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Impaired cerebral oxygenation in heart failure patients at rest and during head-up tilt testing.
ESC Heart Fail. 2021 02; 8(1):586-594.EH

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 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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Authors+Show Affiliations

Kharraziha I
Department of Clinical Sciences, Lund University, Malmö, 20213, Sweden. Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.
Holm H
Department of Clinical Sciences, Lund University, Malmö, 20213, Sweden. Department of Cardiology, Skåne University Hospital, Malmö, Sweden.
Magnusson M
Department of Clinical Sciences, Lund University, Malmö, 20213, Sweden. Department of Cardiology, Skåne University Hospital, Malmö, Sweden. Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden. Hypertension in Africa Research Team (HART), North West University, Potchefstroom, South Africa.
Wollmer P
Department of Translational Medicine, Lund University, Malmö, Sweden. Department of Medical Imaging and Physiology, Skåne University Hospital, Malmö, Sweden.
Molvin J
Department of Clinical Sciences, Lund University, Malmö, 20213, Sweden. Department of Cardiology, Skåne University Hospital, Malmö, Sweden.
Jujic A
Department of Clinical Sciences, Lund University, Malmö, 20213, Sweden. Department of Cardiology, Skåne University Hospital, Malmö, Sweden.
Fedorowski A
Department of Clinical Sciences, Lund University, Malmö, 20213, Sweden. Department of Cardiology, Skåne University Hospital, Malmö, Sweden.
Bachus E
Department of Clinical Sciences, Lund University, Malmö, 20213, Sweden.
Hamrefors V
Department of Clinical Sciences, Lund University, Malmö, 20213, Sweden. Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.

MeSH

Autonomic Nervous SystemBlood PressureFemaleHeart FailureHeart RateHumansMaleTilt-Table Test

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33295067

Citation

Kharraziha, Isabella, et al. "Impaired Cerebral Oxygenation in Heart Failure Patients at Rest and During Head-up Tilt Testing." ESC Heart Failure, vol. 8, no. 1, 2021, pp. 586-594.
Kharraziha I, Holm H, Magnusson M, et al. Impaired cerebral oxygenation in heart failure patients at rest and during head-up tilt testing. ESC Heart Fail. 2021;8(1):586-594.
Kharraziha, I., Holm, H., Magnusson, M., Wollmer, P., Molvin, J., Jujic, A., Fedorowski, A., Bachus, E., & Hamrefors, V. (2021). Impaired cerebral oxygenation in heart failure patients at rest and during head-up tilt testing. ESC Heart Failure, 8(1), 586-594. https://doi.org/10.1002/ehf2.13128
Kharraziha I, et al. Impaired Cerebral Oxygenation in Heart Failure Patients at Rest and During Head-up Tilt Testing. ESC Heart Fail. 2021;8(1):586-594. PubMed PMID: 33295067.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impaired cerebral oxygenation in heart failure patients at rest and during head-up tilt testing. AU - Kharraziha,Isabella, AU - Holm,Hannes, AU - Magnusson,Martin, AU - Wollmer,Per, AU - Molvin,John, AU - Jujic,Amra, AU - Fedorowski,Artur, AU - Bachus,Erasmus, AU - Hamrefors,Viktor, Y1 - 2020/12/09/ PY - 2020/04/21/received PY - 2020/10/19/revised PY - 2020/11/11/accepted PY - 2020/12/10/pubmed PY - 2021/7/2/medline PY - 2020/12/9/entrez KW - Cerebral oximetry KW - Head-up tilt test KW - Heart failure KW - Orthostatic provocation SP - 586 EP - 594 JF - ESC heart failure JO - ESC Heart Fail VL - 8 IS - 1 N2 - 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. SN - 2055-5822 UR - https://www.unboundmedicine.com/medline/citation/33295067/Impaired_cerebral_oxygenation_in_heart_failure_patients_at_rest_and_during_head_up_tilt_testing_ DB - PRIME DP - Unbound Medicine ER -