Hippocampal Blood Flow Abnormality Associated With Depressive Symptoms and Cognitive Impairment in Patients With Chronic Heart Failure

Abstract

Background:Depressive symptoms and memory impairment are prevalent in patients with chronic heart failure (CHF). Although the mechanisms remain to be elucidated, the hippocampus (an important brain area for emotion and memory) may be a possible neural substrate for these symptoms.Methods and Results:We prospectively enrolled 40 Stage C patients, who had past or current CHF symptoms, and as controls 40 Stage B patients, who had structural heart disease but had never had symptoms of HF, in the Brain Assessment and Investigation in Heart Failure Trial (B-HeFT) (UMIN000008584). As the primary index, we measured cerebral blood flow (CBF) in the 4 anterior-posterior segments of the hippocampus, using brain MRI analysis. Depressive symptoms, immediate memory (IM) and delayed memory (DM) were assessed using the Geriatric Depression Scale (GDS), and Wechsler Memory Scale-revised (WMS-R), respectively. Hippocampus CBF in the most posterior segment was significantly lower in the Stage C than in the Stage B group (P=0.029 adjusted for Holm’s method). Multiple regression analysis identified a significant association between hippocampus CBF and GDS or DM score in the Stage C group (all P<0.05). Scores of GDS, IM and DM were significantly lower in Stage C patients with hippocampus CBF above the median than in those with hippocampus CBF below the median (all P<0.05).Conclusions:Hippocampus abnormalities were associated with depressive symptoms and cognitive impairment in CHF patients.