Acute-stage MRI cerebral oxygen consumption biomarkers predict 24-hour neurological outcome in a rat cardiac arrest model.,NMR in Biomedicine

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Acute-stage MRI cerebral oxygen consumption biomarkers predict 24-hour neurological outcome in a rat cardiac arrest model.
NMR in Biomedicine ( IF 2.7 ) Pub Date : 2020-07-14 , DOI: 10.1002/nbm.4377
Zhiliang Wei _{1,

2} , Qihong Wang _{3,

4} , Hiren R Modi ₃ , Sung-Min Cho ₅ , Romergryko Geocadin ₅ , Nitish V Thakor ₃ , Hanzhang Lu _{1,

2,

3}

Affiliation

Brain injury following cardiac arrest (CA) is thought to be caused by a sudden loss of blood flow resulting in disruption in oxygen delivery, neural function and metabolism. However, temporal trajectories of the brain's physiology in the first few hours following CA have not been fully characterized. Furthermore, the extent to which these early measures can predict future neurological outcomes has not been determined. The present study sought to perform dynamic measurements of cerebral blood flow (CBF), oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO₂) with MRI in the first 3 hours following the return of spontaneous circulation (ROSC) in a rat CA model. It was found that CBF, OEF and CMRO₂ all revealed a time‐dependent increase during the first 3 hours after the ROSC. Furthermore, the temporal trajectories of CBF and CMRO₂, but not OEF, were different across rats and related to neurologic outcomes at a later time (24 hours after the ROSC) (P < .001). Rats who manifested better outcomes revealed faster increases in CBF and CMRO₂ during the acute stage. When investigating physiological parameters measured at a single time point, CBF (ρ = 0.82, P = .004) and CMRO₂ (ρ = 0.80, P = .006) measured at ~ 3 hours post‐ROSC were positively associated with neurologic outcome scores at 24 hours. These findings shed light on brain physiological changes following CA, and suggest that MRI measures of brain perfusion and metabolism may provide a potential biomarker to guide post‐CA management.

中文翻译：

急性期 MRI 脑耗氧量生物标志物可预测大鼠心脏骤停模型的 24 小时神经学结果。

心脏骤停 (CA) 后的脑损伤被认为是由血流突然减少导致氧气输送、神经功能和新陈代谢中断引起的。然而，在 CA 后的最初几个小时内，大脑生理学的时间轨迹尚未完全表征。此外，这些早期测量可以预测未来神经系统结果的程度尚未确定。本研究试图在自主循环 (ROSC) 恢复后的前 3 小时内通过 MRI动态测量脑血流量 (CBF)、氧提取分数 (OEF) 和脑氧代谢率 (CMRO ₂ )。大鼠 CA 模型。发现 CBF、OEF 和 CMRO ₂在 ROSC 后的前 3 小时内，所有这些都显示出时间依赖性增加。此外，CBF 和 CMRO ₂的时间轨迹（而非 OEF）在大鼠之间不同，并且与稍后（ROSC 后 24 小时）的神经系统结果相关（P < .001）。表现出更好结果的大鼠在急性期显示 CBF 和 CMRO ₂增加更快。在调查单个时间点测量的生理参数时，CBF (ρ = 0.82, P = .004) 和 CMRO ₂ (ρ = 0.80, P= .006) 在 ROSC 后约 3 小时测量，与 24 小时的神经系统结果评分呈正相关。这些发现揭示了 CA 后大脑的生理变化，并表明脑灌注和代谢的 MRI 测量可能为指导 CA 后管理提供潜在的生物标志物。

更新日期：2020-07-14

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