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Published on: August 17, 2022
Frontal cerebral blood flow is impaired in patients with heart transplantation
Patrizia Burra1, Marco Senzolo, Gilberto Pizzolato
1Gastroenterology Section, Department of Surgical and Gastroenterological Sciences, University of Padua, Via Giustiniani 2, Italy. burra@unipd.it
Insights
Heart transplant recipients show reduced frontal lobe blood flow, not linked to cyclosporine. This cerebral abnormality may stem from pre-existing heart disease, not the immunosuppressant therapy.
Area of Science:
- Neurology
- Cardiology
- Transplantation Medicine
Background:
- Cardiovascular disease is linked to cognitive disturbances.
- These cognitive issues persist even after heart transplantation (HT).
Purpose of the Study:
- To evaluate cerebral function in heart and liver transplant patients.
- To determine if cyclosporine therapy causes cerebral abnormalities one year post-transplantation.
Main Methods:
- Regional cerebral blood flow (rCBF) was assessed using (99m)Tc-hexamethyl-propylene-amineoxime ((99m)Tc-HM-PAO) SPECT.
- Six heart transplant (HT) patients, eight liver transplant (LT) patients, and ten controls were studied.
- rCBF was correlated with cyclosporine blood levels.
Main Results:
- HT and LT patients showed similar rCBF to controls in most regions.
- HT patients exhibited significantly lower rCBF in the frontal inferior region compared to controls.
- No correlation was found between rCBF and cyclosporine levels in either HT or LT patients.
Conclusions:
- Cerebral abnormalities in HT patients, unlike LT patients, may result from long-standing cerebral hypoperfusion due to severe heart disease.
- Cyclosporine therapy does not appear to account for these observed functional alterations.
Abstract:
Patients with cardiovascular disease have cognitive function disturbances that are still evident after heart transplantation (HT). The aim of this study was to evaluate cerebral function in transplant patients and to assess whether cyclosporine therapy was responsible for cerebral abnormalities 1 year after transplantation. Six HT patients, eight liver transplant (LT) patients, and ten age-matched healthy controls underwent regional cerebral blood flow (rCBF) assessment by the (99m)Tc-hexamethyl-propylene-amineoxime ((99m)Tc-HM-PAO) single-photon emission computed tomography (SPECT) technique. The rCBF was correlated with cyclosporine blood levels. rCBF in HT and LT patients was similar to that of controls in all regions assayed, except for the frontal inferior region of HT patients, where it was significantly lower than in controls. No correlations between rCBF and cyclosporine blood levels were found in either HT or LT patients. In conclusion, the cerebral abnormalities seen in patients after HT but not after LT may be due to long-standing cerebral hypoperfusion resulting from severe heart disease, whereas cyclosporine does not account for such functional alterations.
