Abstract 12095: Altered Brain Functional Connectivity During Valsalva Maneuver in Heart Failure
Introduction: Heart failure (HF) patients have abnormal autonomic (ANS) activity, which is linked to damage in specific gray matter brain regions (such as the insulae). Abnormal ANS activity in HF may be due to changes in both structural injury and functional connectivity (FC; temporal correlations between neural structures which indicate connection status and sequence of activation). While insular/brain structural injury has been reported in HF, FC has not been explored.
Hypothesis: FC between brain regions during an autonomic challenge will be less in HF in comparison to controls.
Methods: We collected functional MRI data with Valsalva maneuver block design task in 12 HF (age 55.6±8.1 years; Females 3; BMI 25.2±3.8 kg/m2; LVEF, 26.7±11.5%) and 33 controls (51.6±5.5 years; Females 13; BMI 25.7±3.2 kg/m2), using a 3.0 Tesla MRI scanner. Group independent component analysis was applied to identify individual task-related FC maps, which were compared between HF and controls (ANCOVA; covariates, age and gender; P<0.005)
Results: No significant differences in age, gender, or BMI emerged between the two groups (P>0.05). Decreased FC in HF (Figure 1; p<0.005) were found in the left supramarginal gyrus/inferior parietal lobule, left middle temporal gyrus, bilateral thalamus, left fusiform gyrus, left ligual gyrus, right precuneus, left hippocampus, and left insula. However, increased FC in HF compared to controls were found in the left inferior frontal gyrus, right superior temporal gyrus, left cerebellar cortex, and right insula (P<0.005).
Conclusions: These findings suggest that autonomic, cognitive, and affective deficits in HF may be related to altered FC. The outcomes likely result from the prominent structural changes in both axons and nuclear structures reported earlier in HF. Future interventions may need to address structural and functional deficits in both gray and white matter regions in HF.
Author Disclosures: M.A. Woo: None. B. Park: None. G.C. Fonarow: Consultant/Advisory Board; Modest; Medtronic, Amgen, Johnson & Johnson, Bayer, Boston Scientific. Research Grant; Significant; NIH. Consultant/Advisory Board; Significant; Novartis. R. Kumar: None.
- © 2015 by American Heart Association, Inc.