title: Factors associated with decreased cerebral blood flow in congestive heart failure secondary to idiopathic dilated cardiomyopathy.
abstract: Cerebral blood flow (CBF) is decreased and cognitive dysfunction develops in the advanced stages of heart failure. However, few data are available regarding the factors associated with decreased CBF. Fifty-two patients with advanced congestive heart failure (CHF) secondary to idiopathic dilated cardiomyopathy (ejection fraction <or=35%) and 10 healthy volunteers were included in this study. Echocardiography and symptom-limited bicycle exercise testing were performed. Global CBF was measured by radionuclide angiography. Global CBF was 19% less in patients with CHF than in controls (p <0.01). Such reduced CBF became normalized in 4 patients with CHF who underwent cardiac transplantation. In a univariate linear regression analysis, global CBF was significantly associated with New York Heart Association functional class, disease duration, atrial fibrillation, serum B-type natriuretic peptide level, the early mitral velocity/early diastolic annular velocity ratio, and pulmonary artery systolic pressure. Global CBF was not found to be associated with the ejection fraction, peak oxygen consumption, or anaerobic threshold. In a stepwise multivariate linear regression analysis, serum B-type natriuretic peptide level (p = 0.047) and New York Heart Association functional class (p = 0.003) were significantly related to global CBF (global CBF = 48.373 - 0.05 x serum B-type natriuretic peptide level - 3.283 x New York Heart Association functional class; r(2) = 0.401). In conclusion, CBF is decreased in patients with CHF, which may be used to predict disease severity and chronicity.
authors.affiliation: Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Bong-Ryong
authors.initials: BR
authors.lastname: Choi
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Kim
authors.forename: You Jung
authors.initials: YJ
authors.lastname: Yang
authors.forename: Kyoung-Min
authors.initials: KM
authors.lastname: Park
authors.forename: Cheol Whan
authors.initials: CW
authors.lastname: Lee
authors.forename: Yong-Hak
authors.initials: YH
authors.lastname: Kim
authors.forename: Myeong-Ki
authors.initials: MK
authors.lastname: Hong
authors.forename: Jae-Kwan
authors.initials: JK
authors.lastname: Song
authors.forename: Seong-Wook
authors.initials: SW
authors.lastname: Park
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
authors.forename: Jae-Joong
authors.initials: JJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation / Q000502:physiology*; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000145:classification / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D016027:Heart Transplantation; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood
chemical_list: D020097:Natriuretic Peptide, Brain