BACKGROUND Although depressive symptoms increased mortality and hospitalization in chronic heart failure (CHF) patients, the underlying mechanism remains unclear. The aim of this study was to investigate whether an alteration in hippocampal perfusion, which is the neural substrate of depressive symptoms, is associated with changes in cardiac structures and/or functions in CHF patients. METHODS We used baseline data of 70 CHF patients (66.8 ± 8.9 yrs, 32.5% women), including cerebral blood flow (CBF) in the hippocampus, geriatric depression scale (GDS) scores and echocardiographic parameters, in the Brain Assessment and Investigation in Heart Failure Trial (B-HeFT) (UMIN000008584). Echocardiography was repeated at 3.1 ± 0.5 years after the baseline evaluation. We first tested voxel-wise regression model with hippocampal CBF as dependent variable and each of echocardiographic parameter change as independent variable, adjusted for age and sex. Structural equation modeling was used to test a mediation effect of cognitive test scores on associations between hippocampal perfusion and changes in cardiac structures and/or functions. RESULTS Baseline anterior hippocampal CBF was negatively correlated with changes in left ventricular posterior wall thickness (PWT) (P < 0.05 with family-wise error corrections). An existence of depressive symptoms was positively correlated with the baseline anterior CBF and negatively with the PWT changes (P < 0.05, both). There were both direct effects of the baseline anterior hippocampal CBF on PWT thinning and effects mediated through the depressive symptoms (P < 0.05, both). CONCLUSIONS This study provides the first evidence that the alteration in hippocampal perfusion may lead to changes in cardiac structures via increase in depressive symptoms in CHF patients.

中文翻译：

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海马血流对慢性心力衰竭患者左心室壁厚度变化的影响。

背景尽管抑郁症状增加了慢性心力衰竭 (CHF) 患者的死亡率和住院率，但其潜在机制仍不清楚。本研究的目的是调查作为抑郁症状的神经基质的海马灌注的改变是否与 CHF 患者心脏结构和/或功能的变化有关。方法 我们在大脑评估和心脏调查中使用了 70 名 CHF 患者（66.8 ± 8.9 岁，32.5% 女性）的基线数据，包括海马脑血流量 (CBF)、老年抑郁量表 (GDS) 评分和超声心动图参数失败试验 (B-HeFT) (UMIN000008584)。在基线评估后 3.1 ± 0.5 年重复超声心动图检查。我们首先测试了体素回归模型，其中海马 CBF 作为因变量，每个超声心动图参数变化作为自变量，针对年龄和性别进行了调整。结构方程模型用于测试认知测试分数对海马灌注与心脏结构和/或功能变化之间关联的中介作用。结果 基线前海马 CBF 与左心室后壁厚度 (PWT) 的变化呈负相关（P < 0.05，按家族误差校正）。抑郁症状的存在与基线前 CBF 呈正相关，与 PWT 变化呈负相关（P < 0.05，两者）。基线前海马CBF对PWT变薄有直接影响，也有通过抑郁症状介导的影响（P < 0. 05，两者）。结论 本研究提供了第一个证据，即海马灌注的改变可能通过增加 CHF 患者的抑郁症状而导致心脏结构的变化。