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Cerebral oxygenation responses to standing in elderly patients with predominantly diastolic dysfunction
Author(s) -
MehagnoulSchipper D. Jannet,
Vloet Lilian C.M.,
Colier Willy N.J.M.,
Hoefnagels Willibrord H.L.,
Verheugt Freek W.A.,
Jansen René W.M.M.
Publication year - 2003
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1046/j.1475-097x.2003.00477.x
Subject(s) - medicine , orthostatic vital signs , hemodynamics , oxygenation , cerebral blood flow , cardiology , anesthesia , diastole , blood pressure
Summary Patients with left ventricular dysfunction may have different orthostatic responses of blood pressure (BP) and cerebral oxygenation than healthy elderly subjects. We investigated orthostatic changes in systemic haemodynamic variables and cerebral oxygenation in 21 elderly patients with heart failure New York Heart Association class I–III in stable condition (age 70–83 years) after withdrawal of furosemide and captopril for 2 weeks, and in 18 healthy elderly subjects (age 70–84 years). Frontal cortical concentration changes of oxyhaemoglobin ([O 2 Hb]) and deoxyhaemoglobin ([HHb]) were continuously measured by near‐infrared spectrophotometry and BP changes by Finapres before and during 10 min of standing. Upon standing [O 2 Hb] reflecting blood flow, changed by −1·2 ± 0·9 μ mol L −1 (mean ± SEM) in the patients, whereas it decreased by −4·5 ± 0·6 μ mol L −1 ( P <0·01) in the healthy subjects after standing ( P <0·05 between groups). [HHb] reflecting the sum of cerebral blood flow, arterial oxygen saturation and cerebral oxygen uptake, increased by 1·5 ± 0·5 μ mol L −1 ( P <0·05) and 1·7 ± 0·6 μ mol L −1 ( P <0·05), respectively. Compared with healthy elderly subjects, elderly patients with left ventricular dysfunction showed smaller orthostatic [O 2 Hb] decreases ( P <0·01), in relation to higher orthostatic BP rises ( P <0·05). These findings indicate that BP changes and an altered cardiovascular balance may influence orthostatic cortical haemodynamic responses in elderly subjects.