Cargando…
Internal carotid artery blood flow and pulsatility index in cognitively impaired people with chronic heart failure
AIMS: Mild cognitive impairment and dementia are common and serious co‐morbidities in people with chronic heart failure (HF) as they increase hospitalization rates, mortality and health care costs. Upon other factors, dysregulated cerebral perfusion might contribute to brain pathology. We aimed to e...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10567624/ https://www.ncbi.nlm.nih.gov/pubmed/37401264 http://dx.doi.org/10.1002/ehf2.14462 |
_version_ | 1785119169497268224 |
---|---|
author | Traub, Jan Schließer, Mira Morbach, Caroline Frantz, Stefan Pham, Mirko Störk, Stefan Stoll, Guido Frey, Anna Neugebauer, Hermann |
author_facet | Traub, Jan Schließer, Mira Morbach, Caroline Frantz, Stefan Pham, Mirko Störk, Stefan Stoll, Guido Frey, Anna Neugebauer, Hermann |
author_sort | Traub, Jan |
collection | PubMed |
description | AIMS: Mild cognitive impairment and dementia are common and serious co‐morbidities in people with chronic heart failure (HF) as they increase hospitalization rates, mortality and health care costs. Upon other factors, dysregulated cerebral perfusion might contribute to brain pathology. We aimed to evaluate the association of non‐invasively measured blood flow (BF) and pulsatility index (PI) of the internal carotid artery (ICA) with (i) chronic HF parameters, (ii) brain morphologic measures and (iii) cognitive impairment. METHODS AND RESULTS: This post‐hoc analysis of the observational, prospective Cognition.Matters‐HF study included 107 chronic HF patients without atrial fibrillation or carotid artery stenosis (aged 63 ± 10 years; 19% women). Using extracranial sonography, we measured ICA‐BF and ICA‐PI 1.5 cm distal of the carotid bifurcation. Brain magnetic resonance imaging was performed on a 3‐Tesla scanner to quantify cerebral atrophy, hippocampal atrophy and white matter hyperintensities. Extensive neuropsychological testing tested the cognitive domains intensity of attention, visual/verbal memory and executive function (including its subdomains selectivity of attention, visual/verbal fluency and working memory) using a comprehensive test battery. (i) Neither ICA‐BF (median 630 (quartiles 570, 700) mL/min) nor ICA‐PI (1.05 (0.96. 1.23)) related to left ventricular ejection fraction, left atrial volume index or NT‐proBNP. (ii) Higher ICA‐PI (r = 0.25; P = 0.011), but not ICA‐BF (r = 0.08; P = 0.409), associated with increased volume of white matter hyperintensities beyond ageing, while neither ICA‐PI nor ICA‐BF related to cerebral or hippocampal atrophy indices. (iii) ICA‐BF, but not ICA‐PI, positively correlated with age‐adjusted T‐scores of executive function (r = 0.38; P < 0.001) and its subdomains working memory (r = 0.32; P < 0.001) and visual/verbal fluency (r = 0.32; P < 0.001). In a multivariate linear model of executive function, only ICA‐BF (T = 3.79; P < 0.001), but not HF or magnetic resonance imaging parameters, remained a significant correlate of executive function. CONCLUSIONS: ICA‐BF and ICA‐PI, measured in broadly available extracranial sonography, independently related to measures of functional and structural brain changes in people with chronic HF, respectively. Due to limitations of this cross‐sectional approach without a healthy control group, larger controlled longitudinal studies are needed to further elucidate the role of ICA‐BF dysregulation and its implication for clinical care in this vulnerable cohort. |
format | Online Article Text |
id | pubmed-10567624 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-105676242023-10-13 Internal carotid artery blood flow and pulsatility index in cognitively impaired people with chronic heart failure Traub, Jan Schließer, Mira Morbach, Caroline Frantz, Stefan Pham, Mirko Störk, Stefan Stoll, Guido Frey, Anna Neugebauer, Hermann ESC Heart Fail Short Communications AIMS: Mild cognitive impairment and dementia are common and serious co‐morbidities in people with chronic heart failure (HF) as they increase hospitalization rates, mortality and health care costs. Upon other factors, dysregulated cerebral perfusion might contribute to brain pathology. We aimed to evaluate the association of non‐invasively measured blood flow (BF) and pulsatility index (PI) of the internal carotid artery (ICA) with (i) chronic HF parameters, (ii) brain morphologic measures and (iii) cognitive impairment. METHODS AND RESULTS: