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

Eric Stöhr; Francesco Castagna; James Pearson; Laura Watkeys; Samuel Trocio; Oksana Zatvarska; Timothy Crimmins; Alberto Pinsino; Paolo Colombo; Melana Yuzefpolskaya; Reshad Garan; Veli Topkara; Hiroo Takayama; Koji Takeda; Yoshifumi Naka; John Cockcroft; Joshua Willey; Barry McDonnell

doi:10.1016/j.artres.2017.10.042

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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.2017.10.042 How 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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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.2017.10.042 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

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ris enw bib

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  -

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