Cerebral blood flow autoregulation in ischemic heart failure

J. R. Caldas; R. B. Panerai; V. J. Haunton; J. P. Almeida; G. S.R. Ferreira; L. Camara; R. C. Nogueira; E. Bor-Seng-Shu; M. L. Oliveira; R. R.V. Groehs; L. Ferreira-Santos; M. J. Teixeira; F. R.B.G. Galas; T. G. Robinson; F. B. Jatene; L. A. Hajjar

doi:10.1152/ajpregu.00361.2016

Cerebral blood flow autoregulation in ischemic heart failure

J. R. Caldas, R. B. Panerai^*, V. J. Haunton, J. P. Almeida, G. S.R. Ferreira, L. Camara, R. C. Nogueira, E. Bor-Seng-Shu, M. L. Oliveira, R. R.V. Groehs, L. Ferreira-Santos, M. J. Teixeira, F. R.B.G. Galas, T. G. Robinson, F. B. Jatene, L. A. Hajjar

^*Corresponding author for this work

Peninsula Medical School

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Pages (from-to)	R108-R113
Number of pages	0
Journal	American Journal of Physiology-Regulatory, Integrative and Comparative Physiology
Volume	312
Issue number	1
DOIs	https://doi.org/10.1152/ajpregu.00361.2016
Publication status	Published - 1 Jan 2017

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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. (2017). Cerebral blood flow autoregulation in ischemic heart failure. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 312(1), R108-R113. https://doi.org/10.1152/ajpregu.00361.2016

@article{dee7df330469478da03a90cf65108141,

title = "Cerebral blood flow autoregulation in ischemic heart failure",

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. ",

author = "Caldas, {J. R.} and Panerai, {R. B.} and Haunton, {V. J.} and Almeida, {J. P.} and Ferreira, {G. S.R.} and L. Camara and Nogueira, {R. C.} and E. Bor-Seng-Shu and Oliveira, {M. L.} and Groehs, {R. R.V.} and L. Ferreira-Santos and Teixeira, {M. J.} and Galas, {F. R.B.G.} and Robinson, {T. G.} and Jatene, {F. B.} and Hajjar, {L. A.}",

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doi = "10.1152/ajpregu.00361.2016",

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Caldas, JR, Panerai, RB, Haunton, VJ, Almeida, JP, Ferreira, GSR, Camara, L, Nogueira, RC, Bor-Seng-Shu, E, Oliveira, ML, Groehs, RRV, Ferreira-Santos, L, Teixeira, MJ, Galas, FRBG, Robinson, TG, Jatene, FB & Hajjar, LA 2017, 'Cerebral blood flow autoregulation in ischemic heart failure', American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, vol. 312, no. 1, pp. R108-R113. https://doi.org/10.1152/ajpregu.00361.2016

TY - JOUR

T1 - Cerebral blood flow autoregulation in ischemic heart failure

AU - Caldas, J. R.

AU - Panerai, R. B.

AU - Haunton, V. J.

AU - Almeida, J. P.

AU - Ferreira, G. S.R.

AU - Camara, L.

AU - Nogueira, R. C.

AU - Bor-Seng-Shu, E.

AU - Oliveira, M. L.

AU - Groehs, R. R.V.

AU - Ferreira-Santos, L.

AU - Teixeira, M. J.

AU - Galas, F. R.B.G.

AU - Robinson, T. G.

AU - Jatene, F. B.

AU - Hajjar, L. A.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - 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.

AB - 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.

U2 - 10.1152/ajpregu.00361.2016

DO - 10.1152/ajpregu.00361.2016

M3 - Article

SN - 0363-6119

VL - 312

SP - R108-R113

JO - American Journal of Physiology-Regulatory, Integrative and Comparative Physiology

JF - American Journal of Physiology-Regulatory, Integrative and Comparative Physiology

IS - 1

ER -

Cerebral blood flow autoregulation in ischemic heart failure

Abstract

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