Key result
Supine posture is strongly linked to lower aortic-cerebral transfer and reduced cerebral pulsatility via increased stroke volume.
Why the study?
Stroke volume is greater in the supine than upright posture, yet aortic-to-cerebral pulsatile transmission characteristics under these conditions remain unclear.
Does supine posture reduce aortic-cerebral pulsatile transmission in healthy young adults?
Observational (n=15)
Randomized order
No
Does supine posture reduce aortic-cerebral pulsatile transmission in healthy young adults?
Effect estimate: r -0.62 (95% CI -0.77 to -0.40)
p-value: p=<0.01
In healthy young adults, cerebral pulsatility does not increase despite greater stroke volume in supine postures due to attenuated aortic-cerebral pulsatile transmission associated with decreased systemic vascular resistance.
Reassures clinicians on cerebral pulsatility with supine posture in young adults; extends SV-transfer function research and leaves open relevance in disease.
Excessive pulsatile hemodynamics increased under higher stroke volume (SV) impose mechanical stress on the cerebrovasculature, requiring attenuation before reaching the brain. SV is greater in the supine than upright, yet the characteristics of aortic-to-cerebral pulsatile transmission under such conditions are unclear. To address this, we compared the transfer function gain from aortic pressure (AoP) to middle cerebral artery blood velocity (MCAv, measured by transcranial Doppler) across postures that altered SV. Fifteen young adults underwent four postures: semi-sitting at 60° and 30° backrest, supine, and supine with leg elevation. AoP was estimated from the radial arterial pressure through the general transfer function. AoP and MCAv spectra were analyzed by heart rate harmonic analysis to exclude the effect of postural difference in heart rate. SV (via the Modelflow method) was significantly greater in the supine than in the semi-recumbent positions (60° vs. supine, P < 0.05 for both). There was a significant difference in AoP spectra among postures (main effect of condition, P < 0.01). However, transfer function gain was significantly attenuated in the supine positions (60° vs. supine positions P < 0.05 for both), resulting in no significant increase in MCAv spectra across postures (main effect of condition P > 0.05). Transfer function gain decreased with decreasing systemic vascular resistance (r(rm) = 0.67, P < 0.01). Therefore, cerebral pulsatility may not increase despite greater SV, owing to an attenuation in aortic–cerebral pulsatile transmission associated with changes in systemic vascular resistance in healthy young adults.
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Sakamoto et al. (2026) conducted an observational in Healthy (n=15). Supine posture (0° backrest and with leg elevation) vs. Semi-sitting posture (60° and 30° backrest) was evaluated on Transfer function gain between aortic pressure and middle cerebral artery blood velocity (r -0.62, 95% CI -0.77 to -0.40, p=<0.01). Supine posture-related increases in stroke volume significantly attenuated aortic-cerebral transfer function gain (r = -0.62), preventing increased cerebral pulsatility in healthy young adults.
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