Ambulatory Monitoring of Cerebrovascular Responses to Upright Posture and Walking in Older Adults With Heart Failure.

Autor:	Murray KR; Schlegel-UW Research Institute for Aging, University of Waterloo, Waterloo, Ontario, Canada., Poirier JA; Schlegel-UW Research Institute for Aging, University of Waterloo, Waterloo, Ontario, Canada., Au JS; Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada., Hedge ET; Schlegel-UW Research Institute for Aging, University of Waterloo, Waterloo, Ontario, Canada., Robertson AD; Schlegel-UW Research Institute for Aging, University of Waterloo, Waterloo, Ontario, Canada., Heckman GA; Schlegel-UW Research Institute for Aging, University of Waterloo, Waterloo, Ontario, Canada.; School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada., Hughson RL; Schlegel-UW Research Institute for Aging, University of Waterloo, Waterloo, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	CJC open [CJC Open] 2023 Aug 29; Vol. 5 (12), pp. 870-880. Date of Electronic Publication: 2023 Aug 29 (Print Publication: 2023).
DOI:	10.1016/j.cjco.2023.08.009
Abstrakt:	Background: Insufficient cardiac output in individuals with heart failure (HF) limits daily functioning and reduces quality of life. Although lower cerebral perfusion, secondary to limitations in cardiac output, has been observed during moderate-intensity efforts, individuals with HF also may be at risk for lower perfusion during even low-intensity ambulatory activities. Methods: We determined whether HF is associated with an altered cerebrovascular response to low-intensity activities representative of typical challenges of daily living. In this study, we monitored central hemodynamics and middle cerebral artery blood velocity (MCAv) and cerebral tissue oxygenation (near-infrared spectroscopy) in 10 individuals with HF (aged 78 ± 4 years; left ventricular ejection fraction 20%-61%) and 13 similar-aged controls (79 ± 8 years; 52%-73%) during 3 randomized transitions, as follows: (i) supine-to-standing; (ii) sitting-to-slow-paced over-ground walking; and (iii) sitting-to-normal-paced over-ground walking. Results: Throughout supine, sitting, standing, and both walking conditions, individuals with HF had lower cardiac index and cerebral tissue oxygenation than controls ( P < 0.05), and MCAv was lower across the range of blood pressure in HF patients ( P  = 0.051) and during walking only ( P  = 0.011). Individuals with HF had an attenuated increase in stroke volume index and cardiac index during normal-paced walking, compared to controls ( P < 0.01). Conclusions: The indices of cerebral perfusion from MCAv and cerebral oxygenation were lower during ambulatory activities in individuals with HF; however, relationships between MCAv and blood pressure were not different between those with HF and controls, indicating no difference in static cerebral autoregulation. (© 2023 The Authors.)
Databáze:	MEDLINE
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