Cerebral circulation in hypertensive encephalopathy and chronic heart failure
Abstract
Aim. To compare cerebral circulation in chronic hypertensive encephalopathy (HE) with and without chronic heart failure (CHF).
Material and methods. In total, 122 patients with Stage I-III HE, but free from occlusive carotid disease, were examined. Duplex scanning was used to measure volume blood flow in common carotid arteries (CCA), vertebral arteries (VA), and middle cerebral arteries (MCA). Single photon emission computer tomography was used for cortical cerebral perfusion (CCP) assessment.
Results. Stage I diastolic CHF was diagnosed in 37 patients (30%), and Stage II diastolic CHF — in 68 (56%). Regardless from CHF presence, HE was characterised by unchanged CCA and VA hemodynamics, reduced flow velocity in MCA, and increased MCA resistance parameters. Compared to CHF-free patients, those with Stage ICHF demonstrated increased frontal CCP (p<0,05) and higher prevalence of diffuse leukoaraiosis. This reflected selective deterioration of subcortical perfusion, due to progressing atherosclerosis of penetrating cerebral arteries, which supply deep brain tissue. Compared to Stage I CHF, Stage II CHF was characterised by additional blood flow reduction and resistance index increase in MCA, CCP reduction (p<0,1), and leukoaraiosis prevalence of 40% (p<0,02).
Conclusion. In HE patients, Stage II CHF was associated with reduced cortical and subcortical brain tissue perfusion and therefore could be regarded as a marker of diffuse hypertensive remodelling of cerebral vessels.
About the Authors
L. A. Geraskina
Research Neurology Centre, Russian Academy of Medical Sciences
Russian Federation
Russian Federation
Moscow
T. N. Sharypova
Research Neurology Centre, Russian Academy of Medical Sciences
Russian Federation
Russian Federation
Moscow
V. V. Mashin
Ulyanovsk State University
Russian Federation
Russian Federation
V. Vl. Mashin
Ulyanovsk State University
Russian Federation
Russian Federation
A. V. Fonyakin
Research Neurology Centre, Russian Academy of Medical Sciences
Russian Federation
Russian Federation
Moscow
Z. A. Suslina
Research Neurology Centre, Russian Academy of Medical Sciences
Russian Federation
Russian Federation
Moscow
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Review
For citations:
Geraskina L.A., Sharypova T.N., Mashin V.V., Mashin V.V., Fonyakin A.V., Suslina Z.A. Cerebral circulation in hypertensive encephalopathy and chronic heart failure. Cardiovascular Therapy and Prevention. 2009;8(5):28-32. (In Russ.)
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