Heart Failure (HF) patients show gray matter injury in multiple brain areas, based on various MRI techniques; such injury can accompany loss of subcortical and white matter myelin integrity. However, the extent of regional myelin changes in HF is unclear. We examined regional myelin integrity in HF patients, and found decreased values, likely resulting from hypoxic/ischemic processes, in critical autonomic, cognitive, respiratory, and mood control sites. These functions are deficient in the condition. Myelin mapping, based on simple-to-calculate ratios of T1- and T2-weighted images, is useful for evaluating regional myelin changes.