Cardiology Department, Clinical Medical Center Zvezdara, Belgrade, Serbia.
Aging Male. 2011 Mar;14(1):59-65. doi: 10.3109/13685538.2010.511326. Epub 2010 Sep 27.
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.
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.
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).
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.
慢性心力衰竭（CHF）的一个被低估的并发症是大脑损伤。其主要原因之一可能是脑灌注不足。本研究旨在探讨脑血流（CBF）与 CHF 严重程度之间的关系，并评估其在不同心功能障碍参数中的决定因素。
共招募了 71 名 NYHA 分级 II 和 III 级的 CHF 男性患者和 20 名年龄≥55 岁的健康对照者。通过颅外动脉彩色双功能超声评估 CBF。还评估了超声心动图、6 分钟步行试验、生活质量和内皮功能。测量了血清 NT-pro-BNP 和脂肪因子（脂联素和瘦素）水平。
与健康对照组相比，老年 CHF 患者的 CBF 明显降低（677±170 vs 783±128 ml/min，p=0.011）。降低的 CBF 与左心室射血分数（LVEF）降低（r=0.271，p=0.022）、6 分钟步行距离降低（r=0.339，p=0.004）、生活质量恶化（r=-0.327，p=0.005）、血清脂联素增加（r=-0.359，p=0.002）和 NT-pro-BNP 水平增加（r=-0.375，p=0.001）相关。多元回归分析显示，LVEF 和脂联素是 CHF 患者 CBF 降低的独立相关因素（R²=0.289）。
在轻度至中度 CHF 的老年男性中，CBF 降低与代表 CHF 严重程度的因素相关，包括高血清脂联素和 NT-pro-BNP 水平、LVEF 降低、体力活动受损和生活质量恶化。
