Heart failure is associated with cognitive impairment, anatomical brain changes, poorer functional independence, and increased mortality, with underlying mechanisms remaining poorly understood.
This review highlights that cognitive impairment is common in heart failure, associated with poorer clinical outcomes, and driven by mechanisms such as cerebral hypoperfusion and systemic inflammation.
Cognitive impairment (CI) is common in heart failure (HF). Patients with HF demonstrate reduced global cognition as well as deficits in multiple cognitive domains compared to controls. Degree of CI may be related to HF severity. HF has also been associated with an increased risk of dementia. Anatomical brain changes have been observed in patients with HF, including grey matter atrophy and increased white matter lesions. Patients with HF and CI have poorer functional independence and self-care, more frequent rehospitalisations as well as increased mortality. Pathophysiological pathways linking HF and CI have been proposed, including cerebral hypoperfusion and impaired cerebrovascular autoregulation, systemic inflammation, proteotoxicity and thromboembolic disease. However, these mechanisms are poorly understood. We conducted a search on MEDLINE, Embase and Scopus for original research exploring the connection between HF and CI. We then reviewed the relevant literature and discuss the associations between HF and CI, the patterns of brain injury in HF and their potential mechanisms, as well as the recognition and management of CI in patients with HF.
Goh et al. (Sun,) conducted a review in Heart Failure and Cognitive Impairment. Heart failure is associated with cognitive impairment, anatomical brain changes, poorer functional independence, and increased mortality, with underlying mechanisms remaining poorly understood.
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