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Acute‐stage MRI cerebral oxygen consumption biomarkers predict 24‐hour neurological outcome in a rat cardiac arrest model
Author(s) -
Wei Zhiliang,
Wang Qihong,
Modi Hiren R.,
Cho SungMin,
Geocadin Romergryko,
Thakor Nitish V.,
Lu Hanzhang
Publication year - 2020
Publication title -
nmr in biomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.278
H-Index - 114
eISSN - 1099-1492
pISSN - 0952-3480
DOI - 10.1002/nbm.4377
Subject(s) - cerebral blood flow , medicine , return of spontaneous circulation , perfusion , stage (stratigraphy) , cardiology , biomarker , anesthesia , cerebral perfusion pressure , resuscitation , chemistry , biology , cardiopulmonary resuscitation , paleontology , biochemistry
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 (CMRO 2 ) 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 CMRO 2 all revealed a time‐dependent increase during the first 3 hours after the ROSC. Furthermore, the temporal trajectories of CBF and CMRO 2 , 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 CMRO 2 during the acute stage. When investigating physiological parameters measured at a single time point, CBF (ρ = 0.82, P = .004) and CMRO 2 (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.