Patients with Stage B and C heart failure by ACC-AHA guidelines
Conditions
Interventions
None listed
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: Patients with Stage B and C heart failure by ACC-AHA guidelines with a written informed consent.
Exclusion criteria
Exclusion criteria: (1) Contraindication of MRI: Cardiac devices or claustrophobia. (2) Unstable cardiac function: Patients who had uncontrolled heart failure or required intravenous inotropes. Patients receiving stent implantation for acute myocardial infarction within 3 months. (3) Past history significantly affecting cerebral blood flow and/or brain structure: MMSE < 24, mental retardation, neurodegenerative disease, psychiatric disorder, epilepsy, symptomatic stroke, symptomatic carotid stenosis with or without stenting or endarterectomy, head trauma, hydrocephalus, intracranial mass, alcohol/drug addiction, hypo/hyperthyroidism, aortic stenosis proximal to left cervical artery and/or severe aortic valve stenosis. (4) Difficulty in evaluating brain and/or cardiac MRI: Artifacts of movements or other causes. Patients with complex congenital heart diseases.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| (1) Cerebral blood flow (CBF) Comparison between Stage B patients and Stage C patients. | — |
Secondary
| Measure | Time frame |
|---|---|
| (2) CBF It is analyzed whether CBF is associated with cardiac index (CI), total brain volume (TBV), grey matter (GM), white matter (WM), white matter hyperintensities (WMI) and/or intima media thickness (IMT). (3) TBV, GM and WM It is analyzed whether TBV, GM and/or WM are associated with CI, WMH and/or IMT. (4) WMH It is analyzed whether WMH is associated with CI and/or IMT. (5) IMT It is analyzed whether IMT is associated with CI. (6) Depressive symptoms evaluated by Beck depression Inventory (BDI) and geriatric depression scale (GDS). (7) Cognitive function and mild cognitive impairment (MCI) evaluated by mini-mental state examination (MMSE), frontal assessment battery (FAB) and Wechsler memory scale-reviced (WMS-R). (8) Quality of life (QOL) evaluated by Minnesota living with heart failure questionnaire. In (6)-(8), it is analyzed whether depressive symptoms, cognitive function, MCI and/or QOL are associated with CBF, CI, TBV, GM, WM, WMH and/or IMT. (9) Blood unsaturated fatty acid (omega-3 fatty acids, omega-6 fatty acids, alpha-linolenic acid, docosahexaenoic acid and eicosapentaenoic acid) (10) Blood brain derived neurotrophic factor (BDNF) (11) Blood amyloid beta (A-beta 40 and A-beta 42) In (9)-(11), it is analyzed whether unsaturated fatty acid, BDNF and/or amyloid beta are associated with CBF, CI, TBV, GM, WM, WMH and/or IMT. In (2), comparison among Stage B/C patients with ischemic/nonischemic heart diseases, comparison between patients with heart failure with reduced ejection fraction (HFREF) and patients with heart failure with preserved ejection fraction (HFPEF) and comparison among NYHA classes are analyzed. In (3)-(11), comparison between Stage B patients and Stage C patients, comparison among Stage B/C patients with ischemic/nonischemic heart diseases, comparison between patients with HFREF and patients with HFPEF and comparison among NYHA classes are analyzed. | — |
Countries
Japan
Contacts
Tohoku University Hospital Department of Cardiovascular Medicine