Cerebral blood flow and cognitive functioning in patients with disorders along the heart-brain axis: Cerebral blood flow and the heart-brain axis

Anna E Leeuwis*, Astrid M Hooghiemstra, Esther E Bron, Sanne Kuipers, Eline A Oudeman, Tugba Kalay, Hans-Peter Brunner-La Rocca, L Jaap Kappelle, Robert J van Oostenbrugge, Jacoba P Greving, Wiro J Niessen, Mark A van Buchem, Matthias J P van Osch, Albert C van Rossum, Niels D Prins, Geert-Jan Biessels, Frederik Barkhof, Wiesje M van der Flier, Heart–Brain Connection consortium

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Web of Science)


Introduction: We examined the role of hemodynamic dysfunction in cognition by relating cerebral blood flow (CBF), measured with arterial spin labeling (ASL), to cognitive functioning, in patients with heart failure (HF), carotid occlusive disease (COD), and patients with cognitive complaints and vascular brain injury on magnetic resonance imaging (MRI; ie, possible vascular cognitive impairment [VCI]).

Methods: We included 439 participants (124 HF; 75 COD; 127 possible VCI; 113 reference participants) from the Dutch multi-center Heart-Brain Study. We used pseudo-continuous ASL to estimate whole-brain and regional partial volume-corrected CBF. Neuropsychological tests covered global cognition and four cognitive domains.

Results: CBF values were lowest in COD, followed by VCI and HF, compared to reference participants. This did not explain cognitive impairment, as we did not find an association between CBF and cognitive functioning.

Discussion: We found that reduced CBF is not the major explanatory factor underlying cognitive impairment in patients with hemodynamic dysfunction along the heart-brain axis.

Original languageEnglish
Article numbere12034
Number of pages11
JournalAlzheimer's and Dementia: Translational Research and Clinical Interventions
Issue number1
Publication statusPublished - 2020


  • carotid occlusive disease
  • cognitive impairment
  • heart failure
  • perfusion
  • small vessel disease
  • vascular cognitive impairment

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