Cerebral blood flow autoregulation in ischemic heart failure.
Am J Physiol Regul Integr Comp Physiol
; 312(1): R108-R113, 2017 01 01.
Article
in En
| MEDLINE
| ID: mdl-27927624
ABSTRACT
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.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cerebrovascular Circulation
/
Cerebrovascular Disorders
/
Myocardial Ischemia
/
Heart Failure
Type of study:
Observational_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Am J Physiol Regul Integr Comp Physiol
Journal subject:
FISIOLOGIA
Year:
2017
Document type:
Article
Affiliation country:
Brazil