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(Stroke. 2000;31:508.)
© 2000 American Heart Association, Inc.

Original Contributions

Is the Acetazolamide Test Valid for Quantitative Assessment of Maximal Cerebral Autoregulatory Vasodilation?

An Experimental Study

Pierre Démolis, MD, PhD; Geneviève Florence, DVM, PhD; Lionel Thomas, MS; Yves Roger Tran Dinh, MD, PhD; Jean-François Giudicelli, MD, PhD Jacques Seylaz, PhD

From the Service de Pharmacologie Clinique, Hôpital de Bicêtre (AP-HP), Le Kremlin Bicetre (P.D.); Institut de Médecine Aérospatiale du Service de Santé des Armées, Département de Physiologie Aérospatiale, Bretigny (G.F., L.T.); Unité de Recherches Cérébrovasculaires, Centre National de la Recherche Scientifique (UPR 646), Faculté de Médecine Villemin, UFR Lariboisière-Saint Louis, Paris VII, Paris (Y.R.T.D., J.S.); and Département de Pharmacologie, Faculté de Médecine Paris Sud Université Paris XI, Le Kremlin Bicetre (J-F.G.), France.

Correspondence to Pierre Démolis, MD, PhD, Service de Pharmacologie Clinique, Hôpital de Bicêtre, 78 rue du Général Leclerc, 94275 Le Kremlin Bicetre Cédex, France.

Background and Purpose—The cerebral vasodilating effect of acetazolamide (ACZ) injection has been used as an index of the autoregulatory vasodilation (or cerebral perfusion reserve). The question of whether the ACZ test assesses the maximal autoregulatory vasodilating capacity is not definitely resolved. The effects of ACZ injection on this reserve at a dose producing maximal vasodilation have never been evaluated and may help to resolve this problem.

Methods—The effect of ACZ injection on cerebral blood flow (CBF) autoregulation was tested in anesthetized rats. A pilot experiment evaluated the dose-effect relationship of injected ACZ, cumulative doses (n=4, group 1), and independent bolus doses (n=6, group 2). CBF was estimated by laser-Doppler flowmetry, and cerebrovascular resistance (CVR) was calculated from mean arterial blood pressure (MABP) and from CBF (expressed as a percentage of baseline CBF). A bolus of ACZ of 21 mg/kg produced the maximal cerebral vasodilation that could be obtained by ACZ administration. In the main experiment, MABP was lowered from 110 to 20 mm Hg by stepwise bleeding in 3 groups of 6 animals treated 10 minutes before bleeding by injection of saline (group 3), 7 mg/kg ACZ (group 4), or 21 mg/kg ACZ (group 5).

Results—The CVR-MABP relationship was linear in all groups, indicating that CBF autoregulation was still effective after ACZ administration.

Conclusions—These results indicate that maximal ACZ-induced cerebral vasodilation is not quantitatively equivalent to maximal autoregulatory vasodilating capacity in anesthetized rats.

Editorial Comment

An Experimental Study

Nabil J. Alkayed, MD, PhD, Guest Editor

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland,

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