Neurovascular coupling and cerebral autoregulation in atrial fibrillation

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Neurovascular coupling and cerebral autoregulation in atrial fibrillation. / Junejo, Rehan; Dutra Braz, Igor; Lucas, Sam; van Lieshout, Johannes J; Phillips, Aaron; Lip, Gregory; Fisher, James.

In: Journal of Cerebral Blood Flow and Metabolism, 19.08.2019.

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@article{e679d524b6c3434b805bcfcf761a7149,
title = "Neurovascular coupling and cerebral autoregulation in atrial fibrillation",
abstract = "The risk of cognitive decline and stroke is increased by atrial fibrillation (AF). We sought to determine whether neurovascular coupling and cerebral autoregulation are blunted in people with AF in comparison with age-matched, patients with hypertension and healthy controls. Neurovascular coupling was assessed using five cycles of visual stimulation for 30 s followed by 30 s with both eyes-closed. Cerebral autoregulation was examined using a sit–stand test, and a repeated squat-to-stand (0.1 Hz) manoeuvre with transfer function analysis of mean arterial pressure (MAP; input) and middle cerebral artery mean blood flow velocity (MCA Vm; output) relationships at 0.1 Hz. Visual stimulation increased posterior cerebral artery conductance, but the magnitude of the response was blunted in patients with AF (18 [8] %; mean [SD]) and hypertension (17 [8] %), in comparison with healthy controls (26 [9] %) (P < 0.05). In contrast, transmission of MAP to MCA Vm was greater in AF patients compared to hypertension and healthy controls, indicating diminished cerebral autoregulation. We have shown for the first time that AF patients have impaired neurovascular coupling responses to visual stimulation and diminished cerebral autoregulation. Such deficits in cerebrovascular regulation may contribute to the increased risk of cerebral dysfunction in people with AF.",
keywords = "Aging, atrial fibrillation, brain, cerebral circulation, hypertension",
author = "Rehan Junejo and {Dutra Braz}, Igor and Sam Lucas and {van Lieshout}, {Johannes J} and Aaron Phillips and Gregory Lip and James Fisher",
year = "2019",
month = aug
day = "19",
doi = "10.1177/0271678X19870770",
language = "English",
journal = "Journal of Cerebral Blood Flow and Metabolism",
issn = "0271-678X",
publisher = "Nature Publishing Group",

}

RIS

TY - JOUR

T1 - Neurovascular coupling and cerebral autoregulation in atrial fibrillation

AU - Junejo, Rehan

AU - Dutra Braz, Igor

AU - Lucas, Sam

AU - van Lieshout, Johannes J

AU - Phillips, Aaron

AU - Lip, Gregory

AU - Fisher, James

PY - 2019/8/19

Y1 - 2019/8/19

N2 - The risk of cognitive decline and stroke is increased by atrial fibrillation (AF). We sought to determine whether neurovascular coupling and cerebral autoregulation are blunted in people with AF in comparison with age-matched, patients with hypertension and healthy controls. Neurovascular coupling was assessed using five cycles of visual stimulation for 30 s followed by 30 s with both eyes-closed. Cerebral autoregulation was examined using a sit–stand test, and a repeated squat-to-stand (0.1 Hz) manoeuvre with transfer function analysis of mean arterial pressure (MAP; input) and middle cerebral artery mean blood flow velocity (MCA Vm; output) relationships at 0.1 Hz. Visual stimulation increased posterior cerebral artery conductance, but the magnitude of the response was blunted in patients with AF (18 [8] %; mean [SD]) and hypertension (17 [8] %), in comparison with healthy controls (26 [9] %) (P < 0.05). In contrast, transmission of MAP to MCA Vm was greater in AF patients compared to hypertension and healthy controls, indicating diminished cerebral autoregulation. We have shown for the first time that AF patients have impaired neurovascular coupling responses to visual stimulation and diminished cerebral autoregulation. Such deficits in cerebrovascular regulation may contribute to the increased risk of cerebral dysfunction in people with AF.

AB - The risk of cognitive decline and stroke is increased by atrial fibrillation (AF). We sought to determine whether neurovascular coupling and cerebral autoregulation are blunted in people with AF in comparison with age-matched, patients with hypertension and healthy controls. Neurovascular coupling was assessed using five cycles of visual stimulation for 30 s followed by 30 s with both eyes-closed. Cerebral autoregulation was examined using a sit–stand test, and a repeated squat-to-stand (0.1 Hz) manoeuvre with transfer function analysis of mean arterial pressure (MAP; input) and middle cerebral artery mean blood flow velocity (MCA Vm; output) relationships at 0.1 Hz. Visual stimulation increased posterior cerebral artery conductance, but the magnitude of the response was blunted in patients with AF (18 [8] %; mean [SD]) and hypertension (17 [8] %), in comparison with healthy controls (26 [9] %) (P < 0.05). In contrast, transmission of MAP to MCA Vm was greater in AF patients compared to hypertension and healthy controls, indicating diminished cerebral autoregulation. We have shown for the first time that AF patients have impaired neurovascular coupling responses to visual stimulation and diminished cerebral autoregulation. Such deficits in cerebrovascular regulation may contribute to the increased risk of cerebral dysfunction in people with AF.

KW - Aging

KW - atrial fibrillation

KW - brain

KW - cerebral circulation

KW - hypertension

UR - http://www.scopus.com/inward/record.url?scp=85071473516&partnerID=8YFLogxK

U2 - 10.1177/0271678X19870770

DO - 10.1177/0271678X19870770

M3 - Article

C2 - 31426699

JO - Journal of Cerebral Blood Flow and Metabolism

JF - Journal of Cerebral Blood Flow and Metabolism

SN - 0271-678X

ER -