Abstract 14848: Local Brain Atrophy in Parahypocampal Gyrus is Prominent in Frail Heart Failure Patients Without Dementia
Background: Heart failure (HF) patients with frailty may have potential risk of cognitive impairment (CI) that attenuates the effect of treatment. The local brain atrophy of parahippocampal gyrus is prominent in patients with CI. The Voxel-based morphometry (VBM) of three-dimensional brain magnetic resonance imaging (MRI) detect severity of local atrophy in parahippocampal gyrus and may contribute to predict the potential risk of CI of patients without dementia.
Hypothesis: Local atrophy of parahippocampal gyrus, a potential risk of CI, is prominent in frail HF patients without dementia.
Methods: Twenty four HF patients (age 77+/-7 years, NYHA class II, EF51+/-18 %) were enrolled. Patients with dementia were excluded from this study using mini-mental state examination. Three dimensional T1 weighted sagittal images of whole brain were taken using 1.5T MRI. Image analysis was performed to evaluate the severity of local brain atrophy of gray matter using 2mm VBM by the software based on statistical parametric mapping. The Z-score value of volume of interest (VOI) was calculated to evaluate the severity of atrophy in parahippocampal gyrus. The level of frailty was stratified by Frailty Scale of Canadian Study of Health and Aging.
Results: Patients were divided in frail HF group (n=13, Frailty scale ≥4) and non-frail HF group (n=11). The severity of total brain atrophy was similar between frail HF group (9.3 +/-3.3%) and non-frail HF group (7.7+/-4.4%). However, as shown in the figure of representative cases, the Z-score value of VOI (pink circle), reflecting the severity of atrophy in parahippocampal gyrus (white arrows), was larger in frail HF group (1.46+/-0.61) in comparison with non-frail HF group (0.74+/-0.46, P=0.006). Age, ejection fraction, BNP and left ventricular dimensions were similar between groups. The Z-score value was correlated with Frailty scale.
Conclusions: Frail heart failure patients without dementia have potential risk of CI and dementia.
Author Disclosures: T. Meguro: None.
- © 2016 by American Heart Association, Inc.