Cerebral Hemodynamic and Metabolic Studies in Patients with Congestive Heart Failure

Eisenberg, Seymour; Madison, Leonard L.; Sensenbach, Willis

doi:10.1161/01.cir.21.5.704

Cited by 25 publications

(3 citation statements)

References 12 publications

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“…Though heart failure has been associated with reduced cerebral blood flow for more than five decades [18,19], it was not until 1977 when the term “cardiogenic dementia” was introduced that clinical features (i.e., a mild dementing state) were associated with heart failure [20]. The theory behind “cardiogenic dementia,” which was considered controversial at the time [21,22], proposed that cerebral blood flow changes resulted in a fluctuating cognitive state that could be progressive in nature.…”

Section: Heart Failure As a Clinical Model For Understanding Cardiac mentioning

confidence: 99%

Cardiac Output as a Potential Risk Factor for Abnormal Brain Aging

Jefferson

2010

JAD

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Heart failure has served as a clinically useful model for understanding how cardiac dysfunction is associated with neuroanatomic and neuropsychological changes in aging adults, theoretically because systemic hypoperfusion disrupts cerebral perfusion, contributing to clinical brain injury. This review summarizes more recent data suggesting that subtle cardiac dysfunction or low normal levels of cardiac function, as quantified by cardiac output, are related to cognitive and neuroimaging markers of abnormal brain aging in the absence of heart failure or severe cardiomyopathy. Additional work is required, but such associations suggest that reduced cardiac output may be a risk factor for Alzheimer's disease (AD) and abnormal brain aging through the propagation or exacerbation of neurovascular processes, microembolism due to thrombosis, and AD neuropathological processes. Such mechanistic pathways are discussed in the context of a theoretical model that posits a direct pathway of injury between cardiac output and abnormal brain aging (i.e., reduced systemic blood flow disrupts cerebral blood flow homeostasis), contributing to clinical brain injury, independent of shared risk factors for both cardiac dysfunction and abnormal brain aging.

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Section: Heart Failure As a Clinical Model For Understanding Cardiac mentioning

confidence: 99%

Cardiac Output as a Potential Risk Factor for Abnormal Brain Aging

Jefferson

2010

JAD

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“…This group also performed badly in simple naming tasks and a variety of other cognitive tests. Cognitive deficits have been observed by other investigators in cardiovascular diseases 5 and have been attirbuted to strokes, to arrhythmias, 6 and to severe “end‐stage” congestive failure 7 . The suggestion has been made that repeated bouts of failure or repeated arrhythmias may damage neurons and lead to dementia even without frank stroke 5…”

Section: Discussionmentioning

confidence: 93%

Underdiagnosis of Cognitive Impairment in a Rehabilitation Setting

García

Tweedy²,

Blass³

1984

J American Geriatrics Society

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Of 100 patients consecutively admitted to a rehabilitation hospital, 25 were cognitively impaired. On two brief tests of intellectual function, they scored below the criteria selected by the originators of those tests for clinically significant mental impairment. Nineteen of the 25 had vascular disease of the heart, brain, or peripheral vessels; two had cardiac valvular disease; three had head trauma; and one was mentally retarded. Mental impairment appears to be relatively common among the hospitalized elderly who do not carry the primary diagnosis of "dementia" or "organic brain syndrome." It appears to be particularly common among those with cardiovascular disease, even without frank stroke. Brief mental status examinations should be part of the routine evaluation of such patients.

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“…Congestive heart failure may also present with an acute delirium even in the absence of hypoxia 13 . Eisenberg and Madison studied patients with congestive heart failure and found that chronically impaired blood circulation leads to problems of brain metabolic deficits and cerebral hypoxia 14 …”

Section: Discussionmentioning

confidence: 99%