Altered Neurovascular Coupling in Heart Failure: Insights from a 1-Year Follow-Up Study on Cerebral Hemodynamics and Cognitive Decline

Motivation: Altered neuronal activity and cerebral hemodynamics in heart failure (HF) patients may lead to neurovascular decoupling, but no neuroimaging evidence has confirmed this disruption. Goal(s): To investigate neurovascular decoupling and its clinical implications in HF patients over a 1-year follow-up. Approach: ASL and functional MRI were used to assess changes in neurovascular coupling in HF patients and healthy controls. The relationship between neurovascular coupling, cognitive performance, and cardiac injury was also explored. Results: The neurovascular coupling index was reduced in HF patients, correlating with cerebral glucose metabolism, cognitive scores, and cardiac function. Impact: This study provides new insights into cognitive impairment and potential imaging biomarkers for brain injury in HF.