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European Journal of Heart Failure 2007 9(10):1003-1009; doi:10.1016/j.ejheart.2007.07.006
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© 2007 European Society of Cardiology

Brain magnetic resonance imaging abnormalities in patients with heart failure

Raymond L.C. Vogelsa,b,*, Wiesje M. van der Flierb, Barbera van Hartenc, Alida A. Gouwb, Philip Scheltensb, Jutta M. Schroeder-Tankad and Henry C. Weinsteina

a Department of Neurology, Sint Lucas-Andreas Hospital Amsterdam, The Netherlands
b Department of Neurology and Alzheimer Center, VU University Medical Center Amsterdam, The Netherlands
c Department of Neurology, Medical Center Leeuwarden Leeuwarden, The Netherlands
d Department of Cardiology, Sint Lucas-Andreas Hospital Amsterdam, The Netherlands

* Corresponding author. Department of Neurology, VU Medical Center PO Box 7057, 1007 MB Amsterdam, The Netherlands. Tel.: +31 205108911; fax: +31 206837198. E-mail address: r.vogels{at}vumc.nl


   Abstract

Background: Although heart failure (HF) is a common cardiovascular disorder, to date little research has been conducted into possible associations between HF and structural abnormalities of the brain.

Aims: To determine the frequency and pattern of magnetic resonance imaging (MRI) abnormalities in outpatients with chronic HF, and to identify any demographic and clinical correlates.

Methods: Brain MRI scans were compared between a sample of 58 HF patients, 48 controls diagnosed with cardiovascular disease uncomplicated by HF (cardiac controls) and 42 healthy controls. Deep, periventricular and total white matter hyperintensities (WMH), lacunar and cortical infarcts, global and medial temporal lobe atrophy (MTA) were investigated.

Results: Compared to cardiac and healthy controls, HF patients had significantly more WMH, lacunar infarcts and MTA, whereas cardiac controls only had more MTA, compared to healthy controls. Age and left ventricular ejection fraction (LVEF) were independently associated with total WMH. Age and systolic hypotension were associated with MTA in HF patients and cardiac controls.

Conclusion: Our results suggest that cardiac dysfunction contributes independently to the development of cerebral MRI abnormalities in patients with HF. Age and low LVEF are the principal predictors of cerebral WMH in patients with HF and in cardiac controls.

Key Words: Heart failure • Magnetic resonance imaging • White matter hyperintensities

Received February 26, 2007; Revised June 18, 2007; Accepted July 12, 2007


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