Cerebral and myocardial blood flow responses to hypercapnia and hypoxia in humans

Abstract

In humans, cerebrovascular responses to alterations in arterial Pco2 and Po2 are well documented. However, few studies have investigated human coronary vascular responses to alterations in blood gases. This study investigated the extent to which the cerebral and coronary vasculatures differ in their responses to euoxic hypercapnia and isocapnic hypoxia in healthy volunteers. Participants ( n = 15) were tested at rest on two occasions. On the first visit, middle cerebral artery blood velocity ( V̄P) was assessed using transcranial Doppler ultrasound. On the second visit, coronary sinus blood flow (CSBF) was measured using cardiac MRI. For comparison with V̄P, CSBF was normalized to the rate pressure product [an index of myocardial oxygen consumption; normalized (n)CSBF]. Both testing sessions began with 5 min of euoxic [end-tidal Po2 (PetO2) = 88 Torr] isocapnia [end-tidal Pco2 (PetCO2) = +1 Torr above resting values]. PetO2 was next held at 88 Torr, and PetCO2 was increased to 40 and 45 Torr in 5-min increments. Participants were then returned to euoxic isocapnia for 5 min, after which PetO2 was decreased from 88 to 60, 52 and 45 Torr in 5-min decrements. Changes in V̄P and nCSBF were normalized to isocapnic euoxic conditions and indexed against PetCO2 and arterial oxyhemoglobin saturation. The V̄P gain for euoxic hypercapnia (%/Torr) was significantly higher than nCSBF ( P = 0.030). Conversely, the V̄P gain for isocapnic hypoxia (%/%desaturation) was not different from nCSBF ( P = 0.518). These findings demonstrate, compared with coronary circulation, that the cerebral circulation is more sensitive to hypercapnia but similarly sensitive to hypoxia.