Heart Failure Self-care Associated With Brain Injury in Executive Control Regions.
Sarah Choi, Bhaswati Roy, Rajesh Kumar and 2 others
PMID 31609280WHAT IT FOUND
In adults with heart failure, more prefrontal brain tissue injury was linked to lower self-care maintenance and management scores and slower executive test performance, but not confidence.
This association cannot show cause or treatment benefit.
Key findings
01Higher prefrontal mean diffusivity, indicating more tissue injury, was significantly negatively correlated with self-care maintenance and management scores.
02Higher prefrontal mean diffusivity was significantly positively correlated with longer Trail Making Test B times.
03No significant correlation was found between prefrontal mean diffusivity and self-care confidence scores.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was small, with 21 patients, so results are unstable and could not adjust for many variables such as medications. The study was cross-sectional and correlational, so it cannot show that brain injury causes poor self-care. Participants were younger, mostly had non-ischemic cardiomyopathy, and had fewer comorbidities than many heart failure patients, so findings may not apply to older, sicker, or ischemic populations. Patients who could not lie flat, had pacemakers or implantable cardioverter-defibrillators, stents, coils, braces, claustrophobia, or weight over 125 kg were excluded, so the sample omits some common heart failure groups. Self-care management mean was reported for 11 subjects with symptoms, not the whole sample.
Declared interests
The supplied text lists NIH extramural research support. No author conflict-of-interest statement or sponsor role is provided.
The easy way to misread this
Do not conclude that prefrontal brain injury causes poor heart failure self-care, or that cognitive assessment or brain-directed treatment will improve self-care. This was a small cross-sectional correlation study, and it did not test an intervention.