Details

Autor(en) / Beteiligte

• 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

Titel

Cerebral blood flow autoregulation in ischemic heart failure

Ist Teil von

• American journal of physiology. Regulatory, integrative and comparative physiology, 2017-01, Vol.312 (1), p.R108-R113

Ort / Verlag

United States

Erscheinungsjahr

2017

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• 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 <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.