Abstract 17667: Local Atrophy of Parahippocampal Gyrus is Prominent in Heart Failure Patients Without Dementia

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Tomomi Meguro
Keyword(s):  
Heart Failure ◽  
Cognitive Impairment ◽  
Potential Risk ◽  
Brain Atrophy ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Parahippocampal Gyrus ◽  
Control Group ◽  
Z Score ◽  
Heart Failure Patients

Introduction: The exacerbation of heart failure (HF) induces brain damage and the cognitive impairment that attenuates the effects of treatment. The medial lateral lobe of brain, including parahippocampal gyrus, is known to reduce its volume in patients with cognitive disorder especially in Alzheimer’s disease. The magnetic resonance imaging (MRI) scans identify morphological changes in the brains of patients with HF. Therefore, the Voxel-based morphometry (VBM) of three-dimensional brain MRI may contribute to predict the potential risk of mild cognitive impairment (MCI) of patients with HF. Hypothesis: The severity of local atrophy of parahippocampal gyrus, a potential risk of MCI, is prominent in heart failure patients without dementia. Methods: Ten HF patients (age 72+/-15 years, NYHA class II, EF43+/-15 %) and 9 control (age 76+/- 8 years) were enrolled. Patients with dementia were excluded from this study. 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. Results: The severity of total brain atrophy was similar between HF (8.3+/-3.4%) and control (8.0+/-4.1%). 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 HF patients group (1.4+/-0.7) in comparison with control group (0.8+/-0.4, P=0.034). The Z-score value was not correlated with age, ejection fraction, left atrial dimension, left ventricular dimensions, or BNP in HF group. Conclusions: In patients with HF, atrophy in parahippocampal gyrus was prominent in comparison with control. Patients with heart failure have potential risk of MCI and dementia.

Abstract 15517: Sarcopenia in Heart Failure Patients Without Dementia is Associated With Local Brain Atrophy and Predicts Poor Prognosis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Tomomi Meguro ◽  
Yuko Meguro ◽  
TOSHIO NAGAI
Keyword(s):  
Heart Failure ◽  
Potential Risk ◽  
Brain Atrophy ◽  
Poor Prognosis ◽  
Statistical Parametric Mapping ◽  
Erector Spinae ◽  
Parahippocampal Gyrus ◽  
Z Score ◽  
Age Related ◽  
Local Brain

Background: Sarcopenia is age-related loss of skeletal muscle volume and strength. Aged Heart failure (HF) patients without dementia may have potential risk of cognitive impairment (CI) that attenuates the effect of treatment. Patients with CI have severe brain atrophy in parahippocampal gyrus (PHG). However, it is not clear whether sarcopenia is associated with local brain atrophy and predicts prognosis. Hypothesis: Sarcopenia in HF patients without dementia is associated with local brain atrophy of PHG, a potential risk of CI, and predicts prognosis. Methods: Fifty-four HF patients (age 78+/-8 years, NYHA class II, EF47+/-18 %) were enrolled. We excluded patients with dementia using mini-mental state examination. We took 3D-T1 weighted sagittal images of whole brain using 1.5T magnetic resonance imaging. Image analysis was performed to evaluate the severity of local brain atrophy of gray matter using 2mm voxel-based morphometry by the statistical parametric mapping software. The Z-score value was calculated to evaluate the severity of atrophy in PHG. The cross-sectional area of the erector spinae muscles (CSA), an index of sarcopenia, were measured at the 12th thoracic vertebra using computed tomography. Results: Patients were divided into sarcopenia HF group (n=27) and Non-sarcopenia HF group (n=27) according to median of CSA. The severity of total brain atrophy was similar between sarcopenia HF group (8.1 +/-3.8%) and Non-sarcopenia HF group (8.9+/-3.5%). However, as shown in the representative cases (Figure A), the Z-score value in PHG (pink circle), reflecting the severity of atrophy, was prominent in sarcopenia HF group (1.57+/-0.80) (white arrows) in comparison with Non-sarcopenia HF group (0.94+/-0.63, P=0.002). Although age, gender, BNP and hemodynamic factors were similar between groups, sarcopenia HF group had a lower survival rate (Figure B). Conclusions: HF patients with sarcopenia without dementia have potential risk of CI and poor prognosis.

Heart failure: risk stratification and follow-up

2016 ◽  
Author(s):  
Marie Moonen ◽  
Nico Van de Veire ◽  
Erwan Donal
Keyword(s):  
Heart Failure ◽  
Longitudinal Strain ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Heart Failure Patients ◽  
Reverse Remodelling ◽  
Lv Ejection Fraction

An increasing number of two- and three-dimensional echocardiographic, Doppler, and speckle imaging-derived parameters and values can be related to prognosis in heart failure with left ventricular (LV) systolic dysfunction. This chapter discusses both conventional and new indices, including their advantages and potential limitations. There is increasing evidence for the use of new indices, including three-dimensional LV ejection fraction and global longitudinal strain. The follow-up and monitoring of heart failure patients using two-dimensional transthoracic echocardiography is also discussed in this chapter, including how to estimate the LV filling pressures and quantify LV reverse remodelling.

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