Cerebral blood flow autoregulation in ischemic heart failure

Patients with ischemic heart failure (iHF) have a high risk of neurological complications such as cognitive impairment and stroke. We hypothesized that iHF patients have a higher incidence of impaired dynamic cerebral autoregulation (dCA). Adult patients with iHF and healthy volunteers were included...

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Published in:American journal of physiology. Regulatory, integrative and comparative physiology integrative and comparative physiology, 2017-01, Vol.312 (1), p.R108-R113
Main Authors: Caldas, J R, Panerai, R B, Haunton, V J, Almeida, J P, Ferreira, G S R, Camara, L, Nogueira, R C, Bor-Seng-Shu, E, Oliveira, M L, Groehs, R R V, Ferreira-Santos, L, Teixeira, M J, Galas, F R B G, Robinson, T G, Jatene, F B, Hajjar, L A
Format: Article
Language:English
Subjects:
Blood Flow Velocity
Cerebrovascular Circulation
Cerebrovascular Disorders - etiology
Cerebrovascular Disorders - physiopathology
Female
Heart Failure - complications
Heart Failure - physiopathology
Homeostasis
Humans
Male
Middle Aged
Myocardial Ischemia - complications
Myocardial Ischemia - physiopathology
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Summary:Patients with ischemic heart failure (iHF) have a high risk of neurological complications such as cognitive impairment and stroke. We hypothesized that iHF patients have a higher incidence of impaired dynamic cerebral autoregulation (dCA). Adult patients with iHF and healthy volunteers were included. Cerebral blood flow velocity (CBFV, transcranial Doppler, middle cerebral artery), end-tidal CO (capnography), and arterial blood pressure (Finometer) were continuously recorded supine for 5 min at rest. Autoregulation index (ARI) was estimated from the CBFV step response derived by transfer function analysis using standard template curves. Fifty-two iHF patients and 54 age-, gender-, and BP-matched healthy volunteers were studied. Echocardiogram ejection fraction was 40 (20-45) % in iHF group. iHF patients compared with control subjects had reduced end-tidal CO (34.1 ± 3.7 vs. 38.3 ± 4.0 mmHg, P < 0.001) and lower ARI values (5.1 ± 1.6 vs. 5.9 ± 1.0, P = 0.012). ARI
ISSN:0363-6119
1522-1490
DOI:10.1152/ajpregu.00361.2016