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dc.contributor.authorD. Rosen, Stuarten_US
dc.contributor.authorMurphy, Kevinen_US
dc.contributor.authorP. Leff, Alexanderen_US
dc.contributor.authorCunningham, Vincenten_US
dc.contributor.authorJ.S. Wise, Richarden_US
dc.contributor.authorAdams, Lewisen_US
dc.contributor.authorJ.S. Coats, Andrewen_US
dc.contributor.authorG. Camici, Paoloen_US
dc.contributor.editorFrans Van de Werf (Editor-in-Chief)en_US
dc.description.abstractAims Breathlessness is a cardinal symptom of heart failure and the altered regulation of breathing is common. The contribution of abnormal central nervous system activity has not previously been investigated directly, although abnormal autonomic responses have been described. Our aim was to assess whether heart failure patients exhibit different patterns of regional brain activation after exercise stress. Methods We used positron emission tomography with H215O, to measure changes in regional cerebral blood flow (rCBF) and absolute global cerebral blood flow (gCBF) in 6 male class II/III heart failure patients and 6 normal controls. Breathlessness (0-5 visual analogue scale) and respiratory parameters were measured at rest, after horizontal bicycle exercise and during isocapnic hyperventilation. CBF was measured in each condition in all subjects. Results Both groups were similarly breathless after exercise and the respiratory parameters were comparable. rCBF differences for the main comparison (exercise vs hyperventilation) were: activation of the right frontal medial gyrus () and left precentral gyrus () in controls but not in patients. Both groups had rCBF increases in the left anterior cingulate () and right dorsal cingulate cortex (). The gCBF did not differ between exercise, isocapnic hyperventilation and rest in patients but, in controls, gCBF was greater after exercise compared to either isocapnic hyperventilation or rest. Conclusion Heart failure patients had a distinct pattern of regional cortical activity with exercise-induced breathlessness but unvarying CBF values between conditions. These central neural differences in activity may contribute to some features of heart failure, such as variability in symptoms and autonomic dysregulation.en_US
dc.publisherOxford University Pressen_US
dc.publisher.placeUnited Kingdomen_US
dc.relation.ispartofjournalEuropean Heart Journalen_US
dc.titleIs central nervous system processing altered in patients with heart failure?en_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Peer Reviewed (HERDC)en_US
dc.type.codeC - Journal Articlesen_US
gro.rights.copyrightThis is a pre-copy-editing, author-produced PDF of an article accepted for publication in European Heart Journal following peer review. The definitive publisher-authenticated version Eur Heart J 2004 25: 952-962 is available online at:
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