Brain atrophy in heart failure patients following left ventricular assist device implantation or heart transplantation
Advanced heart failure is associated with accelerated brain atrophy, largely related to chronic cerebral malperfusion. Both heart transplantation (HT) and left ventricular assist device (LVAD) implantation improve vital organ perfusion, but the comparative effect on brain atrophy remains unclear. Gi...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | JHLT Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950133425000060 |
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| author | D.Alan Herbst, MD Banafsheh Shakibajahromi, MD Michael V. Genuardi, MD Amit Iyengar, MD Dawn Mechanic-Hamilton, PhD H. Branch Coslett, MD Pavan Atluri, MD Christopher G. Favilla, MD |
| author_facet | D.Alan Herbst, MD Banafsheh Shakibajahromi, MD Michael V. Genuardi, MD Amit Iyengar, MD Dawn Mechanic-Hamilton, PhD H. Branch Coslett, MD Pavan Atluri, MD Christopher G. Favilla, MD |
| author_sort | D.Alan Herbst, MD |
| collection | DOAJ |
| description | Advanced heart failure is associated with accelerated brain atrophy, largely related to chronic cerebral malperfusion. Both heart transplantation (HT) and left ventricular assist device (LVAD) implantation improve vital organ perfusion, but the comparative effect on brain atrophy remains unclear. Given the MR incompatibility of LVADs, we leveraged serial CT imaging in patients who underwent either HT or LVAD implantation. 58 patients were included in this single-center retrospective cohort (23 LVAD; 35 HT). LVAD patients experienced greater brain atrophy (median: 7.1 mL/year; IQR: 0.9–15.7) than transplant patients (median: 0.4 mL/year; IQR: −6.7–13.9), but this difference was non-significant (p=0.09). Temporal atrophy (expansion of the Sylvian fissure) was greater in LVAD patients (median: 0.91 mm/year; IQR: 0.14–2.27) than HT patients (median: 0.10 mm/year; IQR: 0.02–0.55), p=0.005. These observations reveal a need for future work to prospectively quantify brain atrophy after LVAD implantation and HT, while comparing with that of advanced heart failure. |
| format | Article |
| id | doaj-art-001b8e749c4b427baa661ce859fd8e2d |
| institution | Kabale University |
| issn | 2950-1334 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHLT Open |
| spelling | doaj-art-001b8e749c4b427baa661ce859fd8e2d2025-02-09T05:02:03ZengElsevierJHLT Open2950-13342025-02-017100211Brain atrophy in heart failure patients following left ventricular assist device implantation or heart transplantationD.Alan Herbst, MD0Banafsheh Shakibajahromi, MD1Michael V. Genuardi, MD2Amit Iyengar, MD3Dawn Mechanic-Hamilton, PhD4H. Branch Coslett, MD5Pavan Atluri, MD6Christopher G. Favilla, MD7Division of Cardiothoracic Surgery, University of Pennsylvania, Philadelphia, PADepartment of Neurology, University of Pennsylvania, Philadelphia, PADivision of Cardiology, University of Pennsylvania, Philadelphia, PADivision of Cardiothoracic Surgery, University of Pennsylvania, Philadelphia, PADepartment of Neurology, University of Pennsylvania, Philadelphia, PADepartment of Neurology, University of Pennsylvania, Philadelphia, PADivision of Cardiothoracic Surgery, University of Pennsylvania, Philadelphia, PADepartment of Neurology, University of Pennsylvania, Philadelphia, PA; Reprint requests: Christopher G. Favilla, Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104.Advanced heart failure is associated with accelerated brain atrophy, largely related to chronic cerebral malperfusion. Both heart transplantation (HT) and left ventricular assist device (LVAD) implantation improve vital organ perfusion, but the comparative effect on brain atrophy remains unclear. Given the MR incompatibility of LVADs, we leveraged serial CT imaging in patients who underwent either HT or LVAD implantation. 58 patients were included in this single-center retrospective cohort (23 LVAD; 35 HT). LVAD patients experienced greater brain atrophy (median: 7.1 mL/year; IQR: 0.9–15.7) than transplant patients (median: 0.4 mL/year; IQR: −6.7–13.9), but this difference was non-significant (p=0.09). Temporal atrophy (expansion of the Sylvian fissure) was greater in LVAD patients (median: 0.91 mm/year; IQR: 0.14–2.27) than HT patients (median: 0.10 mm/year; IQR: 0.02–0.55), p=0.005. These observations reveal a need for future work to prospectively quantify brain atrophy after LVAD implantation and HT, while comparing with that of advanced heart failure.http://www.sciencedirect.com/science/article/pii/S2950133425000060LVADHeart transplantBrain atrophyHeart failure |
| spellingShingle | D.Alan Herbst, MD Banafsheh Shakibajahromi, MD Michael V. Genuardi, MD Amit Iyengar, MD Dawn Mechanic-Hamilton, PhD H. Branch Coslett, MD Pavan Atluri, MD Christopher G. Favilla, MD Brain atrophy in heart failure patients following left ventricular assist device implantation or heart transplantation JHLT Open LVAD Heart transplant Brain atrophy Heart failure |
| title | Brain atrophy in heart failure patients following left ventricular assist device implantation or heart transplantation |
| title_full | Brain atrophy in heart failure patients following left ventricular assist device implantation or heart transplantation |
| title_fullStr | Brain atrophy in heart failure patients following left ventricular assist device implantation or heart transplantation |
| title_full_unstemmed | Brain atrophy in heart failure patients following left ventricular assist device implantation or heart transplantation |
| title_short | Brain atrophy in heart failure patients following left ventricular assist device implantation or heart transplantation |
| title_sort | brain atrophy in heart failure patients following left ventricular assist device implantation or heart transplantation |
| topic | LVAD Heart transplant Brain atrophy Heart failure |
| url | http://www.sciencedirect.com/science/article/pii/S2950133425000060 |
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