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Impaired cerebral oxygenation in heart failure patients at rest and during head-up tilt testing

Kharraziha, Isabella LU ; Holm, Hannes LU ; Magnusson, Martin LU ; Wollmer, Per LU ; Molvin, John LU ; Jujic, Amra LU ; Fedorowski, Artur LU ; Bachus, Erasmus LU and Hamrefors, Viktor LU (2021) In ESC Heart Failure 8(1). p.586-594
Abstract

AIMS: Heart failure (HF) confers potentially negative effects on the brain and autonomic nervous system. The measurement cerebral tissue oxygen saturation (SctO2 ) may aid in understanding such effects. We aimed to investigate if compensated HF affects SctO2 at rest and during orthostatic challenge.

METHODS AND RESULTS: Non-invasive haemodynamic monitoring and near-infrared spectroscopy were applied during head-up tilt (HUT) in 61 HF patients [mean (SD) 71 (11) years, 82% male, New York Heart Association (NYHA) class I-III] and 60 controls [60 (12) years, 42% male). Group differences in continuous variables were compared using Student's t-test. Associations between HF and SctO2 were studied using multivariable linear regression... (More)

AIMS: Heart failure (HF) confers potentially negative effects on the brain and autonomic nervous system. The measurement cerebral tissue oxygen saturation (SctO2 ) may aid in understanding such effects. We aimed to investigate if compensated HF affects SctO2 at rest and during orthostatic challenge.

METHODS AND RESULTS: Non-invasive haemodynamic monitoring and near-infrared spectroscopy were applied during head-up tilt (HUT) in 61 HF patients [mean (SD) 71 (11) years, 82% male, New York Heart Association (NYHA) class I-III] and 60 controls [60 (12) years, 42% male). Group differences in continuous variables were compared using Student's t-test. Associations between HF and SctO2 were studied using multivariable linear regression models adjusted for age, sex, diabetes, smoking, systolic blood pressure (SBP), and heart rate in supine position and after 10 min of HUT. Mean SctO2 was lower in HF patients compared with controls both in the supine position (67 vs. 71%; P < 0.001) and after 10 min of HUT (64 vs. 69%; P < 0.001). The HUT-induced SctO2 decrease was greater in HF patients compared with controls (P = 0.026). SBP did not change in neither HF patients nor controls during HUT, whereas diastolic blood pressure and heart rate increased in both groups. HF was associated with lower SctO2 in supine (B = -2.5%, P = 0.023) and after 10 min of HUT (B = -2.6%, P = 0.007) after multivariable adjustments.

CONCLUSIONS: Cerebral tissue oxygenation is lower in HF patients both at rest and during orthostasis compared with subjects without HF. Future studies should test if the lower cerebral oxygenation associates with negative prognosis and with impaired cognitive function.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
ESC Heart Failure
volume
8
issue
1
pages
586 - 594
publisher
John Wiley and Sons
external identifiers
  • scopus:85097256859
  • pmid:33295067
ISSN
2055-5822
DOI
10.1002/ehf2.13128
language
English
LU publication?
yes
additional info
© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
id
f598a4de-19c5-494c-939a-260c4d3fe4f3
date added to LUP
2020-12-11 10:23:24
date last changed
2021-06-16 01:16:24
@article{f598a4de-19c5-494c-939a-260c4d3fe4f3,
  abstract     = {<p>AIMS: Heart failure (HF) confers potentially negative effects on the brain and autonomic nervous system. The measurement cerebral tissue oxygen saturation (SctO2 ) may aid in understanding such effects. We aimed to investigate if compensated HF affects SctO2 at rest and during orthostatic challenge.</p><p>METHODS AND RESULTS: Non-invasive haemodynamic monitoring and near-infrared spectroscopy were applied during head-up tilt (HUT) in 61 HF patients [mean (SD) 71 (11) years, 82% male, New York Heart Association (NYHA) class I-III] and 60 controls [60 (12) years, 42% male). Group differences in continuous variables were compared using Student's t-test. Associations between HF and SctO2 were studied using multivariable linear regression models adjusted for age, sex, diabetes, smoking, systolic blood pressure (SBP), and heart rate in supine position and after 10 min of HUT. Mean SctO2 was lower in HF patients compared with controls both in the supine position (67 vs. 71%; P &lt; 0.001) and after 10 min of HUT (64 vs. 69%; P &lt; 0.001). The HUT-induced SctO2 decrease was greater in HF patients compared with controls (P = 0.026). SBP did not change in neither HF patients nor controls during HUT, whereas diastolic blood pressure and heart rate increased in both groups. HF was associated with lower SctO2 in supine (B = -2.5%, P = 0.023) and after 10 min of HUT (B = -2.6%, P = 0.007) after multivariable adjustments.</p><p>CONCLUSIONS: Cerebral tissue oxygenation is lower in HF patients both at rest and during orthostasis compared with subjects without HF. Future studies should test if the lower cerebral oxygenation associates with negative prognosis and with impaired cognitive function.</p>},
  author       = {Kharraziha, Isabella and Holm, Hannes and Magnusson, Martin and Wollmer, Per and Molvin, John and Jujic, Amra and Fedorowski, Artur and Bachus, Erasmus and Hamrefors, Viktor},
  issn         = {2055-5822},
  language     = {eng},
  number       = {1},
  pages        = {586--594},
  publisher    = {John Wiley and Sons},
  series       = {ESC Heart Failure},
  title        = {Impaired cerebral oxygenation in heart failure patients at rest and during head-up tilt testing},
  url          = {http://dx.doi.org/10.1002/ehf2.13128},
  doi          = {10.1002/ehf2.13128},
  volume       = {8},
  year         = {2021},
}