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Myocardial fibrosis is associated with brain microstructural alterations in patients with heart failure: A diffusion
Chong Zheng1, Yadong Cui1, Shanshan Gu1
1Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China.
Insights
Heart failure patients show altered brain diffusion, linked to cognitive decline and myocardial fibrosis. These brain changes suggest microstructural damage associated with heart conditions.
Area of Science:
- Neuroimaging
- Cardiology
- Neurology
Background:
- Heart failure (HF) is associated with cognitive impairment.
- Brain microstructural changes may underlie cognitive deficits in HF patients.
- Understanding these changes is crucial for patient management.
Purpose of the Study:
- To investigate brain diffusion changes using apparent diffusion coefficient (ADC) in HF patients.
- To explore the relationship between brain diffusion alterations and cardiac injury.
- To correlate brain diffusion changes with cognitive performance.
Main Methods:
- Included 49 HF patients and 39 controls.
- Assessed cognitive function with MMSE and MoCA.
- Utilized brain DWI and cardiac MR (including LGE) for analysis.
Main Results:
- HF patients exhibited significantly increased ADC values in multiple brain regions.
- ADC values in hippocampus, amygdala, and insula correlated negatively with MoCA scores.
- Increased ADC in occipital gyrus and cerebellum correlated with LGE volume.
Conclusions:
- Specific brain regions show microstructural changes in HF patients, linked to cognitive impairment.
- Chronic brain microstructural alterations may be associated with myocardial fibrosis in HF.
- Brain diffusion metrics offer insights into HF-related neurological complications.
Purpose:
This study aimed to examine the changes in brain diffusion in patients with heart failure (HF) by measuring the apparent diffusion coefficient (ADC) and to investigate the relationship between these changes and cardiac injury features.
Methods:
The study included 49 patients with HF and 39 healthy controls. Cognitive performance was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). All participants underwent a brain DWI scan, followed by cardiac MR in patients with HF. The ADC values in different regions of the brain were estimated using region-of-interest analysis. Cardiac MR was used to evaluate left ventricular function and the volume of late gadolinium enhancement (LGE). Group differences in ADC values were analysed using generalised linear mixed modelling. Correlation analysis was used to explore the associations between brain diffusion alterations, cognitive performance, and cardiac injury features.
Results:
Patients with HF showed significantly increased ADC values in several brain regions, including the frontal, parietal, temporal, occipital lobes, cingulate cortex, hippocampus, cerebellum, and deep nuclei. ADC values in the right hippocampus, right amygdala, and bilateral insula were negatively correlated with MoCA scores. ADC values in the left inferior occipital gyrus (r = 0.570, P<0.001) and lobule VI of the cerebellar hemisphere (r = 0.560, P = 0.001) were correlated with LGE volume.
Conclusion:
These findings suggest that specific brain regions in patients with HF experience microstructural changes associated with cognitive impairment. Moreover, chronic brain microstructural alterations may be related to myocardial fibrosis in patients with HF.
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