Key result
Heart failure impairs brain structure and function through reduced perfusion, neurohormonal activation, and systemic inflammation.
Why the study?
Heart failure causes brain injury through multiple mechanisms including reduced cardiac output and neurohormonal, nutritional, and inflammatory factors, affecting patient outcomes.
Key Points
- To review the underlying pathophysiology, diagnostic strategies, clinical outcomes, and therapeutic considerations associated with brain injury occurring in patients with heart failure.
- Narrative review synthesizing clinical and mechanistic evidence on anatomic and functional central nervous system abnormalities across diverse heart failure stages and severities.
- Evaluated the interplay of reduced cardiac output, cardiovascular comorbidities, neurohormonal pathways, nutritional factors, and systemic inflammation in mediating cerebral damage.
- Heart failure induces both structural and functional brain insults across a wide range of cardiac performance levels, directly compromising clinical outcomes and patient survival.
Structured PICO
P
Population
Patients with heart failure (HF)
Ask about this paper
Answers are grounded in this paper and cite their sources.
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“For many years, we've known that patients with heart failure tend to be cognitively impaired, but this was viewed as a coincidence. Only recently have studies suggested that heart failure causes the cognitive problems.”
“Heart failure is a disease that never goes away and treating it relies heavily on a patient's ability to follow specific instructions, monitor their symptoms and keep up with many different medications. Seeing this cognitive decline among patients, and how it worsens over time after a diagnosis of heart failure, should be a warning for providers to assess a patient's cognitive ability early and factor it into the care plan.”
“We need a better understanding of the mechanisms driving accelerated cognitive decline after heart failure to develop interventions that halt or slow the decline.”
Implication
This review highlights the pathophysiology, diagnostic approach, and potential therapeutic options for brain injury induced by heart failure.
Abstract
Heart failure (HF) is a systemic illness with grave implications for bodily functions. The brain, among other vital organs, often suffers insults as a result of HF, and both anatomic and functional brain abnormalities were found in the HF population. This injury was demonstrated across a wide range of clinical conditions and cardiac functions and was shown to affect patients' outcomes. Although reduced cardiac output and high burden of cardiovascular risk factors are the prevailing explanations for these findings, there are data showing the involvement of neurohormonal, nutritional, and inflammatory mechanisms in this complex process. Here, the authors review the suggested pathophysiology behind brain injury in HF, describe its effect on patients' outcomes, offer a diagnostic approach, and discuss possible therapeutic options.
Discussion
No takes yet. Share an insight, caveat, or question.
Cite This Study
Havakuk et al. (2017) conducted a review in Heart failure. Heart failure was evaluated. Heart failure induces anatomic and functional brain abnormalities through reduced cardiac output, cardiovascular risk factors, and neurohormonal, nutritional, and inflammatory mechanisms.