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有心血管疾病和无心血管疾病的老年人的脑血管灌注情况。

Cerebrovascular Perfusion among Older Adults with and Without Cardiovascular Disease.

作者信息

Makwana Bindal, Tart-Zelvin Ariana, Xu Xiaomeng, Gunstad John J, Cote Denise M, Poppas Athena, Cohen Ronald A, Sweet Lawrence H

机构信息

Department of Psychology, Idaho State University, Pocatello, ID.

Psychiatry Department, University of Michigan/Michigan Medicine, Ann Arbor, MI.

出版信息

J Neuroimaging. 2020 Nov;30(6):851-856. doi: 10.1111/jon.12757. Epub 2020 Jul 10.

Abstract

BACKGROUND AND PURPOSE

Cardiovascular disease (CVD) encompasses a range of disorders that affect health and functioning in older adults. While cognitive declines have been linked to both cardiovascular and cerebral blood perfusion, protective neurovascular mechanisms raise the question whether cerebrovascular perfusion differs as a function of cardiovascular health status. The present study examined whether cerebrovascular perfusion significantly differs between healthy older adults with and without diagnosed CVD. The study also examined whether previously documented sex differences in cerebral perfusion would be replicated.

METHODS

Twenty CVD patients without significant heart failure and 39 healthy controls were recruited to undergo a comprehensive assessment, including an interview, echocardiogram, and magnetic resonance imaging). Arterial spin labeling was used to quantify cerebral blood perfusion.

RESULTS

Both groups exhibited mean left ventricular ejection fractions that fell within normal limits. In line with previous research, women exhibited significantly higher cerebral perfusion than men. There were no significant group differences in whole brain cerebrovascular perfusion, regional perfusion, or white matter perfusion by patient status after accounting for sex and age.

CONCLUSIONS

These findings suggest that the effects of mild CVD on cerebrovascular perfusion are minimal. Future studies are needed to investigate the mechanisms involved in maintaining cerebrovascular perfusion in the context of altered peripheral perfusion and to determine whether this finding extends to more acute or severe CVD.

摘要

背景与目的

心血管疾病(CVD)涵盖一系列影响老年人健康和功能的病症。虽然认知能力下降与心血管及脑血流灌注均有关联,但保护性神经血管机制引发了脑血管灌注是否因心血管健康状况而异的问题。本研究探讨了已确诊患有CVD和未患CVD的健康老年人之间脑血管灌注是否存在显著差异。该研究还考察了先前记录的脑灌注性别差异是否会重现。

方法

招募了20名无严重心力衰竭的CVD患者和39名健康对照者,进行全面评估,包括访谈、超声心动图和磁共振成像。动脉自旋标记用于量化脑血流灌注。

结果

两组的平均左心室射血分数均在正常范围内。与先前研究一致,女性的脑灌注显著高于男性。在考虑性别和年龄后,按患者状态划分的全脑、区域或白质脑血管灌注均无显著组间差异。

结论

这些发现表明轻度CVD对脑血管灌注的影响极小。未来需要开展研究,以探究在外周灌注改变的情况下维持脑血管灌注的机制,并确定这一发现是否适用于更急性或严重的CVD。

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