Objective
Cardiac resynchronisation therapy (CRT) has emerged as a new treatment strategy for
a subgroup of patients with heart failure. In this study, we aimed to evaluate acute
effects of CRT on cerebral blood flow.
Material and methods
Twenty-two (six female and 16 male) patients (mean age 60.8 ± 5.3 years) with idiopathic dilated cardiomyopathy were enrolled in the study. Blood
flow in the common carotid artery (CCA), internal carotid artery (ICA), and vertebral
arteries (VA) was evaluated by Colour Doppler ultrasound. All measurements were performed
at a constant heart rate of 90 beats/min for excluding the influence of variant heart rates.
Results
Flow velocities, flow volume, resistivity and pulsatility indices which were correlated
with cardiac output (CO) significantly increased after CRT. The only parameter affecting
the change in mean velocity and flow volume in VA was the change in the CO (β = 1.1, p = 0.02 and β = 1.2, p = 0.04, respectively). The change in peak systolic velocity after CRT in VA and the
change in mean velocity and volume in ICA were affected by the change in the CO (β = 1.2, p = 0.007; β = 0.8, p = 0.08 and β = 0.6, p = 0.03, respectively). The change in total cerebral blood flow was also affected by
the change in CO (β = 1.3, p = 0.003).
Conclusion
CRT increases the carotid and vertebral artery blood flow velocities, flow volumes
and therefore improves cerebral blood flow. This improvement in the cerebral blood
flow after CRT is largely due to the increase in the cardiac output.
Keywords
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Article info
Publication history
Published online: January 07, 2013
Accepted:
October 28,
2012
Received in revised form:
October 10,
2012
Received:
June 6,
2012
Identification
Copyright
© 2012 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier Inc. All rights reserved.
