Caldas JR CBF autoregulation heart failure R2 red lined version.pdf (400.88 kB)
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Cerebral blood flow autoregulation in ischemic heart failure

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journal contribution
posted on 09.04.2018, 15:00 by JR Caldas, Ronney Bernardes Panerai, VJ Haunton, JP Almeida, GSR Ferreira, L Camara, RC Nogueira, E Bor-Seng-Shu, ML Oliveira, RRV Groehs, L Ferreira-Santos, MJ Teixeira, FRBG Galas, TG Robinson, FB Jatene, LA Hajjar
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 CO2(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 CO2(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 <4, suggestive of impaired CA, was more common in iHF patients (28.8 vs. 7.4%, P = 0.004). These results confirm that iHF patients are more likely to have impaired dCA compared with age-matched controls. The relationship between impaired dCA and neurological complications in iHF patients deserves further investigation.

History

Citation

AJP - Regulatory, Integrative and Comparative Physiology, 312 (1), pp. R108-R113

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Cardiovascular Sciences

Version

AM (Accepted Manuscript)

Published in

AJP - Regulatory

Publisher

American Physiological Society

issn

0363-6119

eissn

1522-1490

Acceptance date

01/12/2016

Copyright date

2017

Available date

09/04/2018

Publisher version

https://www.physiology.org/doi/10.1152/ajpregu.00361.2016

Language

en