Microvascular Dysfunction as a Possible Link Between Heart Failure and Cognitive Dysfunction.

Hillier, Elizabeth; Covone, Jason; Fischer, Kady; Chen, Hao Yu; Hafyane, Tarik; Friedrich, Matthias G (2023). Microvascular Dysfunction as a Possible Link Between Heart Failure and Cognitive Dysfunction. Circulation. Heart failure, 16(11), e010117. American Heart Association 10.1161/CIRCHEARTFAILURE.122.010117

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BACKGROUND

Microvascular function in the brain and heart may play an important role in the course of patients with heart failure (HF), but its relationship with ventricular and cognitive function is not well understood. We hypothesized that microvascular function in HF is closely related to both, cardiac and cognitive function.

METHODS

In healthy controls and symptomatic patients with HF (New York Heart Association functional class II or III), we used oxygenation-sensitive magnetic resonance imaging during a standardized breathing maneuver to determine the cerebral oxygenation reserve and the myocardial oxygenation reserve (MORE) as markers for microvascular function. A stepwise multivariable linear regression was performed to determine the variables that best predict changes in cerebral oxygenation reserve and MORE. We also measured cognitive function using the Montreal Cognitive Assessment test.

RESULTS

Twenty patients with HF (age 64.4±8.3 years; 50% female sex), and 21 healthy controls (age 55.0±5.1 years; 62% female sex) were included in the analysis. In patients with HF, cerebral oxygenation reserve and MORE were lower than in healthy controls (MORE, -0.1±3.3 versus 5.0±4.2, cerebral oxygenation reserve: 0.43±0.47 versus 1.21±0.60, respectively) as were Montreal Cognitive Assessment score results (HF, 23.9±3.7; healthy, 27.8±1.5; P=0.002). The Montreal Cognitive Assessment score in patients was correlated with cardiac output (r=0.55, P=0.011) and MORE (r=0.46, P=0.040). In addition to the presence of HF, significant predictors of cerebral and myocardial oxygenation reserve were cardiac output and end-diastolic volume, respectively.

CONCLUSIONS

Our results indicate that heart failure is an independent predictor of coronary and cerebral microvascular dysfunction as defined by a reduced response to a vasodilatory breathing maneuver. This impaired response was associated with reduced cognitive function.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy > Partial clinic Insel
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Fischer, Kady Anne

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1941-3297

Publisher:

American Heart Association

Language:

English

Submitter:

Pubmed Import

Date Deposited:

26 Sep 2023 15:20

Last Modified:

22 Nov 2023 00:14

Publisher DOI:

10.1161/CIRCHEARTFAILURE.122.010117

PubMed ID:

37750336

Uncontrolled Keywords:

brain cognition coronary artery disease heart failure magnetic resonance imaging

BORIS DOI:

10.48350/186623

URI:

https://boris.unibe.ch/id/eprint/186623

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