{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T13:42:32Z","timestamp":1762177352285,"version":"build-2065373602"},"reference-count":38,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T00:00:00Z","timestamp":1602028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>The hemodynamic consequences of a persistent reduced ejection fraction and unknown cardiac output on the brain have not been thoroughly studied. We sought to explore the status of the mechanisms of cerebrovascular regulation in patients with heart failure with reduced (HFrEF) and recovered (HFrecEF) ejection fraction. We monitored cerebral blood flow velocity (CBFV) with transcranial Doppler and blood pressure. Cerebral autoregulation, assessed by transfer function from the spontaneous oscillations of blood pressure to CBFV and neurovascular coupling (NVC) with visual stimulation were compared between groups of HFrEF, HFrecEF and healthy controls. NVC was significantly impaired in HFrEF patients with reduced augmentation of CBFV during stimulation (overshoot systolic CBFV 19.11 \u00b1 6.92 vs. 22.61 \u00b1 7.78 vs. 27.92 \u00b1 6.84, p = 0.04), slower upright of CBFV (rate time to overshoot: 1.19 \u00b1 3.0 vs. 3.06 (4.30) vs. 2.90 \u00b1 3.84, p = 0.02); p = 0.023) and reduced arterial oscillatory properties (natural frequency 0.17 \u00b1 0.06 vs. 0.20 \u00b1 0.09 vs. 0.24 \u00b1 0.07, p = 0.03; attenuation 0.34 \u00b1 0.24 vs. 0.48 \u00b1 0.35 vs. 0.50 \u00b1 0.23, p = 0.05). Cerebral autoregulation was preserved. The neurovascular unit of subjects with chronically reduced heart pumping capability is severely dysfunctional. Dynamic testing with transcranial Doppler could be useful in these patients, but whether it helps in predicting cognitive impairment must be addressed in future prospective studies.<\/jats:p>","DOI":"10.3390\/brainsci10100714","type":"journal-article","created":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T09:12:58Z","timestamp":1602061978000},"page":"714","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Neurovascular Coupling Impairment in Heart Failure with Reduction Ejection Fraction"],"prefix":"10.3390","volume":"10","author":[{"given":"Ana","family":"Aires","sequence":"first","affiliation":[{"name":"Department of Neurology, Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Ant\u00f3nio","family":"Andrade","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3731-4508","authenticated-orcid":false,"given":"Elsa","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Cardiovascular Research and Development Unit, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Filipa","family":"Gomes","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Department of Medicine, Faculty of Medicine of University of Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0158-4146","authenticated-orcid":false,"given":"Jos\u00e9 Paulo","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Cardiovascular Research and Development Unit, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Department of Internal Medicine, Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Department of Medicine, Faculty of Medicine of University of Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Pedro","family":"Castro","sequence":"additional","affiliation":[{"name":"Department of Neurology, Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Cardiovascular Research and Development Unit, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1161\/CIRCRESAHA.119.315813","article-title":"Brain Damage With Heart Failure: Cardiac Biomarker Alterations and Gray Matter Decline","volume":"126","author":"Mueller","year":"2020","journal-title":"Circ. 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