Cerebral blood flow and cognitive functioning in patients with disorders along the heart–brain axis

Leeuwis, Anna E.; Hooghiemstra, Astrid M.; Bron, Esther E.; Kuipers, Sanne; Oudeman, Eline A.; Kalay, Tugba; Rocca, Hans‐Peter Brunner‐La; Kappelle, L. Jaap; Oostenbrugge, Robert J. van; Greving, Jacoba P.; Niessen, Wiro J.; Buchem, Mark A. van; Osch, Matthias J.P. van; Rossum, Albert C. van; Prins, Niels D.; Biessels, Geert Jan; Barkhof, Frederik; Flier, Wiesje M. van der

doi:10.1002/trc2.12034

Cited by 18 publications

(18 citation statements)

References 43 publications

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“…The changes noted in the CBF volume were examined in three studies ( 21 , 23 , 24 ), which elucidated that the combination of CBF decline with AF, depression, or BMI may result in higher number of adverse effects on attention, executive function, memory, and other cognitive areas of HF patients. However, one study ( 18 ) indicated that the CBF value was lower in the HF group, whereas no significant correlation was noted between CBF and CI compared with the control group.…”

Section: Resultsmentioning

confidence: 97%

“…A total of 403 articles were excluded of the 469 remaining articles, following investigation of the full text. Finally, 66 studies ( 18 – 83 ) were included in the analysis, involving a total of 33,579 patients. The flow chart ( Figure 1 ) indicates the search process and study selection.…”

Section: Resultsmentioning

confidence: 99%

“…The results of using AHRQ to evaluate the risk of bias and method quality of 55 cross-sectional studies are shown in Supplementary Material 2 ( Supplementary Table 1 ). A total of seven studies ( 18 , 30 , 37 , 40 , 41 , 68 , 82 ) were included with high quality, and the remaining 48 studies were with medium quality. Specifically, all the included cross-sectional studies contained clear data sources, the inclusion and exclusion criteria, and the evaluations for quality assurance purposes.…”

Section: Resultsmentioning

confidence: 99%

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Brain Imaging Changes and Related Risk Factors of Cognitive Impairment in Patients With Heart Failure

Jiang

Wang

et al. 2022

Front. Cardiovasc. Med.

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Background/AimsTo explore the imaging changes and related risk factors of heart failure (HF) patients with cognitive impairment (CI).MethodsA literature search was systematically carried out in PubMed, Web of Science, Embase, and Cochrane Library. In this systematic review, important relevant information was extracted according to the inclusion and exclusion criteria. The methodological quality was assessed by three scales according to the different study types.ResultsFinally, 66 studies were included, involving 33,579 patients. In the imaging changes, the severity of medial temporal lobe atrophy (MTA) and the decrease of gray Matter (GM) volume were closely related to the cognitive decline. The reduction of cerebral blood flow (CBF) may be correlated with CI. However, the change of white matter (WM) volume was possibly independent of CI in HF patients. Specific risk factors were analyzed, and the data indicated that the increased levels of B-type natriuretic peptide (BNP)/N-terminal pro-B-type natriuretic peptide (NT-proBNP), and the comorbidities of HF, including atrial fibrillation (AF), diabetes mellitus (DM) and anemia were definitely correlated with CI in patients with HF, respectively. Certain studies had also obtained independent correlation results. Body mass index (BMI), depression and sleep disorder exhibited a tendency to be associated with CI. Low ejection fraction (EF) value (<30%) was inclined to be associated with the decline in cognitive function. However, no significant differences were noted between heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) in cognitive scores.ConclusionBNP/NT-proBNP and the comorbidities of HF including AF, DM and anemia were inextricably correlated with CI in patients with HF, respectively. These parameters were independent factors. The severity of MTA, GM volume, BMI index, depression, sleep disorder, and low EF value (<30%) have a disposition to associated with CI. The reduction in the CBF volume may be related to CI, whereas the WM volume may not be associated with CI in HF patients. The present systematic review provides an important basis for the prevention and treatment of CI following HF.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Brain Imaging Changes and Related Risk Factors of Cognitive Impairment in Patients With Heart Failure

Jiang

Wang

et al. 2022

Front. Cardiovasc. Med.

