Abstract 12719: Heart Failure Self-Care Associated With Brain Injury in Executive Control Regions
Heart failure (HF) patients often have poor self-care (SC) management that is linked to increased morbidity and mortality and decreased quality of life. While inadequate SC is known to be strongly related to cognitive/executive decision-making ability, associations between HF SC and brain injury to regions that control executive function (pre-frontal cortices) has not been reported.
Methods: To assess the relationships between HF SC and brain injury in the pre-frontal cortices, diffusion tensor imaging (DTI) was performed in 10 HF (age, 56.8±8.1 years; 8 male; body-mass-index, 25.4±4.1 kg/m2; left ventricular ejection fraction, 26.4±11.9%; New York Heart Association functional class II/III 94/6%), using a 3.0-Tesla magnetic resonance imaging scanner, and self-care was measured with the validated Self-Care of Heart Failure Inventory (SCHFI) questionnaire. Mean diffusivity (MD) maps were calculated, normalized to a common space, and smoothed. The region-of-interest (ROI) analyses were performed on the smoothed MD maps by placing left and right prefrontal ROIs. Both left and right prefrontal cortex values were correlated with SCHFI scores (maintenance and confidence subscales) in HF subjects using partial correlation procedures (covariates, age, and gender).
Results: Continuous data variables were normally distributed (Shapiro-Wilks Test of Normality). Mean SCHFI maintenance score was 74.66±11.24 and SCHFI confidence score was 70.07±16.80. Correlation of MD values with SCHFI Confidence at left prefrontal cortex: r= -0.941, p< 0.001; right prefrontal cortex: r= -0.858, p= 0.006. Correlation of MD values with SCHFI Maintenance at left prefrontal cortex: r= -0.602, p= 0.115/not significant; right prefrontal cortex: r= -0.854, p= 0.007.
Conclusions: With exception of the left prefrontal cortex and SCHFI Maintenance, there were very strong negative correlations between SCHFI subscales (Confidence and Maintenance) and MD values of the pre-frontal cortices. These findings provide evidence that brain injury in cognitive brain regions have strong associations with HF SC. Further research is needed to determine if interventions which support neurogenesis or neuroprotection of these brain regions can positively impact SC in persons with HF.
Author Disclosures: S.E. Choi: None. B. Roy: Research Grant; Significant; NIH/NINR – 1R01 NR014669. R. Kumar: Research Grant; Significant; NIH/NINR – 1R01 NR013625, NIH/NINR – 1R01 NR014669. G.C. Fonarow: Research Grant; Modest; NIH/NINR – 1R01 NR013625, NIH/NINR – 1R01 NR014669. M.A. Woo: Research Grant; Significant; NIH/NINR – 1R01 NR013625, NIH/NINR – 1R01 NR014669.
- © 2016 by American Heart Association, Inc.