Neurovascular coupling and cerebral autoregulation in atrial fibrillation


Junejo, Rehan T ORCID: 0000-0002-0670-8339, Braz, Igor D, Lucas, Samuel JE, van Lieshout, Johannes J, Phillips, Aaron A, Lip, Gregory YH ORCID: 0000-0002-7566-1626 and Fisher, James P (2020) Neurovascular coupling and cerebral autoregulation in atrial fibrillation. JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM, 40 (8). pp. 1647-1657.

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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 V<sub>m</sub>; 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] %) (<i>P</i> < 0.05). In contrast, transmission of MAP to MCA V<sub>m</sub> 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.

Item Type: Article
Uncontrolled Keywords: Aging, atrial fibrillation, brain, cerebral circulation, hypertension
Depositing User: Symplectic Admin
Date Deposited: 03 Oct 2019 08:46
Last Modified: 19 Jan 2023 00:24
DOI: 10.1177/0271678X19870770
Open Access URL: https://doi.org/10.1177/0271678X19870770
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3056834
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