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Título:	Research Article Cardiovascular and Renal Integration Cerebral blood flow autoregulation in ischemic heart failure
Título(s) alternativo(s):	AJP-Regul Integr Comp Physiol • doi:10.1152/ajpregu.00361.2016
Autor(es):	Ribeiro, Juliana Caldas
Palavras-chave:	Integration cardiovascular. Integration Renal. Cerebral blood flow autoregulation in ischemic heart failure.
Data do documento:	7-Dez-2016
Descrição:	Patients with ischemic heart failure (iHF) have a high risk of neurological complications such as cognitive impairment and stroke. We hypothesized that iHF patients have a higher incidence of impaired dynamic cerebral autoregulation (dCA). Adult patients with iHF and healthy volunteers were included. Cerebral blood flow velocity (CBFV, transcranial Doppler, middle cerebral artery), end-tidal CO2 (capnography), and arterial blood pressure (Finometer) were continuously recorded supine for 5 min at rest. Autoregulation index (ARI) was estimated from the CBFV step response derived by transfer function analysis using standard template curves. Fifty-two iHF patients and 54 age-, gender-, and BP-matched healthy volunteers were studied. Echocardiogram ejection fraction was 40 (20–45) % in iHF group. iHF patients compared with control subjects had reduced end-tidal CO2 (34.1 3.7 vs. 38.3 4.0 mmHg, P 0.001) and lower ARI values (5.1 1.6 vs. 5.9 1.0, P 0.012). ARI 4, suggestive of impaired CA, was more common in iHF patients (28.8 vs. 7.4%, P 0.004). These results confirm that iHF patients are more likely to have impaired dCA compared with age-matched controls. The relationship between impaired dCA and neurological complications in iHF patients deserves further investigation.
URI:	http://www7.bahiana.edu.br//jspui/handle/bahiana/2493
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