Ting Liu Yu, Ting Yang Yu, Xiang Tang Chun, Qing Ma Jun, Kong Xiang, Hua Li Jian, Ming Li Yan, Yu Liu Shu, Sheng Zhou Chang, Jiang Zhang Long
Department of Radiology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, China.
Department of Cardiology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, China.
Neuroscience. 2025 Jan 26;565:148-154. doi: 10.1016/j.neuroscience.2024.11.060. Epub 2024 Nov 26.
Heart failure (HF) frequently suffers from brain abnormalities and cognitive impairments. This study aims to investigate brain structure and function alteration in patients with chronic HF. This retrospective study included 49 chronic HF and 49 health controls (HCs). Voxel-based morphometry was conducted on structural MRI to quantify gray matter volume (GMV), and functional connectivity (FC) was assessed with seed-based analysis using resting-state fMRI. White matter microstructure integrity was also evaluated through tract-based spatial statistics employing DTI. Correlations between multimodal MRI features and cognitive performance were further investigated in patients with chronic HF. Patients with chronic HF exhibited significantly reduced regional GMV, white matter microstructure injury (Family wise error correction, p＜0.05), and decreased FC in multiple brain regions involved in cognition, sensorimotor, visual function (Gaussian random field correction, voxel level p＜0.0001 and cluster-level p＜0.01). There was no observed increases in GMV or FC compared with HCs. Decreased GMV showed positive correlations with cognitive performance (r = 0.025-0.577, p = 0.025-0.001), while decreased fractional anisotropy was negatively correlated with anxiety scores (r = -0.339, p = 0.040) in patients with chronic HF. This study revealed that patients with chronic HF exhibited brain structure injury affecting gray matter and white matter, as well as FC abnormalities of brain regions responsible for cognition, sensorimotor and visual function. These findings suggest GMV could serve as a neuroimaging biomarker for cognitive impairments and a potential target for neuroprotective therapies in patients with chronic HF.
心力衰竭（HF）常伴有脑异常和认知障碍。本研究旨在调查慢性HF患者的脑结构和功能改变。这项回顾性研究纳入了49例慢性HF患者和49名健康对照者（HCs）。对结构MRI进行基于体素的形态学测量以量化灰质体积（GMV），并使用静息态功能磁共振成像通过基于种子点的分析评估功能连接（FC）。还通过基于纤维束的空间统计学方法利用扩散张量成像（DTI）评估白质微观结构完整性。进一步研究了慢性HF患者多模态MRI特征与认知表现之间的相关性。慢性HF患者在多个参与认知、感觉运动、视觉功能的脑区表现出显著降低的区域GMV、白质微观结构损伤（家族性错误校正，p＜0.05）以及FC降低（高斯随机场校正，体素水平p＜0.0001，簇水平p＜0.01）。与HCs相比，未观察到GMV或FC增加。在慢性HF患者中，GMV降低与认知表现呈正相关（r = 0.025 - 0.577，p = 0.025 - 0.001），而分数各向异性降低与焦虑评分呈负相关（r = -0.339，p = 0.040）。本研究表明，慢性HF患者存在影响灰质和白质的脑结构损伤以及负责认知、感觉运动和视觉功能的脑区FC异常。这些发现提示GMV可作为认知障碍的神经影像学生物标志物以及慢性HF患者神经保护治疗的潜在靶点。
