Dynamic transcranial Doppler assessment in Heart Failure patients

• Autor(a) principal: António Luís Felgueira de Andrade
• Data de Publicação: 2020
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://hdl.handle.net/10216/128911
• topic: Medicina clínica; Clinical medicine

Heart failure (HF) is a prevalent disease but few is understood in its repercussion in cerebral hemodynamics mechanisms and cognitive decline. We monitored cerebral blood flow velocity (CBFV) with transcranial Doppler in HF patients and healthy controls. Cerebral autoregulation (CA) was assessed by transfer function from the spontaneous oscillations of blood pressure to CBFV and vasoreactivity (VR) with inhalation of CO2 at 5% and hyperventilation. MoCA was measured and associated with each cerebrovascular regulatory component. No differences were detected in VR. HF patients showed a better CA response. (Middle cerebral artery (MCA): very low frequency (VLF) gain 0.47±0.15 vs 0.88±0.19 %/mmHg, p=0.001; low frequency (LF) gain 0.60±0.23 vs 1.28±0.05 %/mmHg, p=0.000; VLF phase 2.05±0.59 vs 1.12±0.12 radians, p=0.021; Posterior cerebral artery (PCA): VLF gain 0.47±0.25 vs 1.11±0.24 %/mmHg, p=0.000; LF gain 0.66±0.32 vs 1.83±0.45 %/mmHg, p=0.000). None of the cerebrovascular parameters correlated significantly with MoCA score. Cerebrovascular hemodynamics could have a major role in the proper management of HF patients.