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Cerebral Ventricular Dimensions in Patients with Heart Failure with Reduced Ejection Fraction (HFrEF): A
1Bolu Abant Izzet Baysal University Medical Faculty, Department of Radiology, Merkez, Bolu, 14030, Turkey.
Insights
Heart failure with reduced ejection fraction (HFrEF) is linked to enlarged brain ventricles. These cerebral ventricular changes correlate with reduced left ventricular ejection fraction (LVEF) in HFrEF patients.
Area of Science:
- Cardiology
- Neurology
- Radiology
Background:
- Heart failure with reduced ejection fraction (HFrEF) is a complex condition with potential neurological implications.
- Cerebral structural changes, specifically ventricular dilation, have been observed in various neurological and cardiovascular diseases.
Purpose of the Study:
- To quantify cerebral ventricular diameters in patients with HFrEF using MRI.
- To compare these diameters with those of healthy controls.
- To investigate the relationship between ventricular dimensions and left ventricular ejection fraction (LVEF) in HFrEF.
Main Methods:
- A cross-sectional case-control study involving 104 HFrEF patients (NYHA class II-IV) and 104 healthy volunteers.
- Cerebral ventricular diameters (BFD, BHD, FHR) measured via MRI; LVEF assessed by echocardiography.
- Calculation of Evans index and anteroposterior diameter of the lateral ventricle index (ALVI).
Main Results:
- HFrEF patients exhibited significantly larger bifrontal diameter (BFD), frontal horn ratio (FHR), ALVI, and Evans index compared to controls.
- ALVI and Evans index demonstrated high diagnostic performance in differentiating HFrEF from healthy individuals (AUC > 0.90).
- LVEF showed a significant negative correlation with both Evans index (r = -0.550) and ALVI (r = -0.585).
Conclusions:
- Patients with HFrEF display significantly increased cranial ventricular dimensions compared to healthy controls.
- These enlarged ventricular indices are inversely correlated with LVEF, suggesting a link between cardiac systolic dysfunction and brain structural changes.
Background:
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).
Methods:
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.
Results:
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).
Conclusion:
Cranial ventricular dimensions are significantly increased in patients with HFrEF compared to healthy controls, and these indices are inversely correlated with LVEF systolic impairment.
