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Neurovascular Coupling Impairment in Heart Failure with Reduction Ejection Fraction
The hemodynamic consequences of a persistent reduced ejection fraction and unknown cardiac output on the brain have not been thoroughly studied. We sought to explore the status of the mechanisms of cerebrovascular regulation in patients with heart failure with reduced (HFrEF) and recovered (HFrecEF)...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7601077/ https://www.ncbi.nlm.nih.gov/pubmed/33036338 http://dx.doi.org/10.3390/brainsci10100714 |
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author | Aires, Ana Andrade, António Azevedo, Elsa Gomes, Filipa Araújo, José Paulo Castro, Pedro |
author_facet | Aires, Ana Andrade, António Azevedo, Elsa Gomes, Filipa Araújo, José Paulo Castro, Pedro |
author_sort | Aires, Ana |
collection | PubMed |
description | The hemodynamic consequences of a persistent reduced ejection fraction and unknown cardiac output on the brain have not been thoroughly studied. We sought to explore the status of the mechanisms of cerebrovascular regulation in patients with heart failure with reduced (HFrEF) and recovered (HFrecEF) ejection fraction. We monitored cerebral blood flow velocity (CBFV) with transcranial Doppler and blood pressure. Cerebral autoregulation, assessed by transfer function from the spontaneous oscillations of blood pressure to CBFV and neurovascular coupling (NVC) with visual stimulation were compared between groups of HFrEF, HFrecEF and healthy controls. NVC was significantly impaired in HFrEF patients with reduced augmentation of CBFV during stimulation (overshoot systolic CBFV 19.11 ± 6.92 vs. 22.61 ± 7.78 vs. 27.92 ± 6.84, p = 0.04), slower upright of CBFV (rate time to overshoot: 1.19 ± 3.0 vs. 3.06 (4.30) vs. 2.90 ± 3.84, p = 0.02); p = 0.023) and reduced arterial oscillatory properties (natural frequency 0.17 ± 0.06 vs. 0.20 ± 0.09 vs. 0.24 ± 0.07, p = 0.03; attenuation 0.34 ± 0.24 vs. 0.48 ± 0.35 vs. 0.50 ± 0.23, p = 0.05). Cerebral autoregulation was preserved. The neurovascular unit of subjects with chronically reduced heart pumping capability is severely dysfunctional. Dynamic testing with transcranial Doppler could be useful in these patients, but whether it helps in predicting cognitive impairment must be addressed in future prospective studies. |
format | Online Article Text |
id | pubmed-7601077 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-76010772020-11-01 Neurovascular Coupling Impairment in Heart Failure with Reduction Ejection Fraction Aires, Ana Andrade, António Azevedo, Elsa Gomes, Filipa Araújo, José Paulo Castro, Pedro Brain Sci Article The hemodynamic consequences of a persistent reduced ejection fraction and unknown cardiac output on the brain have not been thoroughly studied. We sought to explore the status of the mechanisms of cerebrovascular regulation in patients with heart failure with reduced (HFrEF) and recovered (HFrecEF) ejection fraction. We monitored cerebral blood flow velocity (CBFV) with transcranial Doppler and blood pressure. Cerebral autoregulation, assessed by transfer function from the spontaneous oscillations of blood pressure to CBFV and neurovascular coupling (NVC) with visual stimulation were compared between groups of HFrEF, HFrecEF and healthy controls. NVC was significantly impaired in HFrEF patients with reduced augmentation of CBFV during stimulation (overshoot systolic CBFV 19.11 ± 6.92 vs. 22.61 ± 7.78 vs. 27.92 ± 6.84, p = 0.04), slower upright of CBFV (rate time to overshoot: 1.19 ± 3.0 vs. 3.06 (4.30) vs. 2.90 ± 3.84, p = 0.02); p = 0.023) and reduced arterial oscillatory properties (natural frequency 0.17 ± 0.06 vs. 0.20 ± 0.09 vs. 0.24 ± 0.07, p = 0.03; attenuation 0.34 ± 0.24 vs. 0.48 ± 0.35 vs. 0.50 ± 0.23, p = 0.05). Cerebral autoregulation was preserved. The neurovascular unit of subjects with chronically reduced heart pumping capability is severely dysfunctional. Dynamic testing with transcranial Doppler could be useful in these patients, but whether it helps in predicting cognitive impairment must be addressed in future prospective studies. MDPI 2020-10-07 /pmc/articles/PMC7601077/ /pubmed/33036338 http://dx.doi.org/10.3390/brainsci10100714 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Aires, Ana Andrade, António Azevedo, Elsa Gomes, Filipa Araújo, José Paulo Castro, Pedro Neurovascular Coupling Impairment in Heart Failure with Reduction Ejection Fraction |
title | Neurovascular Coupling Impairment in Heart Failure with Reduction Ejection Fraction |
title_full | Neurovascular Coupling Impairment in Heart Failure with Reduction Ejection Fraction |
title_fullStr | Neurovascular Coupling Impairment in Heart Failure with Reduction Ejection Fraction |
title_full_unstemmed | Neurovascular Coupling Impairment in Heart Failure with Reduction Ejection Fraction |
title_short | Neurovascular Coupling Impairment in Heart Failure with Reduction Ejection Fraction |
title_sort | neurovascular coupling impairment in heart failure with reduction ejection fraction |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7601077/ https://www.ncbi.nlm.nih.gov/pubmed/33036338 http://dx.doi.org/10.3390/brainsci10100714 |
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