Relationship of reduced cerebral blood flow and heart failure severity in elderly males.
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.
Loncar
Goran
G
Cardiology Department, Clinical Medical Center Zvezdara, Belgrade, Serbia.
Bozic
Biljana
B
Lepic
Toplica
T
Dimkovic
Sinisa
S
Prodanovic
Nenad
N
Radojicic
Zoran
Z
Cvorovic
Vojkan
V
Markovic
Natasa
N
Brajovic
Milan
M
Despotovic
Nebojsa
N
Putnikovic
Biljana
B
Popovic-Brkic
Vera
V
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
D052242:Adiponectin; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain