risk factors (eg, macrovascular arterial steno-occlusion) and the mechanisms underlying such events are incompletely characterized. This study evaluated cerebral hemometabolism with respect to imaging markers of vascular shunting in 143 participants with SCD, including 73 pediatric (aged 6-17 years) and 70 adult (aged 18-40 years) participants using 3-Tesla brain magnetic resonance imaging (MRI). Vascular shunting was assessed in each patient using a previously published ordinal venous hyperintensity score (VHS) of 0, 1, or 2 on cerebral blood flow-weighted MRI. Participants with VHS of 2, indicative of the most rapid arteriovenous transit, had significantly reduced blood oxygen content (CaO2; 10.90 ± 1.69 mL O2/100 mL blood), oxygen extraction fraction (OEF; 33.52% ± 5.54%), and cerebral metabolic rate of oxygen consumption (CMRO2; 2.91 ± 0.69 mL O2/100 g tissue per minute) compared with their counterparts with VHS = 0 (CaO2 = 12.42 ± 1.58 mL O2/100 mL blood; OEF = 39.03% ± 3.80%; CMRO2 = 3.77 ± 0.84 mL O2/100 g tissue per minute) or VHS = 1 (CaO2 = 11.86 ± 1.73 mL O2/100 mL blood; OEF = 36.37% ± 5.11%; CMRO2 = 3.59 ± 0.78 mL O2/100 g tissue per minute). Both pediatric and adult patients with SCD presenting with greater imaging evidence of vascular shunting had mildly reduced OEF and CMRO2. These findings highlight that imaging markers of vascular shunting are associated with significant, albeit mild, evidence of reduced OEF and CMRO2 in patients with SCD. |
| format | Article |
| id | doaj-art-58982659a14d41efa9fbf2eab1d244a2 |
| institution | Kabale University |
| issn | 2473-9529 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Blood Advances |
| spelling | doaj-art-58982659a14d41efa9fbf2eab1d244a22025-01-18T05:04:59ZengElsevierBlood Advances2473-95292025-01-0192386397Cerebral vascular shunting and oxygen metabolism in sickle cell diseaseAlexander K. Song0Wesley T. Richerson1Megan A. Aumann2Spencer L. Waddle3R. Sky Jones4Samantha Davis5Lauren Milner6Chelsea Custer7L. Taylor Davis8Sumit Pruthi9Dann Martin10Lori C. Jordan11Manus J. Donahue12Department of Neurology, Vanderbilt University Medical Center, Nashville, TN; Vanderbilt Brain Institute, Vanderbilt University, Nashville, TNDepartment of Neurology, Vanderbilt University Medical Center, Nashville, TNDepartment of Neurology, Vanderbilt University Medical Center, Nashville, TNDepartment of Neurology, Vanderbilt University Medical Center, Nashville, TNDepartment of Neurology, Vanderbilt University Medical Center, Nashville, TN; Division of Pediatric Neurology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TNDivision of Pediatric Neurology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TNDivision of Pediatric Neurology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TNDepartment of Neurology, Vanderbilt University Medical Center, Nashville, TN; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TNDepartment of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TNDepartment of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TNDepartment of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TNDepartment of Neurology, Vanderbilt University Medical Center, Nashville, TN; Division of Pediatric Neurology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TNDepartment of Neurology, Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN; Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN; Correspondence: Manus J. Donahue, Behavioral and Cognitive Neurology, Vanderbilt University Medical Center, 1500 21st Ave South Village at Vanderbilt, Suite 2600, Nashville, TN 37212;Abstract: Patients with sickle cell disease (SCD) are at elevated risk of silent cerebral infarcts and strokes; however, they frequently lack established stroke risk factors (eg, macrovascular arterial steno-occlusion) and the mechanisms underlying such events are incompletely characterized. This study evaluated cerebral hemometabolism with respect to imaging markers of vascular shunting in 143 participants with SCD, including 73 pediatric (aged 6-17 years) and 70 adult (aged 18-40 years) participants using 3-Tesla brain magnetic resonance imaging (MRI). Vascular shunting was assessed in each patient using a previously published ordinal venous hyperintensity score (VHS) of 0, 1, or 2 on cerebral blood flow-weighted MRI. Participants with VHS of 2, indicative of the most rapid arteriovenous transit, had significantly reduced blood oxygen content (CaO2; 10.90 ± 1.69 mL O2/100 mL blood), oxygen extraction fraction (OEF; 33.52% ± 5.54%), and cerebral metabolic rate of oxygen consumption (CMRO2; 2.91 ± 0.69 mL O2/100 g tissue per minute) compared with their counterparts with VHS = 0 (CaO2 = 12.42 ± 1.58 mL O2/100 mL blood; OEF = 39.03% ± 3.80%; CMRO2 = 3.77 ± 0.84 mL O2/100 g tissue per minute) or VHS = 1 (CaO2 = 11.86 ± 1.73 mL O2/100 mL blood; OEF = 36.37% ± 5.11%; CMRO2 = 3.59 ± 0.78 mL O2/100 g tissue per minute). Both pediatric and adult patients with SCD presenting with greater imaging evidence of vascular shunting had mildly reduced OEF and CMRO2. These findings highlight that imaging markers of vascular shunting are associated with significant, albeit mild, evidence of reduced OEF and CMRO2 in patients with SCD.http://www.sciencedirect.com/science/article/pii/S2473952924006566 |
| spellingShingle | Alexander K. Song Wesley T. Richerson Megan A. Aumann Spencer L. Waddle R. Sky Jones Samantha Davis Lauren Milner Chelsea Custer L. Taylor Davis Sumit Pruthi Dann Martin Lori C. Jordan Manus J. Donahue Cerebral vascular shunting and oxygen metabolism in sickle cell disease Blood Advances |
| title | Cerebral vascular shunting and oxygen metabolism in sickle cell disease |
| title_full | Cerebral vascular shunting and oxygen metabolism in sickle cell disease |
| title_fullStr | Cerebral vascular shunting and oxygen metabolism in sickle cell disease |
| title_full_unstemmed | Cerebral vascular shunting and oxygen metabolism in sickle cell disease |
| title_short | Cerebral vascular shunting and oxygen metabolism in sickle cell disease |
| title_sort | cerebral vascular shunting and oxygen metabolism in sickle cell disease |
| url | http://www.sciencedirect.com/science/article/pii/S2473952924006566 |
| work_keys_str_mv | AT alexanderksong cerebralvascularshuntingandoxygenmetabolisminsicklecelldisease AT wesleytricherson cerebralvascularshuntingandoxygenmetabolisminsicklecelldisease AT meganaaumann cerebralvascularshuntingandoxygenmetabolisminsicklecelldisease AT spencerlwaddle cerebralvascularshuntingandoxygenmetabolisminsicklecelldisease AT rskyjones cerebralvascularshuntingandoxygenmetabolisminsicklecelldisease AT samanthadavis cerebralvascularshuntingandoxygenmetabolisminsicklecelldisease AT laurenmilner cerebralvascularshuntingandoxygenmetabolisminsicklecelldisease AT chelseacuster cerebralvascularshuntingandoxygenmetabolisminsicklecelldisease AT ltaylordavis cerebralvascularshuntingandoxygenmetabolisminsicklecelldisease AT sumitpruthi cerebralvascularshuntingandoxygenmetabolisminsicklecelldisease AT dannmartin cerebralvascularshuntingandoxygenmetabolisminsicklecelldisease AT loricjordan cerebralvascularshuntingandoxygenmetabolisminsicklecelldisease AT manusjdonahue cerebralvascularshuntingandoxygenmetabolisminsicklecelldisease |