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Blood-Brain Barrier Dysfunction in Adults With Heart Failure.

Bhaswati Roy1, Xingfeng Shao2, Kamlesh J Jobanputra3

  • 1Department of Anesthesiology, University of California Los Angeles, Los Angeles, California, USA.

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|July 4, 2025
PubMed
Summary
This summary is machine-generated.

Heart failure (HF) patients exhibit impaired blood-brain barrier (BBB) function, leading to brain tissue injury and affecting cognitive and mood regulation. Addressing BBB dysfunction is crucial for improving brain health in HF.

Keywords:
BDI‐IIanxietyarterial transient timecognitiondepressiondiffusion‐weighted pseudo‐continuous arterial spin labelingmagnetic resonance imagingwater exchange rate

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Area of Science:

  • Neuroscience
  • Cardiology
  • Radiology

Background:

  • Heart failure (HF) is associated with brain tissue injury affecting autonomic, cognitive, and mood functions, increasing patient morbidity and mortality.
  • The precise pathological mechanisms of brain injury in HF remain unclear, with blood-brain barrier (BBB) dysfunction being a potential contributor.

Purpose of the Study:

  • To investigate blood-brain barrier (BBB) integrity and function in patients with heart failure (HF) compared to healthy controls.
  • To explore the relationship between BBB dysfunction, large artery integrity, and cognitive and mood impairments in HF.

Main Methods:

  • Diffusion-weighted pseudo-continuous arterial spin labeling (DW-pCASL) MRI was employed on 27 HF patients and 59 controls.
  • Arterial transit time (ATT) and water exchange rate across the BBB (Kw) were quantified to assess large artery integrity and BBB function, respectively.
  • Cognitive function, anxiety, and depressive symptoms were evaluated and correlated with MRI findings.

Main Results:

  • HF patients demonstrated significantly poorer cognition and increased mood deficits compared to controls.
  • Altered Kw and ATT values were observed in multiple brain regions involved in cognition and mood regulation in HF patients.
  • Specifically, increased Kw was noted in the insula, hippocampus, and cerebellum, while ATT changes varied across different brain areas.

Conclusions:

  • Heart failure is associated with impaired blood-brain barrier (BBB) function and altered large artery integrity.
  • These BBB alterations may contribute to neural damage in brain regions regulating autonomic, mood, and cognitive functions.
  • Therapeutic strategies targeting BBB repair are warranted to mitigate neurological damage and improve brain function in HF patients.