Cerebral Ventricular Dimensions in Patients with Heart Failure with Reduced Ejection Fraction (HFrEF): A...

The aim of this cross-sectional case-control study was to measure the cerebral ventricular diameters of patients with heart failure with reduced ejection fraction (HFrEF) using magnetic resonance imaging (MRI) and to investigate their differences compared to healthy controls, as well as their relationship with left ventricular ejection fraction (LVEF).

A total of 104 healthy volunteers and 104 patients with HFrEF (New York Heart Association [NYHA] class II-IV) were included in the study (mean age: 57.2 ± 8.4 vs. 59.7 ± 10.8 years, respectively; p = 0.007). In both groups, LVEF was measured using echocardiography, and cerebral ventricular diameters-including the bifrontal diameter (BFD), bihemispheric diameter (BHD), and frontal horn ratio (FHR)-were measured using MRI. Finally, the Evans index and the anteroposterior diameter of the lateral ventricle index (ALVI) were calculated.

The BFD, FHR, ALVI, and Evans index were significantly higher in the HFrEF group than in the healthy control group (BFD: 37.30 ± 3.4 vs. 31.97 ± 2.2, p < 0.001; FHR: 0.32 ± 0.03 vs. 0.28 ± 0.01, p < 0.001; ALVI: 0.44 ± 0.04 vs. 0.38 ± 0.03, p < 0.001; Evans index: 0.27 ± 0.02 vs. 0.23 ± 0.01, p < 0.001). ROC curve analysis demonstrated high diagnostic and discriminatory performance for both indices in distinguishing HFrEF patients from healthy controls (AUC = 0.901 [95% CI: 0.859-0.943], p < 0.001 for ALVI and AUC = 0.903 [95% CI: 0.862-0.944], p < 0.001 for Evans index). Correlation analysis revealed that LVEF was significantly and negatively correlated with both the Evans index (r = -0.550, p < 0.001) and ALVI (r = -0.585, p < 0.001).

Cranial ventricular dimensions are significantly increased in patients with HFrEF compared to healthy controls, and these indices are inversely correlated with LVEF systolic impairment.