Abstract 16234: Regional Cerebral Blood Flow and Cognitive Function in Patients with Heart Failure

Abstract

Background: Previous studies have shown that patients with congestive heart failure (CHF) present cognitive deficits related with a poor clinical prognosis. The objective of the present study was to determine an association between ventricular function, brain blood flow and cognitive function of CHF patients.

Methods: A cross-sectional study including 85 CHF patients was performed. Brain natriuretic peptide (BNP) levels were determined using quantitative inmmunochropatography (Biosystems, Spain). Left ventricular function was evaluated by a trained cardiologist blind to the patient’s condition, using a bidimensional echocardiogram (General Electric Vivid 7, Milwaukee, USA). Brain blood flow and pulsatibility index were measured by a neurologist using a transcranial Doppler (Nicolete EME Legend TC22). Regional Cerebral Blood Flow (rCBF) was assessed by Single Photon Emission Computed Tomography (SPECT) with 99m Tc HMPAO. For the evaluation of cognitive function a series of neuropsychological tests were applied including the subtest digit span from the Wechsler scale, the Trail Making Test (TMT) and the Mini-Mental exam.

Results: Mean age of included subjects was 63.48±11.4 years, with a time since CHF diagnosis of 67.3±62.0 months and a mean ejection fraction of 33.7±15.9%. 70.59% (60) of the patients included were women. Linear regression analyses showed an association between stroke volume and the mean velocity of anterior cerebral arteries with the results of digit span forward test. In addition it was found a hypoperfusion of the dorsomedial and dorsolateral prefrontal cortex correlated with a lower ejection fraction and a lower score of the digit span forward test.

Discussion: This study presents evidence about a relationship between ventricular dysfunction, hypoperfusion of prefrontal cortex with working memory and attention alterations in patients with CHF. Further studies are required to elucidate the clinical significance of this association. colciencias n. 656645921606.