Abstract 2288: Brain White Matter Abnormalities in Heart Failure
Heart failure (HF) patients show gray matter loss in multiple brain areas, but it is unclear whether these changes extend to associated white matter. We hypothesized that abnormalities in nerve fibers projecting to gray matter areas would be present in HF pts.
Methods. Using a 3T MRI scanner, we acquired diffusion-weighted images from 5 HF pts (LVEF < 40%, NYHA class I-II; mean age 50±8; 3 male) and 43 control subjects (mean age 48±7; 17 male). We calculated apparent diffusion coefficient (ADC) values from the images; higher ADC values correspond to damaged neural tissue. We used ANCOVA to assess regions of significant differences in ADC between HF and control groups with age and sex as covariates.
Results. HF pts showed abnormal ADC values (indicating white matter/nerve fiber abnormalities) in the fornix near the septum, the internal capsule bordering the head of the caudate and anterior insula (primarily on the left side), fibers within the cerebellar cortex and deep nuclei, and medial ponto-medullary junction (Figure⇓; p < 0.001).
Discussion. Specific regions of damaged nerve fibers appear in patients with HF. These regions project to limbic and cerebellar structures involved in cardiovascular regulation, and may contribute to the gray matter loss and altered autonomic physiology found in HF.