Cerebral blood flow in the chronic heart failure patients

Abstract

Background

Global cerebral blood flow (CBF), as a measure of cerebral perfusion, can be non-invasively studied using Doppler sonography. Chronic heart failure (CHF) increases the risk of stroke and dementia. One of the possible causes may be cerebral hypoperfusion in CHF patients. Therefore, we aimed to investigate the relationship between CBF and CHF severity.

Methods

The study was performed in 76 ischemic or idiopathic dilatative cardiomyopathy patients, left ventricular ejection fraction (LVEF) < 40%, with no clinical evidence of decompensation and 20 healthy volunteers. Each CHF patient was categorized according to the New NYHA criteria. All patients underwent Doppler echocardiography examination (GE Vivid 7). The LVEF was quantified using the Simpson method. CBF was estimated by a 7.0-MHz linear transducer of a computed sonography system (Toshiba Power vision 6000). CBF volume was determined as the sum of the flow volumes of the ICA and the VA of both sides.

Results

Atrial fibrillation was noted in 30%, left bundle branch block in 26%, while pacemaker was implanted in 9% of patients with CHF. History of myocardial infarction was presented in 64% of patients. No differences in age, waist/hip ratio, body mass index and lipid profile were found between CHF patients and healthy subjects. CBF was calculated in 71 of 76 patients. Three patients had occlusion of ICA, while VA was occluded in another two patients. Others did not have a hemodynamically significant ICA and VA stenosis. CBF volume was decreased in CHF patients, (677 ± 170) according to control (783 ± 128).

Conclusion

Our results of noninvasive sonographic measurement of CBF according to LVEF and NYHA criteria, suggest on significantly reduced CBF in CHF patients.