Neurovascular Coupling Impairment in Heart Failure with Reduction Ejection Fraction

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Aires, A (Author) Other; Andrade, A (Author) Other; Elsa Azevedo (Author) FMUP; Gomes, F (Author) FMUP; Araújo JP (Author) FMUP; Pedro Castro (Author) FMUP

Journal

Title: Brain Sciences

Vol. 10 No. 8, Article number 556

Pages: 1-10

ISSN: 2076-3425

Publisher: MDPI

Indexing

ISI Web of Knowledge - 8 Citations

Scopus - 9 Citations

Other information

Authenticus ID: P-00S-T9X

DOI: 10.3390/brainsci10100714

Abstract (EN): 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.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 10