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“…Several factors, including large artery stenosis and occlusion due to atherosclerotic disease, hypotension, or anemia, may underlie the development of this subtype of stroke [ 38 , 39 , 40 ]. The decrease in cerebral blood flow may be further compromised due to the reduced cardiac output in patients with HF in the presence of large artery stenosis [ 41 , 42 ]. The cerebral hypoperfusion leads to a decrease in blood flow to the areas of brain supplied by deep arteries lacking collateral flow, which makes them vulnerable to ischemic damage [ 21 ], vascular dementia [ 43 , 44 ], silent or subclinical stroke, and cognitive impairment [ 14 , 45 , 46 ].…”

Section: Etiology Of Stroke and Risk Factors In Heart Failurementioning

confidence: 99%

Ischemic Stroke and Heart Failure: Facts and Numbers. An Update

Barkhudaryan

Doehner

Scherbakov

2021

JCM

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Heart failure (HF) is a severe clinical syndrome accompanied by a number of comorbidities. Ischemic stroke occurs frequently in patients with HF as a complication of the disease. In the present review, we aimed to summarize the current state of research on the role of cardio–cerebral interactions in the prevalence, etiology, and prognosis of both diseases. The main pathophysiological mechanisms underlying the development of stroke in HF and vice versa are discussed. In addition, we reviewed the results of recent clinical trials investigating the prevalence and prevention of stroke in patients with HF.

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“… 57 , 58 However, a recent study showed no relation between cerebral blood flow, measured with arterial spin labelling MRI, and cognitive functioning in patients with HF and vascular brain injury. 59 In two studies comparing patients with HF to controls, medial temporal lobe atrophy (MTA) was related to cognitive functioning in patients with HF. 47 , 60 MTA is an early feature of Alzheimer’s disease (AD) and is associated with an increased risk of progression to dementia.…”

Section: Heart and Brainmentioning

confidence: 99%

Reciprocal organ interactions during heart failure: a position paper from the ESC Working Group on Myocardial Function

Ciccarelli

Dawson

Falcão-Pires

et al. 2021

Cardiovascular Research

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Heart failure—either with reduced or preserved ejection fraction (HFrEF/HFpEF)—is a clinical syndrome of multifactorial and gender-dependent aetiology, indicating the insufficiency of the heart to pump blood adequately to maintain blood flow to meet the body's needs. Typical symptoms commonly include shortness of breath, excessive fatigue with impaired exercise capacity, and peripheral oedema, thereby alluding to the fact that heart failure is a syndrome that affects multiple organ systems. Patients suffering from progressed heart failure have a very limited life expectancy, lower than that of numerous cancer types. In this position paper, we provide an overview regarding interactions between the heart and other organ systems, the clinical evidence, underlying mechanisms, potential available or yet-to-establish animal models to study such interactions and finally discuss potential new drug interventions to be developed in the future. Our working group suggests that more experimental research is required to understand the individual molecular mechanisms underlying heart failure and reinforces the urgency for tailored therapeutic interventions that target not only the heart but also other related affected organ systems to effectively treat heart failure as a clinical syndrome that affects and involves multiple organs.

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Cerebral blood flow and cognitive functioning in patients with disorders along the heart–brain axis

Cited by 18 publications

References 43 publications

Brain Imaging Changes and Related Risk Factors of Cognitive Impairment in Patients With Heart Failure

Brain Imaging Changes and Related Risk Factors of Cognitive Impairment in Patients With Heart Failure

Ischemic Stroke and Heart Failure: Facts and Numbers. An Update

Reciprocal organ interactions during heart failure: a position paper from the ESC Working Group on Myocardial Function

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