This post‐hoc analysis of the observational, prospective Cognition.Matters‐HF study included 107 chronic HF patients without atrial fibrillation or carotid artery stenosis (aged 63 ± 10 years; 19% women). Using extracranial sonography, we measured ICA‐BF and ICA‐PI 1.5 cm distal of the carotid bifurcation. Brain magnetic resonance imaging was performed on a 3‐Tesla scanner to quantify cerebral atrophy, hippocampal atrophy and white matter hyperintensities. Extensive neuropsychological testing tested the cognitive domains intensity of attention, visual/verbal memory and executive function (including its subdomains selectivity of attention, visual/verbal fluency and working memory) using a comprehensive test battery. (i) Neither ICA‐BF (median 630 (quartiles 570, 700) mL/min) nor ICA‐PI (1.05 (0.96. 1.23)) related to left ventricular ejection fraction, left atrial volume index or NT‐proBNP. (ii) Higher ICA‐PI (r = 0.25; P = 0.011), but not ICA‐BF (r = 0.08; P = 0.409), associated with increased volume of white matter hyperintensities beyond ageing, while neither ICA‐PI nor ICA‐BF related to cerebral or hippocampal atrophy indices. (iii) ICA‐BF, but not ICA‐PI, positively correlated with age‐adjusted T‐scores of executive function (r = 0.38; P < 0.001) and its subdomains working memory (r = 0.32; P < 0.001) and visual/verbal fluency (r = 0.32; P < 0.001). In a multivariate linear model of executive function, only ICA‐BF (T = 3.79; P < 0.001), but not HF or magnetic resonance imaging parameters, remained a significant correlate of executive function. CONCLUSIONS: ICA‐BF and ICA‐PI, measured in broadly available extracranial sonography, independently related to measures of functional and structural brain changes in people with chronic HF, respectively. Due to limitations of this cross‐sectional approach without a healthy control group, larger controlled longitudinal studies are needed to further elucidate the role of ICA‐BF dysregulation and its implication for clinical care in this vulnerable cohort. John Wiley and Sons Inc. 2023-07-04 /pmc/articles/PMC10567624/ /pubmed/37401264 http://dx.doi.org/10.1002/ehf2.14462 Text en © 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Short Communications Traub, Jan Schließer, Mira Morbach, Caroline Frantz, Stefan Pham, Mirko Störk, Stefan Stoll, Guido Frey, Anna Neugebauer, Hermann Internal carotid artery blood flow and pulsatility index in cognitively impaired people with chronic heart failure |
title | Internal carotid artery blood flow and pulsatility index in cognitively impaired people with chronic heart failure |
title_full | Internal carotid artery blood flow and pulsatility index in cognitively impaired people with chronic heart failure |
title_fullStr | Internal carotid artery blood flow and pulsatility index in cognitively impaired people with chronic heart failure |
title_full_unstemmed | Internal carotid artery blood flow and pulsatility index in cognitively impaired people with chronic heart failure |
title_short | Internal carotid artery blood flow and pulsatility index in cognitively impaired people with chronic heart failure |
title_sort | internal carotid artery blood flow and pulsatility index in cognitively impaired people with chronic heart failure |
topic | Short Communications |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10567624/ https://www.ncbi.nlm.nih.gov/pubmed/37401264 http://dx.doi.org/10.1002/ehf2.14462 |
work_keys_str_mv | AT traubjan internalcarotidarterybloodflowandpulsatilityindexincognitivelyimpairedpeoplewithchronicheartfailure AT schließermira internalcarotidarterybloodflowandpulsatilityindexincognitivelyimpairedpeoplewithchronicheartfailure AT morbachcaroline internalcarotidarterybloodflowandpulsatilityindexincognitivelyimpairedpeoplewithchronicheartfailure AT frantzstefan internalcarotidarterybloodflowandpulsatilityindexincognitivelyimpairedpeoplewithchronicheartfailure AT phammirko internalcarotidarterybloodflowandpulsatilityindexincognitivelyimpairedpeoplewithchronicheartfailure AT storkstefan internalcarotidarterybloodflowandpulsatilityindexincognitivelyimpairedpeoplewithchronicheartfailure AT stollguido internalcarotidarterybloodflowandpulsatilityindexincognitivelyimpairedpeoplewithchronicheartfailure AT freyanna internalcarotidarterybloodflowandpulsatilityindexincognitivelyimpairedpeoplewithchronicheartfailure AT neugebauerhermann internalcarotidarterybloodflowandpulsatilityindexincognitivelyimpairedpeoplewithchronicheartfailure |