Abstract 12792: Relationship Between Depression and Brain Injury in Heart Failure

Abstract

Introduction: Depression is common in heart failure (HF), and is an independent predictor of mortality and morbidity. MRI detected brain injury in many regions, including those associated with depressive symptoms (hippocampus, insular lobes). However, the association between depressive symptoms and documented brain injury has not been reported in HF. Methods: Using a 3.0-Tesla MRI scanner, we assessed brain tissue injury (DTI-based mean diffusivity [MD] procedures [damage indicated by increased diffusion/MD value]) and depressive symptoms (Beck Depression Inventory-II [BDI]; BDI scores >17 indicate depression) in 16 HF (age 55.1 + 7.7 years; 12 males; LVEF 27.8 + 6.8) and 26 controls (age 49.7 + 10.8 years; 17 males). All HF subjects were NYHA Class I-II and were able to lie flat in an MRI scanner. Statistics consisted of Mann-Whitney U and Spearman’s Rho with significance set at p<0.05. Results: No significant differences were found between the groups for age or BMI. A significant difference in depression scores were seen between the groups on the BDI (HF = 10.75 + 7.66; controls= 3.54 + 4.33; p < 0.01) with only HF subjects exhibiting severe depression. Significant, positive correlations between brain injury and depression were detected in the right hippocampus, left insula, right frontal and right and left cerebellar areas (see Table 1). Discussion: This study reinforces the findings of depressive symptoms in HF patients but is the first study to show evidence of a correlation between damage to areas of emotion, cognition, and motor coordination in the brain and symptoms of depression. This study reveals a strong relationship between depression and brain damage in HF. Clinicians should not assume depression in HF is situational but may be due to brain injury.