title: Relationship of reduced cerebral blood flow and heart failure severity in elderly males.
abstract: BACKGROUND
  Brain detrimental effects are under-recognised complication of chronic heart failure (CHF). One of the major causes may be cerebral hypoperfusion. This study was designed to investigate the relationship between cerebral blood flow (CBF) and severity of CHF as well as to evaluate its determinants among different parameters of cardiac dysfunction.
  
  
  METHODS
  Seventy-one CHF males with NYHA class II and III and 20 control subjects age ≥ 55 years were recruited. CBF was evaluated by colour duplex sonography of extracranial arteries. Echocardiography, 6-min walk test, quality of life and endothelial function were also assessed. Serum NT-pro-BNP and adipokines levels (adiponectin and leptin) were measured.
  
  
  RESULTS
  CBF was significantly reduced in elderly patients with CHF compared to healthy controls (677 +/- 170 vs 783 +/- 128 ml/min, p=0.011). Reduced CBF was associated with reduced left ventricular ejection fraction (LVEF) (r=0.271, p=0.022), lower 6-min walk distance (r=0.339, p=0.004), deteriorated quality of life (r= -0.327, p=0.005), increased serum adiponectin (r= -0.359, p=0.002), and NT-pro-BNP levels (r= -0.375, p=0.001). In multivariate regression analysis, LVEF and adiponectin were independently associated with reduced CBF in CHF patients (R(2)=0.289).
  
  
  CONCLUSIONS
  CBF was reduced in elderly males with mild-to-moderate CHF, and was associated with factors that represent the severity of CHF including high serum adiponectin and NT-pro-BNP levels, decreased LVEF, impaired physical performance, and deteriorated quality of life.
authors.affiliation: Cardiology Department, Clinical Medical Center Zvezdara, Belgrade, Serbia.
authors.forename: Goran
authors.initials: G
authors.lastname: Loncar
authors.forename: Biljana
authors.initials: B
authors.lastname: Bozic
authors.forename: Toplica
authors.initials: T
authors.lastname: Lepic
authors.forename: Sinisa
authors.initials: S
authors.lastname: Dimkovic
authors.forename: Nenad
authors.initials: N
authors.lastname: Prodanovic
authors.forename: Zoran
authors.initials: Z
authors.lastname: Radojicic
authors.forename: Vojkan
authors.initials: V
authors.lastname: Cvorovic
authors.forename: Natasa
authors.initials: N
authors.lastname: Markovic
authors.forename: Milan
authors.initials: M
authors.lastname: Brajovic
authors.forename: Nebojsa
authors.initials: N
authors.lastname: Despotovic
authors.forename: Biljana
authors.initials: B
authors.lastname: Putnikovic
authors.forename: Vera
authors.initials: V
authors.lastname: Popovic-Brkic
mesh_terms: D052242:Adiponectin / Q000097:blood; D000367:Age Factors; D000368:Aged; D000375:Aging; D002560:Cerebrovascular Circulation; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular; D005080:Exercise Test; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000473:pathology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain; D010446:Peptide Fragments; D011788:Quality of Life / Q000523:psychology; D013318:Stroke Volume; D011795:Surveys and Questionnaires; D018615:Ultrasonography, Doppler, Color; D016277:Ventricular Function, Left
chemical_list: D052242:Adiponectin; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain