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Cerebral Perfusion is Associated With White Matter Hyperintensities in Older Adults With Heart Failure
Open accessAbstract
Cognitive impairment is common in heart failure (HF) and believed to be the result of cerebral hypoperfusion and subsequent brain changes including white matter hyperintensities (WMHs). The current study examined the association between cerebral blood flow and WMHs in patients with HF and the relationship between WMHs and cognitive impairment. Sixty‐nine patients with HF completed the Mini‐Mental State Examination (MMSE) and underwent echocardiography, transcranial Doppler sonography for cerebral blood flow velocity of the middle cerebral artery, and brain magnetic resonance imaging. Multivariable hierarchical regression analyses controlling for medical and demographic characteristics as well as intracranial volume showed reduced cerebral blood flow velocity of the middle cerebral artery was associated with greater WMHs (β=−0.34, P=.02). Follow‐up regression analyses adjusting for the same medical and demographic factors in addition to cerebral perfusion also revealed marginal significance between increased WMHs and poorer performance on the MMSE (β=−0.26, P=.05). This study suggests that reduced cerebral perfusion is associated with greater WMHs in older adults with HF. These findings support the widely proposed mechanism of cognitive impairment in HF patients and prospective studies are needed to confirm these results.
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“Other causes of cognitive impairment induced by global reductions in cerebral perfusion include cardiac arrest, severe cardiac failure, arrhythmias, and severe hypotension. 91-94”
From Vascular Cognitive Impairment (2017) · cites this paper as [92]
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“Reduction in global cerebral perfusion caused by cardiac arrest, arrhythmias, cardiac failure, or hypotension can produce brain dysfunction and impair cognition transiently or permanently (table 1) (Alosco et al., 2013; Justin et al., 2013; Marshall, 2012; Stefansdottir et al., 2013).”
From The Pathobiology of Vascular Dementia (2013) · cites this paper as Alosco et al., 2013
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- Roger VL, 2012, Heart disease and stroke statistics‐2012 update, Circulation, 125, e2
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The Pathobiology of Vascular Dementia
Iadecola, C. (2013) · Neuron · doi:10.1016/j.neuron.2013.10.008 · Cited by 1,857
“Reduction in global cerebral perfusion caused by cardiac arrest, arrhythmias, cardiac failure, or hypotension can produce brain dysfunction and impair cognition transiently or permanently (Table 1) (Alosco et al., 2013; Justin et al., 2013; Marshall, 2012; Stefansdottir et al., 2013).”
Cerebral blood flow in small vessel disease: A systematic review and meta-analysis
Shi, Y., Thrippleton, M. J., Makin, S., Marshall, I., Geerlings, M. I., de Craen, A. J. M., van Buchem, M. A., & Wardlaw, J. M. (2016) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1177/0271678x16662891 · Cited by 313
Modifiable Risk Factors for Alzheimer’s Disease
Edwards III, G. A., Gamez, N., Escobedo Jr., G., Calderon, O., & Moreno-Gonzalez, I. (2019) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2019.00146 · Cited by 253
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Heart failure and cognitive dysfunction
Ampadu, J. O., & Morley, J. E. (2014) · International Journal of Cardiology · doi:10.1016/j.ijcard.2014.10.087 · Cited by 172
Metadata
- Authors
- Alosco, M. L., Brickman, A. M., Spitznagel, M. B., Garcia, S. L., Narkhede, A., Griffith, E. Y., Raz, N., Cohen, R., Sweet, L. H., Colbert, L. H., Josephson, R., Hughes, J., Rosneck, J., & Gunstad, J.
- Affiliations
- Kent State University (US)
- Columbia University (US)
- Summa Health System (US)
- Department of Psychology Kent State University Kent OH
- Wayne State University (US)
- University of Florida (US)
- University of Georgia (US)
- University of Wisconsin–Madison (US)
- University Hospitals Cleveland Medical Center (US)
- Corresponding author
- Alosco, Michael L.
- ORCID
- Venue
- Congestive Heart Failure
- Publisher
- Wiley
- Published
- 2013-03-20
- Volume
- 19
- Issue
- 4
- Pages
- E29-34
- ISSN
- 1527-5299 (ISSN-L)
- 1751-7133
- PMC
- PMC3692594
- OpenAlex
- W2077264199
- Cited by
- 125
- References
- 63
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 7 · 2023: 8 · 2022: 10 · 2021: 7 · 2020: 7 · 2019: 9 · 2018: 7 · 2017: 5 · 2016: 13 · 2015: 8 · 2014: 16 · 2013: 6
- FWCI
- 10.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Congestive Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (R37AG011230, R01AG034189, P30AG028740)
- National Heart, Lung, and Blood Institute (R01HL089311, HL089311)
- National Institute of Diabetes and Digestive and Kidney Diseases (R56DK075119, DK075119, R01DK075119)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Health Sciences › Medicine › Clinical Neurology › Cerebrovascular and genetic disorders
- Keywords
- heart failure, white matter hyperintensities, cerebral perfusion, cerebral blood flow velocity, middle cerebral artery, cognitive impairment, cerebral hypoperfusion, older adults, transcranial Doppler, brain MRI, Mini-Mental State Examination
- MeSH terms
- Aged, Aged, 80 and over, Brain, Cerebrovascular Circulation, Cognition Disorders, Female, Heart Failure, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neuropsychological Tests, Prospective Studies
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