ArticleJournal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism2018
Transit time homogenization in ischemic stroke - A novel biomarker of penumbral microvascular failure?
Article in Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 44 citations in OpenAlex.
- Clinical benefit of tenecteplase despite failed recanalization in late-window ischemic stroke: a post hoc analysis of the TRACE-3 trial.BMC medicine · 2026Trial
- Two-way comparison of brain perfusion image processing software for patients with acute ischemic strokes in real-world.Neuroradiology · 2022Trial
- Article
- Haemorrhage, hypercoagulability and ischaemia: Evolution of brain injury after aneurysmal subarachnoid haemorrhage.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026Review
- Blood-Based Biomarkers for Post-Stroke Cognitive Impairment.Current issues in molecular biology · 2026Review
- Postresuscitation Cerebral Vasospasm and Capillary Failure After Experimental Asphyxial Cardiac Arrest.Journal of the American Heart Association · 2026Article
- Pulsatility index: Insights into post-stroke haemodynamics.Neuroscience insights · 2026Review
- Contralateral Neurovascular Coupling in Patients with Ischemic Stroke After Endovascular Thrombectomy.Neurocritical care · 2025Article
- Pericytes in the brain and heart: functional roles and response to ischaemia and reperfusion.Cardiovascular research · 2025Review
- Quantitative imaging outperforms No-reflow in predicting functional outcomes in a translational stroke model.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Article
- Exploring vascular contributions to cognitive impairment and dementia (ENIGMA): protocol for a prospective observational study.BMC neurology · 2024Article
- Differentiation of MS lesions through analysis of microvascular distribution.Imaging neuroscience (Cambridge, Mass.) · 2024Article
- Article
- Neurovascular Uncoupling Is Linked to Microcirculatory Dysfunction in Regions Outside the Ischemic Core Following Ischemic Stroke.Journal of the American Heart Association · 2023Article
- Preserving and enhancing mitochondrial function after stroke to protect and repair the neurovascular unit: novel opportunities for nanoparticle-based drug delivery.Frontiers in cellular neuroscience · 2023Review
- A Review on Adjunctive Therapies for Endovascular Treatment in Acute Ischemic Stroke.Journal of neuroendovascular therapy · 2023Review
- How can imaging in acute ischemic stroke help us to understand tissue fate in the era of endovascular treatment and cerebroprotection?Neuroradiology · 2022Article
- Metabolic MRI with hyperpolarized [1-Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2021Article
- Plasminogen deficiency causes reduced angiogenesis and behavioral recovery after stroke in mice.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2021Article
- MTT Heterogeneity in Perfusion CT Imaging as a Predictor of Outcome after Aneurysmal SAH.AJNR. American journal of neuroradiology · 2021Article
Corrections and comments
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Authors and funding
20 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Cerebral ischemia causes widespread capillary no-flow in animal studies. The extent of microvascular impairment in human stroke, however, is unclear. We examined how acute intra-voxel transit time characteristics and subsequent recanalization affect tissue outcome on follow-up MRI in a historic cohort of 126 acute ischemic stroke patients. Based on perfusion-weighted MRI data, we characterized voxel-wise transit times in terms of their mean transit time (MTT), standard deviation (capillary transit time heterogeneity - CTH), and the CTH:MTT ratio (relative transit time heterogeneity), which is expected to remain constant during changes in perfusion pressure in a microvasculature consisting of passive, compliant vessels. To aid data interpretation, we also developed a computational model that relates graded microvascular failure to changes in these parameters. In perfusion-diffusion mismatch tissue, prolonged mean transit time (>5 seconds) and very low cerebral blood flow (≤6 mL/100 mL/min) was associated with high risk of infarction, largely independent of recanalization status. In the remaining mismatch region, low relative transit time heterogeneity predicted subsequent infarction if recanalization was not achieved. Our model suggested that transit time homogenization represents capillary no-flow. Consistent with this notion, low relative transit time heterogeneity values were associated with lower cerebral blood volume. We speculate that low RTH may represent a novel biomarker of penumbral microvascular failure.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.