Artery Research

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Volume 20, Issue C, December 2017, Pages 57 - 57

4.4 MIDDLE CEREBRAL ARTERY PULSATILITY IN HEART FAILURE AND PATIENTS WITH CONTINUOUS-FLOW LEFT VENTRICULAR ASSIST DEVICES

Authors
Eric Stöhr1, Francesco Castagna1, James Pearson2, Laura Watkeys3, Samuel Trocio1, Oksana Zatvarska1, Timothy Crimmins1, Alberto Pinsino1, Paolo Colombo1, Melana Yuzefpolskaya1, Reshad Garan1, Veli Topkara1, Hiroo Takayama1, Koji Takeda1, Yoshifumi Naka1, John Cockcroft3, Joshua Willey1, Barry McDonnell3
1Columbia University Irving Medical Center, USA
2University of Colorado at Colorado Springs, USA
3Cardiff Metropolitan University, UK
Available Online 6 December 2017.
DOI
10.1016/j.artres.2017.10.042How to use a DOI?
Abstract

Background: High pulsatility index (PI) in the cerebral circulation has been associated with increased prevalence of stroke (1). Interestingly, heart failure (HF) patients implanted with continuous-flow left ventricular assist devices (CF-LVADs) have increased rates of stroke despite presenting with dramatically lower pulse pressures compared with healthy individuals (20 mmHg vs. 30–40 mmHg). Characterising and understanding flow velocity profiles of the middle cerebral artery (MCA) may provide a useful and local marker of pulsatile energy transmitted into the brain of HF and CF-LVAD patients.

Methods: PI and resistance index (RI) were quantified from Duplex ultrasound images (2D and pulsed-wave Doppler) of the MCA obtained in four heart failure patients (HF; 68 ± 7 yrs), eight CF-LVAD patients (59 ± 4 yrs) and 20 healthy controls (51 ± 7 yrs).

Results: Compared with healthy controls, PI of the MCA was actually higher in the HF group (0.72 ± 0.16 vs. 1.32 ± 0.17, P < 0.0001), but markedly lower in patients on CF-LVAD (0.36 ± 0.21, P < 0.0001). However, RI was similar between healthy controls and HF patients (P > 0.05), and only lower in CF-LVAD patients (P < 0.0001).

Conclusions: PI in the MCA is significantly higher in HF but markedly lower in CF-LVAD patients, relative to healthy controls. The higher PI in HF does not appear to be associated with an altered RI. Future work should examine the cerebrovascular outcomes associated with varying levels of pulsatility and resistance in both HF and CF-LVAD patients.

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This is an open access article distributed under the CC BY-NC license.

Reference

1.AJ Webb, M Simoni, S Mazzucco, W Kuker, U Schulz, and PM Rothwell, Increased cerebral arterial pulsatility in patients with leukoaraiosis: arterial stiffness enhances transmission of aortic pulsatility, Stroke, Vol. 43, No. 10, 2012, pp. 2631-6.
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Journal
Artery Research
Volume-Issue
20 - C
Pages
57 - 57
Publication Date
2017/12/06
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2017.10.042How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

risenwbib
TY  - JOUR
AU  - Eric Stöhr
AU  - Francesco Castagna
AU  - James Pearson
AU  - Laura Watkeys
AU  - Samuel Trocio
AU  - Oksana Zatvarska
AU  - Timothy Crimmins
AU  - Alberto Pinsino
AU  - Paolo Colombo
AU  - Melana Yuzefpolskaya
AU  - Reshad Garan
AU  - Veli Topkara
AU  - Hiroo Takayama
AU  - Koji Takeda
AU  - Yoshifumi Naka
AU  - John Cockcroft
AU  - Joshua Willey
AU  - Barry McDonnell
PY  - 2017
DA  - 2017/12/06
TI  - 4.4 MIDDLE CEREBRAL ARTERY PULSATILITY IN HEART FAILURE AND PATIENTS WITH CONTINUOUS-FLOW LEFT VENTRICULAR ASSIST DEVICES
JO  - Artery Research
SP  - 57
EP  - 57
VL  - 20
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2017.10.042
DO  - 10.1016/j.artres.2017.10.042
ID  - Stöhr2017
ER  -