Elevated Levels of Interleukin 6 and C‐Reactive Protein Associated With Cognitive Impairment in Heart Failure

Abstract

There is abundant evidence on inflammatory mechanisms in heart failure (HF) that are used for prognostication of the disease; however, data are lacking regarding the association between elevated cytokines, C-reactive protein (CRP), and cognition in HF. A cross-sectional pilot study of 38 patients with HF, aged 62 years (standard deviation± 9 years), predominantly men (68%) and Cau casian (79%) were screened for cognitive function using the Montreal Cognitive Assessment (MoCA). The study aimed to examine cognitive scores on MoCA with cytokines, interleukin 6 [IL-6] and tumor necrosis factor α [TNF-α], and CRP as indicators of early cognitive changes in HF. The result showed no direct correlation between cardiac variables and the MoCA score. The MoCA score, however, was inversely associated with IL-6 (r=−0.53, P=.001) and CRP (r=−0.34, P=.04), with no association to TNF-α. Regression analysis on the MoCA score and log-transformed IL-6 accounted for an additional 11% variation and remained statistically significant (P=.008) after controlling for covariates of education, living arrangements, and loneliness. The large effect size (R2=0.87) found in this pilot study provides rationale for a larger exploratory study to examine associations between cognitive function, cytokines, and CRP levels and help design future intervention studies.

Differential Peripheral Inflammatory Factors Associated with Cognitive Function in Patients with Heart Failure

“…We assessed biomarkers known to be involved in cerebro- and/or cardiovascular disease, and cognitive impairment: interferon-γ (IFNγ), TNFα, sICAM-1, sVCAM-1, BDNF, IL-8, matrix metallopeptidase-9 (MMP-9), IL-6, CRP, and SAA [11, 13, 15, 19, 22]. After a 10-min rest period, whole blood was drawn into a 10-mL vacutainer tube preserved with EDTA while participants were in an upright sitting position.…”

“…Meanwhile, there is a relative lack of knowledge relating peripheral neuroinflammation biomarkers and cognitive function specifically in patients with HF. Although, one study found an inverse association between peripheral concentrations of both IL-6 and C-reactive protein (CRP) and cognitive function in patients with HF [19]. Determining definitive arrays of peripheral biomarker expression that can predict cognitive impairment and its progression would be beneficial for early diagnosis, and monitoring treatments.…”

Heart failure and cognitive dysfunction

“…A small study of patients with NYHA II or III heart failure found that higher levels of IL-6 and CRP were associated with poorer performance on the MoCA [97]. There was no association with TNF-α.…”

A review of the neuro- and systemic inflammatory responses in post concussion symptoms: Introduction of the “post-inflammatory brain syndrome” PIBS

“…These include obesity (Miller and Spencer, 2014), HIV infections (Correia et al, 2013;Hilsabeck et al, 2010), healthy older adults (Elderkin-Thompson et al, 2012;Noble et al, 2010;Simpson et al, 2013), chemotherapy (Cheung et al, 2013;Ganz et al, 2013;Kesler et al, 2013), heart failure (Athilingam et al, 2013), RA (Hamed et al, 2012), hepatitis C virus infection (Farag et al, 2011) and bipolar disorder (Bauer et al, 2014;Lotrich et al, 2014).…”