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Brain dysconnectivity with heart failure

Structural brain damage associated with heart failure is well described; however, little is known about associated changes in various specific brain functions that bear immediate clinical relevance. A satisfactory pathophysiological link between heart failure and decline in cognitive function is sti...

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Autores principales: Mueller, Karsten, Thiel, Friederike, Taskin, Birol, Beutner, Frank, Teren, Andrej, Dubovoy, Vladimir K, Möller, Harald E, Villringer, Arno, Schroeter, Matthias L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116577/
https://www.ncbi.nlm.nih.gov/pubmed/37091590
http://dx.doi.org/10.1093/braincomms/fcad103
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author Mueller, Karsten
Thiel, Friederike
Taskin, Birol
Beutner, Frank
Teren, Andrej
Dubovoy, Vladimir K
Möller, Harald E
Villringer, Arno
Schroeter, Matthias L
author_facet Mueller, Karsten
Thiel, Friederike
Taskin, Birol
Beutner, Frank
Teren, Andrej
Dubovoy, Vladimir K
Möller, Harald E
Villringer, Arno
Schroeter, Matthias L
author_sort Mueller, Karsten
collection PubMed
description Structural brain damage associated with heart failure is well described; however, little is known about associated changes in various specific brain functions that bear immediate clinical relevance. A satisfactory pathophysiological link between heart failure and decline in cognitive function is still missing. In the present study, we aim to detect functional correlates of heart failure in terms of alterations in functional brain connectivity (quantified by functional magnetic resonance imaging) related to cognitive performance assessed by neuropsychological testing. Eighty patients were post hoc grouped into subjects with and without coronary artery disease. The coronary artery disease patients were further grouped as presenting with or without heart failure according to the guidelines of the European Society of Cardiology. On the basis of resting-state functional magnetic resonance imaging, brain connectivity was investigated using network centrality as well as seed-based correlation. Statistical analysis aimed at specifying centrality group differences and potential correlations between centrality and heart failure-related measures including left ventricular ejection fraction and serum concentrations of N-terminal fragment of the pro-hormone brain-type natriuretic peptide. The resulting correlation maps were then analysed using a flexible factorial model with the factors ‘heart failure’ and ‘cognitive performance’. Our core findings are: (i) A statistically significant network centrality decrease was found to be associated with heart failure primarily in the precuneus, i.e. we show a positive correlation between centrality and left ventricular ejection fraction as well as a negative correlation between centrality and N-terminal fragment of the pro-hormone brain-type natriuretic peptide. (ii) Seed-based correlation analysis showed a significant interaction between heart failure and cognitive performance related to a significant decrease of precuneus connectivity to other brain regions. We obtained these results by different analysis approaches indicating the robustness of the findings we report here. Our results suggest that the precuneus is a brain region involved in connectivity decline in patients with heart failure, possibly primarily or already at an early stage. Current models of Alzheimer’s disease—having pathophysiological risk factors in common with cerebrovascular disorders—also consider reduced precuneus connectivity as a marker of brain degeneration. Consequently, we propose that heart failure and Alzheimer’s disease exhibit partly overlapping pathophysiological paths or have common endpoints associated with a more or less severe decrease in brain connectivity. This is further supported by specific functional connectivity alterations between the precuneus and widely distributed cortical regions, particularly in patients showing reduced cognitive performance.
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spelling pubmed-101165772023-04-21 Brain dysconnectivity with heart failure Mueller, Karsten Thiel, Friederike Taskin, Birol Beutner, Frank Teren, Andrej Dubovoy, Vladimir K Möller, Harald E Villringer, Arno Schroeter, Matthias L Brain Commun Original Article Structural brain damage associated with heart failure is well described; however, little is known about associated changes in various specific brain functions that bear immediate clinical relevance. A satisfactory pathophysiological link between heart failure and decline in cognitive function is still missing. In the present study, we aim to detect functional correlates of heart failure in terms of alterations in functional brain connectivity (quantified by functional magnetic resonance imaging) related to cognitive performance assessed by neuropsychological testing. Eighty patients were post hoc grouped into subjects with and without coronary artery disease. The coronary artery disease patients were further grouped as presenting with or without heart failure according to the guidelines of the European Society of Cardiology. On the basis of resting-state functional magnetic resonance imaging, brain connectivity was investigated using network centrality as well as seed-based correlation. Statistical analysis aimed at specifying centrality group differences and potential correlations between centrality and heart failure-related measures including left ventricular ejection fraction and serum concentrations of N-terminal fragment of the pro-hormone brain-type natriuretic peptide. The resulting correlation maps were then analysed using a flexible factorial model with the factors ‘heart failure’ and ‘cognitive performance’. Our core findings are: (i) A statistically significant network centrality decrease was found to be associated with heart failure primarily in the precuneus, i.e. we show a positive correlation between centrality and left ventricular ejection fraction as well as a negative correlation between centrality and N-terminal fragment of the pro-hormone brain-type natriuretic peptide. (ii) Seed-based correlation analysis showed a significant interaction between heart failure and cognitive performance related to a significant decrease of precuneus connectivity to other brain regions. We obtained these results by different analysis approaches indicating the robustness of the findings we report here. Our results suggest that the precuneus is a brain region involved in connectivity decline in patients with heart failure, possibly primarily or already at an early stage. Current models of Alzheimer’s disease—having pathophysiological risk factors in common with cerebrovascular disorders—also consider reduced precuneus connectivity as a marker of brain degeneration. Consequently, we propose that heart failure and Alzheimer’s disease exhibit partly overlapping pathophysiological paths or have common endpoints associated with a more or less severe decrease in brain connectivity. This is further supported by specific functional connectivity alterations between the precuneus and widely distributed cortical regions, particularly in patients showing reduced cognitive performance. Oxford University Press 2023-03-30 /pmc/articles/PMC10116577/ /pubmed/37091590 http://dx.doi.org/10.1093/braincomms/fcad103 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the Guarantors of Brain. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Mueller, Karsten
Thiel, Friederike
Taskin, Birol
Beutner, Frank
Teren, Andrej
Dubovoy, Vladimir K
Möller, Harald E
Villringer, Arno
Schroeter, Matthias L
Brain dysconnectivity with heart failure
title Brain dysconnectivity with heart failure
title_full Brain dysconnectivity with heart failure
title_fullStr Brain dysconnectivity with heart failure
title_full_unstemmed Brain dysconnectivity with heart failure
title_short Brain dysconnectivity with heart failure
title_sort brain dysconnectivity with heart failure
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116577/
https://www.ncbi.nlm.nih.gov/pubmed/37091590
http://dx.doi.org/10.1093/braincomms/fcad103
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