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A Breath‐Holding Index Applied to the Internal Carotid Artery Siphon in Transcranial Doppler Studies
Author(s) -
Jung KyuOn,
Lee SeungJae,
Lee TaeKyeong
Publication year - 2020
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12752
Subject(s) - medicine , internal carotid artery , intraclass correlation , transcranial doppler , middle cerebral artery , brain heart infusion , stenosis , reproducibility , cardiology , clinical psychology , statistics , mathematics , ischemia , psychometrics , biology , bacteria , agar , genetics
BACKGROUND AND PURPOSE The breath‐holding index (BHI) is a useful method to assess cerebrovascular reactivity. It is calculated based on the mean flow velocities of the middle cerebral artery (MCA) using transcranial Doppler (BHI MCA ). Therefore, it is not feasible in patients with poor temporal windows. This study tested the feasibility of a BHI using the internal carotid artery (ICA) siphon flow velocity (BHI ICA ). METHODS Twenty‐four patients (aged 38‐79 years) with unilateral or bilateral stenosis of the cervical ICAs were prospectively recruited. The 48 examined bilateral ICAs were divided into three groups according to the stenosis degree: <50%, 50‐99%, and occlusion. We investigated the reproducibility of both BHI methods (BHI MCA and BHI ICA ), the correlation between the two BHI methods, and the tendency for the BHIs to decrease with increasing degree of cervical ICA stenosis. RESULTS For the BHI MCA , we found a good reproducibility (intraclass correlation coefficient, r I > .9 ) and a significantly decreased BHI with increasing stenosis of the ICA ( P = .001). For the BHI ICA , good reproducibility was demonstrated ( r I > or ≒ .9), but there was no significant decrease in the BHI related to the increasing degree of ICA stenosis ( P = .952). Furthermore, the correlation between the two BHI methods was not robust (kappa coefficient, right .259; left .619). CONCLUSIONS Our study suggests that the BHI ICA is not a feasible alternative method to the BHI MCA.