Cerebral Blood Flow in Patients With Chronic Heart Failure Before and After Heart Transplantation

Gruhn, Nicolai; Larsen, Fin Stolze; Boesgaard, Søren; Knudsen, Gitte M.; Mortensen, Svend Aage; Thomsen, Gerda; Aldershvile, Jan

doi:10.1161/hs1101.098360

Cited by 259 publications

(235 citation statements)

References 27 publications

(28 reference statements)

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“…Estudos utilizando as técnicas de PET ou SPECT têm demonstrado a presença de achados de redução de fluxo sangüíneo cerebral (FSC) global em pacientes com ICC-grave na comparação com voluntários normais, os quais podem ser atenuados após tratamentos como transplante cardíaco (Gruhn et al, 2001). No mais recente destes estudos, Gruhn et al (2001) compararam 12 pacientes com ICC-grave, CF III e IV da NYHA, através de SPECT com xenônio ( 133 Xe), e observaram redução importante (31%) do FSC global em pacientes com ICC CF III e IV NYHA, reversível pós-transplante cardíaco (n = 5). Estes achados têm dado suporte à hipótese de que a redução crônica do FSC global, secundário à diminuição do débito cardíaco, poderia ser fator crítico para o surgimento de declínio cognitivo associado à ICC (Zuccala et al, 2003).…”

Section: Neuroimagem E Bases Neuraisunclassified

Fatores de risco cardiovascular, declínio cognitivo e alterações cerebrais detectadas através de técnicas de neuroimagem

Alves¹,

Wajngarten²,

Filho³

2005

Rev. psiquiatr. clín.

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ResumoDiversos estudos têm demonstrado associação entre fatores de risco cardiovascular e desenvolvimento de declínio cognitivo. Também há evidências do aumento das taxas de morbimortalidade em pacientes com doenças cardiovasculares e déficit cognitivo. Dentre os fatores de risco cardiovascular, hipertensão arterial e insuficiência cardíaca apresentaram forte associação com a presença de déficit cognitivo, entretanto os mecanismos cerebrais subjacentes não foram totalmente esclarecidos. Nos pacientes cardiopatas, o prejuízo cognitivo se dá principalmente nos aspectos de memória (fixação e aprendizado) e processamento das informações. Nesse artigo, revisa-se os achados de neuroimagem observados em amostras de pacientes com fatores de risco cardiovascular com declínio cognitivo, incluindo achados regionais de anormalidades volumétricas, hiperintensidade de substância branca, acidentes vasculares silenciosos, infartos lacunares e déficits funcionais na perfusão cerebral global (associada à redução do débito cardíaco) e perfusão cerebral regional. Discute-se, também, as implicações destes achados para a fisiopatologia do declínio cognitivo e suas aplicações clínicas. Finalmente, aborda-se o potencial de utilização de novas técnicas de imagem em estudos futuros na avaliação das alterações estruturais e funcionais associadas a fatores de riscos vasculares em amostras de base populacional.

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Section: Neuroimagem E Bases Neuraisunclassified

Fatores de risco cardiovascular, declínio cognitivo e alterações cerebrais detectadas através de técnicas de neuroimagem

Alves¹,

Wajngarten²,

Filho³

2005

Rev. psiquiatr. clín.

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“…Some reports in recent years have suggested that cerebral perfusion is impaired in patients with chronic low cardiac output. [7][8][9] Thus, considering that cardiac output decreases with the decrease in blood flow into the LV from the left atrium as a result of the progression in LV diastolic dysfunction, and also considering that a chronic decrease in cerebral blood flow is thought to be the primary mechanism underlying cerebral WML formation, the present results can also be interpreted as suggesting that decreased cardiac output elicits chronic cerebral ischemia. 10 Further investigation is necessary to clarify these points.…”

Section: Left Ventricular Diastolic Dysfunction Is Directly Associatementioning

confidence: 52%

Left ventricular diastolic dysfunction is directly associated with cerebral white matter lesions in elderly patients

Shimizu

Kokubo

Mitsui

et al. 2015

Geriatrics Gerontology Int

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“…Additionally, CHD can be associated with cardiac complications (atrial fibrillation, heart failure), whose association with cognitive impairment or dementia is well-established [7,9]. Additionally, CHD and accompanying vascular insufficiency can lead to cerebrovascular changes such as reduced cerebral blood flow (which can lead to hypoperfusion) [41], white matter lesions and brain infarctions [21], which in turn are associated with reduced cognitive functioning and risk of dementia [42,43]. CHD might however not itself be causally related to cognition, but brain-effects (e.g.…”

Section: Discussionmentioning

confidence: 99%

[P3–542]: Coronary Heart Disease and Risk for Cognitive Impairment or Dementia: A Systematic Review and Meta‐analysis

Deckers

Schievink

Rodriquez

et al. 2017

Alzheimer's & Dementia

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Aims/HypothesisAccumulating evidence suggests an association between coronary heart disease and risk for cognitive impairment or dementia, but no study has systematically reviewed this association. Therefore, we summarized the available evidence on the association between coronary heart disease and risk for cognitive impairment or dementia. MethodsMedline, Embase, PsycINFO, and CINAHL were searched for all publications until 8 th January 2016. Articles were included if they fulfilled the inclusion criteria: (1) myocardial infarction, angina pectoris or coronary heart disease (combination of both) as predictor variable; (2) cognition, cognitive impairment or dementia as outcome; (3) population-based study; (4) prospective (!1 year follow-up), cross-sectional or case-control study design; (5) !100 participants; and (6) aged !45 years. Reference lists of publications and secondary literature were hand-searched for possible missing articles. Two reviewers independently screened all abstracts and extracted information from potential relevant full-text articles using a standardized data collection form. Study quality was assessed with the Newcastle-Ottawa Scale. We pooled estimates from the most fully adjusted model using random-effects metaanalysis. ResultsWe identified 6,132 abstracts, of which 24 studies were included. A meta-analysis of 10 prospective cohort studies showed that coronary heart disease was associated with increased risk of cognitive impairment or dementia (OR = 1.45, 95%CI = 1.21-1.74, p<0.001). Between-study heterogeneity was low (I 2 = 25.7%, 95%CI = 0-64, p = 0.207). Similar significant associations were found in separate meta-analyses of prospective cohort studies for the individual predictors (myocardial infarction, angina pectoris). In contrast, meta-analyses of cross-sectional and case-control studies were inconclusive. Funding: The author(s) received no specific funding for this work. Competing interests:The authors have declared that no competing interests exist. Conclusion/InterpretationThis meta-analysis suggests that coronary heart disease is prospectively associated with increased odds of developing cognitive impairment or dementia. Given the projected worldwide increase in the number of people affected by coronary heart disease and dementia, insight into causal mechanisms or common pathways underlying the heart-brain connection is needed.

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Cerebral Blood Flow in Patients With Chronic Heart Failure Before and After Heart Transplantation

Cited by 259 publications

References 27 publications

Fatores de risco cardiovascular, declínio cognitivo e alterações cerebrais detectadas através de técnicas de neuroimagem

Fatores de risco cardiovascular, declínio cognitivo e alterações cerebrais detectadas através de técnicas de neuroimagem

Left ventricular diastolic dysfunction is directly associated with cerebral white matter lesions in elderly patients

[P3–542]: Coronary Heart Disease and Risk for Cognitive Impairment or Dementia: A Systematic Review and Meta‐analysis

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