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.
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DOI：
10.1111/chf.12025
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发表时间：
2013-07
期刊：
影响因子：
--
通讯作者：
Gunstad J
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文献类型：
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作者：
Alosco ML;Brickman AM;Spitznagel MB;Garcia SL;Narkhede A;Griffith EY;Raz N;Cohen R;Sweet LH;Colbert LH;Josephson R;Hughes J;Rosneck J;Gunstad J
认知障碍在心力衰竭 (HF) 中很常见，被认为是脑灌注不足和随后的大脑变化（包括白质高信号 (WMH)）的结果。目前的研究探讨了心力衰竭患者脑血流量与 WMH 之间的关联以及 WMH 与认知障碍的关系。 69例心力衰竭患者完成了简易精神状态检查（MMSE）、超声心动图、经颅多普勒超声检查（TCD）大脑中动脉脑血流速度和脑磁共振成像（MRI）。控制医学和人口特征以及颅内容量的多变量分层回归分析显示，大脑中动脉的脑血流速度降低与 WMH 升高相关（β = -.34，p = .02）。除了脑灌注之外，针对相同的医疗和人口因素进行的后续回归分析也揭示了 WMH 增加和 MMSE 表现较差之间的边际显着性（β = -.26，p = .05）。这项研究表明，患有心力衰竭的老年人脑灌注减少与 WMH 升高相关。我们的研究结果支持广泛提出的心力衰竭患者认知障碍机制，需要前瞻性研究来证实我们的研究结果。
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.