Abstract 18519: Increased Mean Diffusivity (Brain Injury) Values in Insular, Hippocampal, Frontal, and Cerebellar Sites in Heart Failure
While gray matter injury appears in heart failure (HF), the presence and extent of tissue injury impacting on autonomic, cognitive, emotional, and breathing regions is unclear.
Methods: We performed diffusion tensor imaging in 16 HF (age, 55.1±7.8 years; LVEF, 27.7±6.7; 12 male) and 26 control subjects (49.7±10.8 years; 17 male), and assessed whole-brain mean diffusivity (MD) changes across the brain in HF compared to controls. Groups were compared between groups using ANCOVA, with age and gender as covariates.
Results: Insular (HF vs controls; left insula, 1.08±0.09 vs 0.97±0.06x10-3 mm2/s, p<0.001; right insula, 1.06±0.11 vs 0.98±0.06x10-3 mm2/s, p=0.001), frontal cortices (left frontal, 0.96±0.05 vs 0.89±0.05x10-3 mm2/s, p<0.001; right frontal, 0.93±0.06 vs 0.87±0.05x10-3 mm2/s, p=0.001), hippocampal (left hippocampus, 1.18±0.26 vs 1.03±0.12 x10-3 mm2/s, p=0.04; right hippocampus, 1.33±0.40 vs 1.03±0.13x10-3 mm2/s, p=0.01), and cerebellar (left cerebellar, 0.90±0.09 vs 0.81±0.05x10-3 mm2/s, p<0.001; right cerebellar, 0.84±0.06 vs 0.78±0.03x10-3 mm2/s, p<0.001) MD values showed significant groups differences (increased MD values in HF, indicative of tissue injury) between HF and control subjects. Whole-brain voxel-based analyses showed multiple brain regions with tissue injury, including the left and right insular lobes, frontal cortices, hippocampal, and cerebellar sites (Figure; p = 0.005) that control autonomic, cognitive, emotional, and breathing processes.
CONCLUSIONS: HF subjects show injury in the insular, hippocampal, frontal cortices, and cerebellar areas, sites which control autonomic, cognitive, emotional, and breathing functions. Injury in these areas may contribute to deficient functions found in the condition.
- © 2013 by American Heart Association, Inc.