Cognitive dysfunction in congestive heart failure: transcranial Doppler evidence of microembolic etiology

Jesus, Pedro A. P.; Vieira-de-Melo, Rodrigo M.; Reis, Francisco José Farias Borges dos; Viana, Leila C.; Lacerda, Amanda Mota; Dias, Jesângeli Sousa; Oliveira‐Filho, Jamary

doi:10.1590/s0004-282x2006000200007

Cited by 32 publications

(28 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is hypothesized that WMHs—and resulting cognitive impairment—in HF is a manifestation of cerebral hypoperfusion and subsequent ischemia secondary to the effects of reduced cardiac pumping efficiency and comorbid medical conditions . Past findings showing cerebral hypoperfusion is common in this population (ie, reduced by as much as 30%) and associated with impairments in global cognitive functioning support this hypothesis. In addition, reduced cardiac function, as measured by ejection fraction and/or cardiac output, has also been shown to be related to increased WMHs in other cardiac populations .…”

mentioning

confidence: 99%

Cerebral Perfusion is Associated With White Matter Hyperintensities in Older Adults With Heart Failure

Alosco

Brickman

Spitznagel

et al. 2013

Congestive Heart Failure

View full text Add to dashboard Cite

Cognitive impairment is common in heart failure (HF) and believed to be the result of cerebral hypoperfusion and subsequent brain changes including white matter hyperintensities (WMH). The current study examined the association between cerebral blood flow and WMH in HF patients and the relationship of WMH to cognitive impairment. Sixty-nine patients with HF completed the mini mental state examination (MMSE), echocardiogram, transcranial Doppler sonography (TCD) for cerebral blood flow velocity of the middle cerebral artery and brain magnetic resonance imaging (MRI). Multivariable hierarchical regression analyses controlling for medical and demographic characteristics as well as intracranial volume showed reduced cerebral blood flow velocity of the middle cerebral artery was associated with greater WMH (β = −.34, p = .02). Follow up regression analyses adjusting for the same medical and demographic factors in addition to cerebral perfusion also revealed marginal significance between increased WMH and poorer performance on the MMSE (β = −.26, p = .05). This study suggests that reduced cerebral perfusion is associated with greater WMH in older adults with HF. Our findings support the widely proposed mechanism of cognitive impairment in HF patients and prospective studies are needed to confirm our findings.

show abstract

mentioning

confidence: 99%

Cerebral Perfusion is Associated With White Matter Hyperintensities in Older Adults With Heart Failure

Alosco

Brickman

Spitznagel

et al. 2013

Congestive Heart Failure

View full text Add to dashboard Cite

show abstract

“…A reduction in CBF during heart failure due to low cardiac output leads to certain types of neurologic and psychological impairment that can be reversed with treatment . However, most of these studies were conducted on adult patients; limited data is available on pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, some investigators have attempted to demonstrate that heart failure is a risk factor for Alzheimer’s disease, which may be associated with decreased CBF velocity . Jesus et al investigated an association between cognitive impairment and CBF velocity in adults with heart failure; they found a decrease in the mean flow velocity of the right middle cerebral artery and an increase in the pulsatility index. Alves et al compared 17 adults with New York Heart Association class II‐III heart failure with a healthy control group.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Alterations in cerebral blood flow in children with congestive heart failure due to ventricular septal defect

Tasar¹,

Köşger

Uzuner

et al. 2018

Congenital Heart Disease

View full text Add to dashboard Cite

Objective We aimed to investigate the effect of ventricular septal defect (VSD) and heart failure on cerebral blood flow (CBF) in children, whether heart failure treatment improves CBF, and if there is any relationship between CBF and serum N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) level. Method Forty children with VSD (13 with heart failure) aged between 1 and 36 months were studied. The control group comprised 25 healthy children in the same age group. Maximum, minimum, and mean blood flow velocities and pulsatility indices of the right and left middle cerebral arteries were assessed using transcranial Doppler ultrasonography. Measurements of CBF and serum NT‐proBNP levels were repeated in patients with heart failure a month post–heart failure treatment initiation. The groups were also compared in terms of defect diameters, cardiac structural changes, left ventricular systolic function, and findings related to pulmonary hypertension determined by echocardiography. Correlations between echocardiographic measurements and CBF parameters were analyzed. Results Although no significant difference was found between patient and control groups for CBF, right and left maximum CBF velocities significantly increased posttreatment in patients with heart failure (P = .04 and P = .01, respectively). Serum NT‐proBNP levels in children with VSD associated with heart failure were significantly higher than those in children with VSD alone (P = .04) or in healthy children (P < .001). NT‐proBNP levels were negatively correlated with right and left maximum CBF velocities (r = −0.39, P = .013 and r = −0.32, P = .043, respectively). Conclusion Although no significant difference was found in CBF velocity among the study groups, increase in the CBF velocity post heart failure treatment and negative correlations between CBF velocity and both the VSD diameter and NT‐proBNP levels indicate that the hemodynamic status due to VSD associated with heart failure has an effect on CBF.

show abstract

“…However, CI persistence, despite adequate dialysis, indicates that other factors contribute to brain dysfunction. Cerebrovascular disease is a major risk factor for CI both among the general population and CKD patients [6-8]. Considering the high prevalence of cardiovascular and cerebrovascular disease in CKD, CI in these patients may be mediated by impaired microcirculation [9-13].…”

Section: Introductionmentioning

confidence: 99%

Influence of Intradialytic Aerobic Training in Cerebral Blood Flow and Cognitive Function in Patients with Chronic Kidney Disease: A Pilot Randomized Controlled Trial

Belik

Silva

Braga

et al. 2018

Nephron

View full text Add to dashboard Cite

Background and Objectives: Changes in cerebral blood flow may play an important role in cognitive impairment among hemodialysis (HD) patients. Physical activity has a promising role in delaying cognitive impairment in general population, but there are only a few studies in HD to confirm this finding. We aimed to evaluate the effects of intradialytic aerobic training on cerebral blood flow and cognitive impairment in HD. Design, Setting, Participants, and Measurements: This is a pilot, controlled, randomized trial. Fifteen patients underwent intradialytic aerobic training 3 times a week for 4 months. The control group was comprised of another 15 patients. Results: Trained patients had a statistically significant improvement of cognitive impairment and basilar maximum blood flow velocity. The proportion of arteries with increased flow velocity was statistically significant between groups. Conclusions: Intradialytic aerobic training improves cognitive impairment and cerebral blood flow of patients in HD, suggesting a possible mechanism improving cognitive impairment by physical training in HD. These data still need to be confirmed by major trials.

show abstract

Cognitive dysfunction in congestive heart failure: transcranial Doppler evidence of microembolic etiology

Cited by 32 publications

References 12 publications

Cerebral Perfusion is Associated With White Matter Hyperintensities in Older Adults With Heart Failure

Cerebral Perfusion is Associated With White Matter Hyperintensities in Older Adults With Heart Failure

Alterations in cerebral blood flow in children with congestive heart failure due to ventricular septal defect

Influence of Intradialytic Aerobic Training in Cerebral Blood Flow and Cognitive Function in Patients with Chronic Kidney Disease: A Pilot Randomized Controlled Trial

Contact Info

Product

Resources

About