Relationship of cerebral blood flow to cardiac output, mean arterial pressure, blood volume, and alpha and beta blockade in cats

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✓ The relationship among cerebral blood flow (CBF), blood volume, cardiac output (CO), and mean arterial blood pressure (MABP) at varying levels of arterial CO2 tensions (PaCO2) were studied in 70 normal cats. The CBF was measured from the clearance curve of xenon−133 and CO with a thermal dilution catheter placed in the pulmonary artery. The CBF, CO, and MABP values varied appropriately with changes in PaCO2, confirming the reliability of the preparations and the presence of normal autoregulatory responses. Moderate hypovolemia that did not change MABP did, nevertheless, significantly decrease CO and CBF. In an effort to determine if this decrease in CO and CBF were coupled responses, the effects of beta stimulation, hypervolemia, and alpha and beta blockade were investigated. Propranolol, in a dosage insufficient to change MABP, decreased both CO and CBF. This agent abolished the CO response to elevations in PaCO2 but not the CBF response, making it unlikely that this CBF reduction resulted from impaired cerebral autoregulation. Isoproterenol, which, in contrast to propranolol, does not cross the normal blood-brain barrier, alone or in combination with phenoxybenzamine, produced a 38% and 72% increase in CO, respectively, without a change in CBF. Alpha blockade (no major change in CO) and beta blockade (major decrease in CO) did not significantly effect cerebral autoregulation to changes in MABP from angiotensin. The ability of the brain to resist increases in MABP and CO and maintain normal CBF is explained by normal cerebral autoregulation. However, its vulnerability to modest decreases in blood volume, which cannot be attributed to variations in perfusion pressure, is unexplained but obviously has important therapeutic implications. This may be related to reduction in CO, changes in autonomic activity, or a decrease in the size of the perfused capillary bed.

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    Cerebral blood flow (CBF), cardiac output (CO), and mean arterial blood pressure (MABP) art compared at varying levels of PaCO2 in four groups of 10 animals each, in which CO was altered by hypovolemia, propranolol, and isoproterenol alone, or hypervolemia, isoproterenol, and phenoxybenzamine combined. Cerebral chemical autoregulation was preserved in all four groups, but CO reactivity to variations in PaCO2 was altered by beta blockade and by beta stimulation. The CBF was decreased by propranolol and hypovolemia yet remained unchanged with increased CO following the administration of isoproterenol. Alpha blockade produced changes primarily through a reduction in MABP. Values are mean ± SE. Tables of data are available from authors upon request.

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    The normal PaCO2-cerebral blood flow (CBF) response curve shown from the control periods in the four groups of Fig. 1. Note the very steep slope a graphed curve should have between a PaCO2 of 35 and 55 torr. Square = pre-propranolol levels; cross = pre-hypovolemia levels; circle = pre-isoproterenol levels; and triangle = pre-phenoxybenzamine-hypervolemia-isoproterenol levels.

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    The effects of alpha and beta blockade on autoregulation of cerebral blood flow (CBF) to changes in mean arterial blood pressure (MABP) produced by the infusion of angiotensin. There were 10 animals in each of the three groups studied. Alpha and beta blockade did not appear to appreciably alter the autoregulatory response.

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