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Brain damage with heart failure: Cardiac biomarker alterations and gray matter decline

MPS-Authors
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Mueller,  Karsten
Methods and Development Unit Nuclear Magnetic Resonance, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Thiel,  Friederike
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Frisch,  Stefan
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Ballarini,  Tommaso
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Möller,  Harald E.
Methods and Development Unit Nuclear Magnetic Resonance, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Ihle,  Kristin
Methods and Development Unit Nuclear Magnetic Resonance, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Villringer,  Arno
Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Germany;
Clinic for Cognitive Neurology, University of Leipzig, Germany;
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Schroeter,  Matthias L.
Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Germany;
Clinic for Cognitive Neurology, University of Leipzig, Germany;
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Mueller_2020.pdf
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Citation

Mueller, K., Thiel, F., Beutner, F., Teren, A., Frisch, S., Ballarini, T., et al. (2020). Brain damage with heart failure: Cardiac biomarker alterations and gray matter decline. Circulation Research, 126(6), 750-764. doi:10.1161/CIRCRESAHA.119.315813.


Cite as: http://hdl.handle.net/21.11116/0000-0004-CC9F-4
Abstract
Rationale: Heart failure (HF) following heart damage leads to a decreased blood flow due to a reduced pump efficiency of the heart muscle. A consequence can be insufficient oxygen supply to the organism including the brain. While HF clearly shows neurological symptoms, such as fatigue, nausea and dizziness, the implications for brain structure are not well understood. Few studies show regional gray matter decrease related to HF, however, the underlying mechanisms leading to the observed brain changes remain unclear. Objective: To study the relationship between impaired heart function, hampered blood circulation and structural brain change in a case-control study. Methods and Results: Within a group of 80 patients of the Leipzig Heart Center, we investigated a potential correlation between HF biomarkers and the brain's gray matter density (GMD) obtained by magnetic resonance imaging. We observed a significant positive correlation between cardiac ejection fraction and GMD across the whole frontal and parietal medial cortex reflecting the consequence of HF onto the brain's gray matter. Moreover, we also obtained a relationship between GMD and the N-terminal prohormone of brain natriuretic peptide (NT-proBNP) − a biomarker that is used for screening, diagnosis and prognosis of HF. Here we found a significant negative correlation between NT-proBNP and GMD in the medial and posterior cingulate cortex but also in precuneus and hippocampus, which are key regions implicated in structural brain changes in dementia. Conclusions: We obtained significant correlations between brain structure and markers of heart failure including EF and NT-proBNP. A diminished GMD was found with decreased EF and increased NT-proBNP in wide brain regions including the whole frontomedian cortex as well as hippocampus and precuneus. Our observations might reflect structural brain damage in areas that are related to cognition, however, whether these structural changes facilitate the development of cognitive alterations has to be proven by further longitudinal studies.