Is central nervous system processing altered in patients with heart failure?

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Title Is central nervous system processing altered in patients with heart failure?
Author Rosen, Stuart D.; Murphy, Kevin; Leff, Alexander P.; Cunningham, Vincent; Wise, Richard J.S.; Adams, Lewis; Coats, Andrew J.S.; Camici, Paolo G.
Journal Name European Heart Journal
Editor Frans Van de Werf (Editor-in-Chief)
Year Published 2004
Place of publication United Kingdom
Publisher Oxford University Press
Abstract Aims Breathlessness is a cardinal symptom of heart failure and the altered regulation of breathing is common. The contribution of abnormal central nervous system activity has not previously been investigated directly, although abnormal autonomic responses have been described. Our aim was to assess whether heart failure patients exhibit different patterns of regional brain activation after exercise stress. Methods We used positron emission tomography with H215O, to measure changes in regional cerebral blood flow (rCBF) and absolute global cerebral blood flow (gCBF) in 6 male class II/III heart failure patients and 6 normal controls. Breathlessness (05 visual analogue scale) and respiratory parameters were measured at rest, after horizontal bicycle exercise and during isocapnic hyperventilation. CBF was measured in each condition in all subjects. Results Both groups were similarly breathless after exercise and the respiratory parameters were comparable. rCBF differences for the main comparison (exercise vs hyperventilation) were: activation of the right frontal medial gyrus () and left precentral gyrus () in controls but not in patients. Both groups had rCBF increases in the left anterior cingulate () and right dorsal cingulate cortex (). The gCBF did not differ between exercise, isocapnic hyperventilation and rest in patients but, in controls, gCBF was greater after exercise compared to either isocapnic hyperventilation or rest. Conclusion Heart failure patients had a distinct pattern of regional cortical activity with exercise-induced breathlessness but unvarying CBF values between conditions. These central neural differences in activity may contribute to some features of heart failure, such as variability in symptoms and autonomic dysregulation.
Peer Reviewed Yes
Published Yes
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Copyright Statement This is a pre-copy-editing, author-produced PDF of an article accepted for publication in European Heart Journal following peer review. The definitive publisher-authenticated version Eur Heart J 2004 25: 952-962 is available online at:
Volume 25
Page from 952
Page to 962
ISSN 0195-668X
Date Accessioned 2005-05-06
Language en_AU
Research Centre Menzies Health Institute Qld
Faculty Griffith Health Faculty
Subject Neurosciences
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1

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