The Influence of Heart Stress on the Brain: a Preliminary Study

The Influence of Heart Stress on the Brain: a Preliminary Study

A.K. Macpherson S. Neti M. Averbach K. Murugesan V. Koushik

Institute of Biomedical Engineering and mathematical Biology, lehigh university, uSa.Institute of Biomedical Engineering and mathematical Biology, lehigh university, USA.

Division of cardiology, St lukes hospital, USA.

Department of applied Technology, rogers State university, USA.

6 April 2010
| Citation



The interaction between the cardiac hemodynamics and brain activity has been extensively studied in the past. However these studies have involved not only an increase in heart rate but also an increase in blood pressure. One method to evaluate for underlying coronary artery disease is to perform stress testing. Often, myocardial stress is achieved by the patient walking on a treadmill or riding a stationary bicycle while being monitored. In patients that are unable to exercise, pharmacologic stress testing is performed, either with vasodilatory agents (e.g. adenosine) or dobutamine, which is a pro-inotropic and chronotropic drug. During dobutamine infusion, the heart rate increases, but there is a negligible increase in blood pressure. The result is that the heart rate increases as a function of the dosage. Thus by monitoring brain activity while patients are undergoing dobutamine stress testing the effect of increased blood pressure on the brain is removed. It was found in the results of one patient that there are fi ve areas of the brain which show a change in the frequency of EEG activity that is a function of dobutamine dosage. Using Fourier transforms it was established that this change occurred at a frequency around 12.5 Hz. The regions of the brain where the increased activity were a function of heart rate occurred in the CZ-PZ, C4-P4, T5-O1, T4-T6 and C3-P3 regions. In undertaking these calculations it was realized that the stress on the ventricle could be calculated. The physicians monitor ECG of the patient to evaluate the cardiac status of the patient. Since currently the attending physician does not have data on the stress being applied to the myocardium, it would be useful to have this calculated on a real time basis. The motivation for the present preliminary study is to both investigate the feasibility of producing such information for clinicians as well as to investigate the variation between different patients as the heart rate varies. It was found that generally the surface shear stress increased with heart rate around most of the left ventricle. While the time averaged shear stress may be important for diagnosis the maximum shear stress probably is the limiting factor in terminating testing.


brain, diagnostic tool, echocardiogram, electroencephalogram, frequency, heart, stress


[1] Paetsch, I., Jahnke, c., Wahl, a., Gebker, r., Neuss, m., fleck, E. & Nagel, E., comparison of dobutamine stress magnetic resonance, adenosine stress magnetic resonance, and adenosine stress magnetic resonance perfusion. Circulation, 110, pp. 835–842, 2004. doi:10.1161/01.cIr.0000138927.00357.fB

[2] Picano, E., lattanzi, f., Orlandini, a., marini, c. & l’abbate, a., Stress echocardiography and the human factor: the importance of being expert. Journal of the American College of Cardiology, 17, pp. 666–669, 1991.

[3] madler, c.f., Payne, N., Wilkenshoff, u., cohen, a., Derumeaux, G.a., Pierard, l.a., Engvall, J., Brodin, l.a., Sutherland, G.r. & fraser, a.G., Non-invasive diagnosis of coronary artery disease by quantitative stress echocardiography: optimal diagnostic models using off-line tissue Doppler in the myDISE study. European Heart Journal, 24, pp. 1584–1594, 2003. doi:10.1016/S0195-668X(03)00099-X

[4] Voigt, J.u., Exner, B., Schmiedehausen, K., huchzermeyer, c., reulbach, u., Nixdorff, u., Platsch, G., Kuwert, T., Daniel, W.G., flachskampf, f.a., Strain-rate imaging during dobutamine stress echocardiography provides objective evidence of inducible ischemia. Circulation, 107, pp. 2120–2126, 2003. doi:10.1161/01.cIr.0000065249.69988.aa

[5] hoffman, r., lethen, h., Kuhl, h., lepper, W. & hanrath, P., Extent and severity of test positivity during dobutamine stress echocardiography. European Heart Journal, 20, pp. 1485–1492, 1999. doi:10.1053/euhj.1999.1628

[6] Geleijnse, m.l., fioretti, P.m. & roelandt, J.r., methodology, feasibility, safety and diagnostic accuracy of dobutamine stress echocardiography. Journal of the American College of Cardiology, 30, pp. 595–606, 1997.

[7] Dikshit, B.B., The production of cardiac irregularities by excitation of the hypothalamic centres. Journal of Physiology, 81, pp. 382–394, 1934. doi:10.1016/S0735-1097(97)00206-4

[8] Jessup, m., Brozena, S., heart failure. The New England Journal of Medicine, 348, pp. 2007–2018, 2003. doi:10.1056/NEJmra021498, doi:10.1056/NEJme030030