Localized cerebral blood flow reductions in patients with heart failure:: A study using 99mTc-HMPAO SPECT

被引:98
作者
Alves, TCTF
Rays, J
Fraguas, R
Wajngarten, M
Meneghetti, JC
Prando, S
Busatto, GF
机构
[1] Univ Sao Paulo, Sch Med, Dept Psychiat, Sao Paulo, Brazil
[2] Univ Sao Paulo, Sch Med, Div Geriatr Cardiol, Sect Radio Isotopes,Inst Heart, Sao Paulo, Brazil
[3] Univ Sao Paulo, Inst Phys, Sao Paulo, Brazil
关键词
cerebrovascular blood flow (CBF); heart failure (HF); cognition; single-photon emission computed tomaraphy (SPECT); neuroimage;
D O I
10.1177/1051228404272880
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose. Reduced resting global cerebral blood flow has been previously detected in association with heart failure (HF), but it is not clear whether there are brain regions that could be specifically affected by those brain perfusion deficits. The authors used a fully automated, voxel-based image analysis method to investigate, across the entire cerebral volume, the presence of resting regional cerebral blood flow (rCBF) abnormalities in HF patients compared to healthy controls. Methods. rCBF was evaluated with Tc-99m-single-photon emission computed tomography in 17 HF patients (New York Heart Association functional class II or III) and 18 elderly healthy volunteers. Voxel-based analyses of rCBF data were conducted using the statistical parametric mapping software. Results. Significant rCBF reductions in HF patients relative to controls (P < .05, corrected for multiple comparisons) were detected in 2 foci, encompassing, respectively, the left and right precuneus and cuneus and the right lateral temporoparietal cortex and posterior cingulate gyrus. In the HF group, there was also a significant direct correlation between the degree of cognitive impairment as assessed using the Cambridge Mental Disorders of the Elderly Examination and rCBF on a voxel cluster involving the right posterior cingulate cortex and precuneus, located closely to the site where between-group rCBF differences had been identified. Conclusions. These preliminary findings indicate that posterior cortical areas of the brain may be particularly vulnerable to brain perfusion reductions associated with HF and suggest that functional deficits in these regions might be relevant to the pathophysiology of the cognitive impairments presented by HF patients.
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页码:150 / 156
页数:7
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