title: Poorer physical fitness is associated with reduced structural brain integrity in heart failure.
abstract: OBJECTIVE
  Physical fitness is an important correlate of structural and functional integrity of the brain in healthy adults. In heart failure (HF) patients, poor physical fitness may contribute to cognitive dysfunction and we examined the unique contribution of physical fitness to brain structural integrity among patients with HF.
  
  
  METHODS
  Sixty-nine HF patients performed the Modified Mini Mental State examination (3MS) and underwent brain magnetic resonance imaging. All participants completed the 2-minute step test (2MST), a brief measure of physical fitness. We examined the associations between cognitive performance, physical fitness, and three indices of global brain integrity: total cortical gray matter volume, total white matter volume, and whole brain cortical thickness.
  
  
  RESULTS
  Regression analyses adjusting for demographic characteristics, medical variables (e.g., left ventricular ejection fraction), and intracranial volume revealed reduced performance on the 2MST were associated with decreased gray matter volume and thinner cortex (p<.05). Follow up analyses showed that reduced gray matter volume and decreased cortical thickness were associated with poorer 3MS scores (p<.05).
  
  
  CONCLUSIONS
  Poor physical fitness is common in HF and associated with reduced structural brain integrity. Prospective studies are needed to elucidate underlying mechanisms for the influence of physical fitness on brain health in HF.
authors.affiliation: Department of Psychology, Kent State University, Kent, OH 44242, USA. Malosco@kent.edu
authors.forename: Michael L
authors.initials: ML
authors.lastname: Alosco
authors.forename: Adam M
authors.initials: AM
authors.lastname: Brickman
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Spitznagel
authors.forename: Erica Y
authors.initials: EY
authors.lastname: Griffith
authors.forename: Atul
authors.initials: A
authors.lastname: Narkhede
authors.forename: Naftali
authors.initials: N
authors.lastname: Raz
authors.forename: Ronald
authors.initials: R
authors.lastname: Cohen
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Sweet
authors.forename: Lisa H
authors.initials: LH
authors.lastname: Colbert
authors.forename: Richard
authors.initials: R
authors.lastname: Josephson
authors.forename: Joel
authors.initials: J
authors.lastname: Hughes
authors.forename: Jim
authors.initials: J
authors.lastname: Rosneck
authors.forename: John
authors.initials: J
authors.lastname: Gunstad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D010809:Physical Fitness / Q000502:physiology*; D012044:Regression Analysis