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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)...

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Autores principales: Aires, Ana, Andrade, António, Azevedo, Elsa, Gomes, Filipa, Araújo, José Paulo, Castro, Pedro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
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.
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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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