Related Experiment Video
Updated: Jul 15, 2026
MRI and PET in Mouse Models of Myocardial Infarction
Published on: December 19, 2013
Association of Glymphatic System Dysfunction with Cardiac Injury and Cognitive Impairment in Heart Failure:
Chong Zheng1, Yadong Cui1, Rui Qin1
1Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China (C.Z., Y.C., R.Q., G.L., J.L.); Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China (C.Z., Y.C., R.Q., G.L., J.L.).
Insights
Heart failure patients show impaired brain glymphatic function, linked to cardiac injury and cognitive decline. The mean ALPS index mediates this connection, highlighting a potential therapeutic target for cognitive impairment in heart failure.
Area of Science:
- Neuroscience
- Cardiology
- Radiology
Background:
- Glymphatic dysfunction is a key factor in cognitive impairment.
- Its role in heart failure (HF) is not well understood.
- This study examines glymphatic function in HF patients.
Purpose of the Study:
- Investigate glymphatic dysfunction in heart failure patients.
- Explore the relationship between cardiac injury and cognitive performance.
- Determine if cardiac injury contributes to cognitive impairment via glymphatic pathways.
Main Methods:
- Brain MRI was used to assess glymphatic markers in 46 HF patients and 39 healthy controls (HCs).
- Cardiac MRI assessed cardiac injury markers in HF patients.
- Correlations, regressions, and mediation analyses examined relationships between glymphatic markers, cardiac injury, and cognition.
Main Results:
- HF patients had significantly altered glymphatic markers compared to HCs, including higher choroid plexus volume, perivascular space scores, and fractional free water, and lower ALPS index and BOLD-CSF coupling.
- The ALPS index and perivascular space scores correlated with cognitive function (MoCA scores).
- Cardiac function (stroke volume) correlated with the ALPS index, which mediated the link between cardiac function and cognition.
Conclusions:
- Heart failure patients exhibit significant glymphatic dysfunction.
- The mean ALPS index is closely linked to cardiac function and cognitive status.
- Cardiac injury-induced glymphatic dysfunction may underlie cognitive impairment in heart failure.
Rationale And Objectives:
Glymphatic dysfunction, a critical pathway to cognitive impairment, remains underexplored in heart failure (HF). This study investigated glymphatic dysfunction in patients with HF and the relationship between cardiac injury and cognitive performance.
Methods:
46 HF patients and 39 age- and sex-matched healthy controls (HCs) underwent brain MR to assess glymphatic markers: choroid plexus (CP) volume, perivascular space (PVS) score, white matter fractional free water (FW), diffusivity along perivascular spaces (ALPS), blood-oxygen-level-dependent (BOLD) signals, and cerebrospinal fluid (CSF) coupling. Group differences were analyzed, and same-day cardiac MR in HF patients assessed cardiac injury markers. Correlation, regression, and mediation analyses explored associations between glymphatic markers, cardiac injury markers, and cognition.
Results:
Patients with HF exhibited significantly higher CP volume, PVS scores, and FW, alongside a lower mean ALPS index and BOLD-CSF coupling than HCs (all P<0.05). Montreal Cognitive Assessment (MoCA) score correlated positively with the mean ALPS index (r=0.479, Padjust=0.014) and inversely with basal ganglia PVS score (r=-0.462, Padjust=0.033) and BOLD-CSF coupling (r=-0.398, Padjust=0.043). Among cardiac MRI parameters, stroke volume (SV) and SV index (SVI) correlated significantly with the mean ALPS index (r=0.419, Padjust=0.020; r=0.448, Padjust=0.014). Mediation analysis showed that the mean ALPS index mediated the correlation between SV/SVI and MoCA scores.
Conclusion:
Patients with HF exhibit glymphatic dysfunction, with the mean ALPS index closely correlated to cardiac function and cognition. Cardiac injury-related glymphatic dysfunction in patients with HF may link to cognitive impairment.
Related Concept Videos
01:17Pathophysiology of Heart Failure
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...