Some aspects of cardio-cerebral relationship in surgical patients with multifocal atherosclerosis and heart failure

Abstract

Relevance . The level of cerebral perfusion in patients with multifocal atherosclerosis depends not only on the restriction of blood flow through the carotid arteries, but also on the degree of myocardial changes. Goal of investigation. Determine the presence of a relationship between the indices of regional cerebral blood flow according to SPECT data and echocardiographic parameters of cardiac activity and analyze the mechanism of their relationship. Material and methods . We examined 22 patients (18 men and 4 women aged 64 ± 6.5 years) with signs of chronic heart failure and multifocal atherosclerosis with the involvement of carotid and coronary arteries, who underwent simultaneous surgery. All patients underwent echocardiographic examination of the heart and SPECT of the brain. Results . Moderate direct correlations were revealed between the indices of regional cerebral blood flow (CBF) and ejection fraction (p = 0.009307), SV/EDV (p = 0.012431); moderate inverse correlations between the indices of CBF and SV (p = 0.002913), EDV (p = 0.031737), ESV (p = 0.016483), ESV/EDV (p = 0.010645), ESV/SV (p = 0.007255). In the postoperative period, a moderate direct correlation was found between indicators of cognitive status (MMSE) and indicators of cerebral perfusion in the right occipital, parietal and frontal lobes (p = 0.021162, R = 0.511475). Conclusion . The echocardiographic parameters we studied in patients with chronic heart failure correlate with indicators of regional cerebral blood flow, and this relationship is more pronounced not in the ejection fraction, but is traced between the parameters of the end diastolic volume, end systolic volume and their ratio according to the principle of the golden ratio. The data obtained on the perfusion of the brain by the SPECT method are associated with indicators of cardiac activity and reflect the severity of chronic heart failure.