Aberrant cortical morphology patterns are associated with cognitive impairment in patients with chronic heart failure

Chronic heart failure (HF) frequently correlates with significant declines in executive function, memory, and processing speed. Prior research has shown that systemic circulatory failure often leads to secondary neurological complications through reduced cerebral perfusion and chronic inflammation. These patients frequently exhibit subtle changes in brain structure that mirror their physical symptoms and functional limitations. However, the specific structural alterations in the brain's outer layers, including folding and depth, remained poorly defined in clinical populations. Understanding how cardiac function influences the physical structure of the cortex is essential for early detection of dementia-like symptoms. The relationship between the New York Heart Association (NYHA) functional classification and specific neuroanatomical markers has not been fully elucidated. This absence of evidence motivated the current investigation into the neuroanatomical underpinnings of cognitive deficits in heart failure patients.

Researchers sought to quantify specific changes in cortical thickness, complexity, and folding patterns in individuals with chronic heart failure (HF). The investigation compared these morphological indices between patients and healthy controls to identify distinct neuroanatomical signatures associated with heart disease. Scientists evaluated how clinical severity markers, such as the New York Heart Association (NYHA) class and disease duration, relate to brain health. The team also examined whether these structural brain changes could predict long-term cardiovascular outcomes over a three-year period. Identifying reliable imaging biomarkers for cognitive impairment remains a primary objective for improving patient management and quality of life. This work focuses on clarifying the relationship between circulatory failure duration and the physical degradation of specific brain regions like the left precentral gyrus. Final objectives included determining if cortical gyrification and sulcal depth could serve as more sensitive markers than simple volume measurements.

The research team recruited forty-nine individuals with chronic heart failure (HF) and an equal number of healthy control subjects for a retrospective analysis. Participants underwent high-resolution brain structural Magnetic Resonance Imaging (MRI) to capture detailed anatomical data across the entire cerebral cortex. Clinical experts administered standardized cognitive assessments to evaluate the mental performance and global cognitive status of all participants. This analysis focused on the cortical morphology index, which includes measurements of thickness, complexity, sulcal depth, and gyrification. Statistical comparisons utilized family-wise error (FWE) correction to ensure the validity of the observed differences between groups and to minimize false positives. Logistic regression analysis helped identify specific risk factors, such as the New York Heart Association (NYHA) class, capable of predicting major adverse cardiovascular events (MACE) over a three-year follow-up. The researchers also performed correlation analyses to link morphological data with clinical variables like disease duration and cognitive scores.

Patients with chronic heart failure (HF) demonstrated significantly lower cognitive scores compared to the healthy control group (p < .001). Imaging data revealed decreased cortical thickness, sulcal depth, and gyrification in brain regions associated with autonomic, sensorimotor, and cognitive functions (p < .05). Disease duration showed a negative correlation with the thickness of the left precentral gyrus (r = -.387, p = .006). Structural measurements in the left pars opercularis exhibited a strong positive association with global cognitive performance (r = .476, p < .001). The New York Heart Association (NYHA) functional class emerged as an independent risk factor for major adverse cardiovascular events (MACE) (p = .001). These findings indicate that prolonged cardiac dysfunction is linked to progressive thinning and reduced complexity of the cerebral cortex. This work also identified that the severity of physical symptoms directly mirrors the extent of morphological degradation in the brain.

The observed relationship between structural brain changes and mental decline suggests that cortical morphology serves as a viable imaging biomarker. These results provide a clearer understanding of the neuroanatomical mechanisms that drive cognitive impairment in heart failure populations. Monitoring changes in the left pars opercularis and precentral gyrus may help clinicians identify patients at higher risk for neurological complications. Future clinical strategies might incorporate brain imaging to better manage the multi-organ impact of chronic circulatory issues and prevent cognitive decline. The study highlights the importance of early intervention to preserve both cardiac and cerebral health in aging populations. Researchers suggest that targeting these morphological markers could refine the prediction of long-term cardiovascular outcomes and major adverse events. This work establishes a foundation for using cortical complexity and gyrification as diagnostic tools in the intersection of cardiology and neurology.