Brain Function and Perfusion in Patients With Heart Failure

Study Overview
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Brief Summary
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The investigators will evaluate the determinants of cerebral impairment in patients with non-ischemic heart failure compared to controls, and its relation to cognitive function. They hypothesize that patients with heart failure have impaired brain perfusion and hemodynamic factors are associated with cognitive dysfunction.

Official Title
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Brain Function and Perfusion in Patients With Heart Failure

Conditions
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Heart Failure, Dilated Cardiomyopathy, Perfusion, Cognitive Impairment, Cerebral Hypoperfusion

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria Control Group: Healthy subject, as assessed by clinician Age matched with patient group Exclusion Criteria Control Group: Age < 18 years Carotid artery or intracranial disease, as assessed by echo-doppler (significant stenosis > 50%) Unable or unwilling to undergo MRI The presence of ferromagnetic material in or on the body, for example tattoos with ferrous ink or pacemakers or cardiac defibrillators. Also the presence of pregnancy and claustrophobia. History of cognitive impairment Unable to understand procedures Unable or unwilling to provide informed consent Inclusion Criteria DCM-group: Heart failure due to DCM 15 patients with NYHA class II 15 patients with NYHA class III/IV Exclusion Criteria DCM-Group: Age < 18 years History of myocardial infarction History of peripheral artery disease History of cerebrovascular disease or Carotid artery or intracranial disease, as assessed by echo-doppler (significant stenosis > 50%) History of cognitive impairment Unable to undergo MRI (eg pacemaker) Unable to understand procedures Unable or unwilling to provide informed consent

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Controls<br>Age matched healthy subjects | |
| Mild DCM<br>Heart failure patients with dilated cardiomyopathy (DCM) with NYHA-functional class II | |
| Severe DCM<br>Heart failure patients with dilated cardiomyopathy (DCM) with NYHA-functional class III/IV | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Determinants of cerebral impairment | Determinants of cerebral impairment in patients with heart failure compared to controls, where cerebral impairment is defined as decreased cognitive function and cerebral hypoperfusion | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prevalence of cognitive impairment | Prevalence of cognitive impairment in patients with heart failure | Baseline | 
| Relation of cognitive impairment with local perfusion | Relation of cognitive impairment with perfusion of carotid artery territory and basilar artery territory | Baseline | 
| Relation of cognitive impairment with the severity of heart failure | Relation of cognitive impairment with the severity of heart failure | Baseline | 
| Relation of cognitive impairment with cardiac output | Relation of cognitive impairment with cardiac output | Baseline | 
| Relation of cognitive impairment with the severity of congestion | Relation of cognitive impairment with the severity of congestion | Baseline | 
| Relation of cognitive impairment with the decrease in cerebral perfusion | Relation of cognitive impairment with the decrease in cerebral perfusion | Baseline | 
| The difference of cognitive domains in above relations | The difference of cognitive domains in above relations | Baseline |