Abstract
Heart failure patients often manifest white matter hyperintensites on brain magnetic resonance imaging (MRI). White matter hyperintnsities have also been linked with cognitive problems in patients with heart failure. Sleep disordered breathing may contribute to structural brain changes in heart failure. The purpose of this study was to test the extent to which the apnea hypopnea index is associated with global and regional white matter hyperintensities, and is a moderating factor in the relationship between age and white matter hyperintensites. A total of 28 HF patients [mean age (SD) = 67.89 (5.8)] underwent T1-weighted and T2FLAIR MRI and a home sleep monitoring study. The apnea hypopnea index cut off of 10 was used to compare between higher and lower risks of sleep disordered breathing. Regression analysis was used to test the association between apnea hypopnea index and both global and regional white matter hyperintensities. The interaction term was entered to identify the moderation effect. Apnea hypopnea index was associated with higher regional white matter hyperintensities but not global white matter hyperintensities. There was a significant interaction between the apnea hypopnea index and age, such that older participants with the apnea hypopnea index ≥10 showed greater regional white matter hyperintensities than those with the apnea hypopnea index <10. The results of this preliminary study indicate that a higher apnea hypopnea index is associated with more white matter hyperintensities. The age-related white matter hyperintensities appear to be exacerbated by apnea hypopnea index in our individuals with heart failure. Future studies are needed to further investigate the underlying mechanisms.
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Abbreviations
- FOV:
-
field of view
- HF:
-
heart failure
- ICBM:
-
The International Consortium for Brain Mapping
- ICV:
-
Intracranial volume
- LVEF:
-
left ventricular ejection fraction
- MRI:
-
magnetic resonance imaging
- MNI:
-
Montreal Neurological Institute
- AHI:
-
apnea hypopnea index
- SDB:
-
sleep disordered breathing
- SPM8:
-
statistical parametric mapping 8
- T2FLARE:
-
T2 Fluid attenuation inversion recovery
- TE:
-
echo time
- TI:
-
inversion time
- TR:
-
repetition time
- WMH:
-
white matter hyperintensities
- WMHp:
-
white matter hyperinensity percent
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Authors thank to members of the Wisconsin Alzheimer's Diesease Research Center for advices regarding MRI data acquisition and analysis.
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The project described in this paper was supported by the Sigma Theta Tau Beta-Eta at Large chapter and the National Institute of Nursing Research, award Number R00NR012773 (Brain Alterations and Cognitive Impairment in Older Adults with Heart Failure). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health.
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Moon, C., Bendlin, B.B., Melah, K.E. et al. The association of sleep-disordered breathing and white matter hyperintensities in heart failure patients. Metab Brain Dis 33, 2019–2029 (2018). https://doi.org/10.1007/s11011-018-0309-0
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DOI: https://doi.org/10.1007/s11011-018-0309-0