Key result
Sodium nitroglycerin increased right middle cerebral artery cross-sectional area compared to placebo (6.6 vs 5.4 mm2; P<0.05) but did not change total cerebral blood flow.
Why the study?
Does sodium nitroglycerin alter right middle cerebral artery cross-sectional area, blood velocity, and overall blood flow in young, healthy adults?
RCT (n=10)
Does sodium nitroglycerin alter right middle cerebral artery cross-sectional area, blood velocity, and overall blood flow in young, healthy adults?
Absolute Event Rate: 6.6% vs 5.4%
p-value: p=<0.05
Exogenous nitric oxide via sodium nitroglycerin dilates the right middle cerebral artery but does not change overall cerebral blood flow due to a concurrent decrease in blood velocity.
Nitroglycerin may dilate cerebral arteries without changing total flow in healthy adults; hypothesis-generating for cerebrovascular regulation.
New Findings What is the central question of this study? Nitric oxide causes dilatation in peripheral vessels; however, whether nitric oxide affects basal cerebral artery dilatation has not been explored. What is the main finding and its importance? This study demonstrated that vasodilatation occurs in the right middle cerebral artery in response to exogenous nitric oxide. However, blood velocity decreased and, therefore, overall cerebral blood flow remained unchanged. This study provides new insight into the role of nitric oxide in cerebral blood flow control. Abstract Recent evidence indicates that basal cerebral conduit vessels dilate with hypercapnia, with a nitric oxide (NO) mechanism explaining one way in which parenchymal cerebral arterioles dilate. However, whether NO affects basal cerebral artery dilatation remains unknown. This study quantified the effect of an exogenous NO donor [sodium nitroglycerin (NTG); 0.4 mg sublingual spray] on the right middle cerebral artery (rMCA) cross‐sectional area (CSA), blood velocity and overall blood flow. Measures of vessel CSA (7 T magnetic resonance imaging) and MCA blood velocity (transcranial Doppler ultrasound) were made at baseline (BL) and after exogenous NTG or placebo (PLO) administration in young, healthy individuals ( n = 10, two males, age range 20–23 years). The CSA increased in the rMCA [BL, 5.2 ± 1.2 mm 2 ; PLO, 5.4 ± 1.5 mm 2 ; NTG, 6.6 ± 1.5 mm 2 , P < 0.05; mean ± SD]. Concurrently, rMCA blood velocity decreased from BL during NTG compared with PLO (BL, 67 ± 10 cm s −1 ; PLO, 62 ± 10 cm s −1 ; NTG, 59 ± 9.3 cm s −1 , P < 0.05; mean ± SD]. However, total MCA blood flow did not change with NTG or PLO [BL, 221 ± 37.4 ml min −1 ; PLO, 218 ± 35.0 ml min −1 ; NTG, 213 ± 46.4 ml min −1 ). Therefore, exogenous NO mediates a dilatory response in the rMCA, but not in its downstream vascular bed.
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Schulz et al. (2018) conducted an RCT in Healthy (n=10). Sodium nitroglycerin (NTG) vs. Placebo (PLO) was evaluated on Right middle cerebral artery (rMCA) cross-sectional area (CSA) (p=<0.05). Sodium nitroglycerin increased right middle cerebral artery cross-sectional area compared to placebo (6.6 vs 5.4 mm2; P<0.05) but did not change total cerebral blood flow.
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