BACKGROUND Inadequate self-care is linked to poor health outcomes in heart failure (HF). Self-care depends on decision-making abilities, but links between self-care and brain injury to executive decision-making regulatory areas (prefrontal cortices) are unclear. OBJECTIVE We investigated the relationships between HF self-care and status of prefrontal cortices. METHODS Magnetic resonance imaging-based diffusion tensor imaging was performed in 21 patients with HF (age, 53.8 ± 7.9 years; 15 men; left ventricular ejection fraction, 25.1% ± 6.1%), and self-care and executive function were measured with the Self-care of Heart Failure Index (SCHFI) and Trail Making Test B. Using diffusion tensor imaging data, mean diffusivity (MD) maps were calculated and region-of-interest analyses were performed on the left and right prefrontal brain areas. Statistical analyses consisted of partial correlations (covariates, age, and gender). RESULTS The mean ± SD SCHFI scores were 70.78 ± 11.37 for maintenance, 70 ± 17.32 for management, and 74.91 ± 15.76 for confidence. The mean ± SD Trail Making Test B score was 90.2 ± 73.3 seconds. The mean ± SD MD values (higher values indicate tissue injury) of the left and right prefrontal cortices were 1.46 ± 0.16 (×10 mm/s) and 1.44 ± 0.14 (×10 mm/s), respectively. Significant negative correlations emerged between prefrontal MD values and SCHFI maintenance (left/right, r = -0.64/-0.70; P < .003) and SCHFI management (r = -0.93/-0.86; P < .003). Significant positive correlations were observed between prefrontal MD values and Trail Making Test B (r = 0.71/0.74; P < .001). A nonsignificant correlation emerged between prefrontal MD values and SCHFI confidence scores. CONCLUSIONS Brain tissue integrity in executive function regulatory regions is associated with HF self-care for maintenance and management. The findings indicate that protection and brain injury repair in executive control areas may improve HF self-care.

中文翻译：

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执行控制区域的心力衰竭自我护理与脑损伤相关。

背景技术自我保健不足与心力衰竭（HF）的不良健康结果有关。自我保健取决于决策能力，但自我保健和脑损伤与行政决策制定监管区域（额叶皮层）之间的联系尚不清楚。目的我们研究了HF自我护理与前额叶皮质状态之间的关系。方法对21例HF患者（年龄53.8±7.9岁; 15例男性;左室射血分数25.1％±6.1％）进行了基于磁共振成像的弥散张量成像，并通过心力衰竭指数（SCHFI）和跟踪制作测试B的自我保健。使用扩散张量成像数据，计算平均扩散率（MD）映射，并在左右前额脑区域进行感兴趣区域分析。统计分析包括部分相关性（协变量，年龄和性别）。结果维持的平均±SD SCHFI评分为70.78±11.37，管理的平均评分为70±17.32，置信度为74.91±15.76。SD追踪制作测验B的平均值为90.2±73.3秒。左和右前额叶皮层的平均±SD MD值（较高值表示组织损伤）分别为1.46±0.16（×10 mm / s）和1.44±0.14（×10 mm / s）。前额叶MD值与SCHFI维持率（左/右，r = -0.64 / -0.70； P <.003）和SCHFI管理之间存在显着的负相关性（r = -0.93 / -0.86； P <.003）。在前额叶MD值和Trail制作测试B之间观察到显着正相关（r = 0.71 / 0.74； P <.001）。前额叶MD值与SCHFI置信度得分之间无显着相关性。结论执行功能调节区域的脑组织完整性与用于维护和管理的HF自我护理有关。研究结果表明，执行控制区域的保护和脑损伤修复可能会改善心衰自我护理。