Factors Associated With Decreased Cerebral Blood Flow in Congestive Heart Failure Secondary to Idiopathic Dilated Cardiomyopathy

Choi, Bong-Ryong; Kim, Jae Seung; Yang, You Jung; Park, Kyoung-Min; Lee, Cheol Whan; Kim, Yong-Hak; Hong, Myeong-Ki; Song, Jae-Kwan; Park, Seong-Wook; Park, Seung-Jung; Kim, Jae-Joong

doi:10.1016/j.amjcard.2005.11.059

« Previous Next »American Journal of Cardiology
Volume 97, Issue 9 , Pages 1365-1369, 1 May 2006

Factors Associated With Decreased Cerebral Blood Flow in Congestive Heart Failure Secondary to Idiopathic Dilated Cardiomyopathy

Bong-Ryong Choi, MD
- Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Jae Seung Kim, MD
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
You Jung Yang, MD
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Kyoung-Min Park, MD
- Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Cheol Whan Lee, MD, PhD
- Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Yong-Hak Kim, MD, PhD
- Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Myeong-Ki Hong, MD, PhD
- Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Jae-Kwan Song, MD, PhD
- Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Seong-Wook Park, MD, PhD
- Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Seung-Jung Park, MD, PhD
- Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Jae-Joong Kim, MD, PhD
- Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Corresponding author: Tel: 82-2-3010-3150; fax: 82-2-486-5918.

Received 22 August 2005; received in revised form 14 November 2005; accepted 14 November 2005. published online 17 March 2006.

Cerebral blood flow (CBF) is decreased and cognitive dysfunction develops in the advanced stages of heart failure. However, few data are available regarding the factors associated with decreased CBF. Fifty-two patients with advanced congestive heart failure (CHF) secondary to idiopathic dilated cardiomyopathy (ejection fraction ≤35%) and 10 healthy volunteers were included in this study. Echocardiography and symptom-limited bicycle exercise testing were performed. Global CBF was measured by radionuclide angiography. Global CBF was 19% less in patients with CHF than in controls (p <0.01). Such reduced CBF became normalized in 4 patients with CHF who underwent cardiac transplantation. In a univariate linear regression analysis, global CBF was significantly associated with New York Heart Association functional class, disease duration, atrial fibrillation, serum B-type natriuretic peptide level, the early mitral velocity/early diastolic annular velocity ratio, and pulmonary artery systolic pressure. Global CBF was not found to be associated with the ejection fraction, peak oxygen consumption, or anaerobic threshold. In a stepwise multivariate linear regression analysis, serum B-type natriuretic peptide level (p = 0.047) and New York Heart Association functional class (p = 0.003) were significantly related to global CBF (global CBF = 48.373 − 0.05 × serum B-type natriuretic peptide level − 3.283 × New York Heart Association functional class; r² = 0.401). In conclusion, CBF is decreased in patients with CHF, which may be used to predict disease severity and chronicity.