Cognitive Deficits and Related Brain Lesions in Patients With Chronic Heart Failure

Frey, Anna; Sell, Roxane; Homola, György A.; Malsch, Carolin; Kraft, Peter; Gunreben, Ignaz; Morbach, Caroline; Alkonyi, Bálint; Schmid, E; Colonna, Isabella; Hofer, Edith; Müllges, Wolfgang; Ertl, Georg; Heuschmann, Peter U.; Solymosi, L.; Schmidt, Reinhold; Störk, Stefan; Stoll, Guido

doi:10.1016/j.jchf.2018.03.010

Cited by 76 publications

(100 citation statements)

References 24 publications

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“…Also in our study we found significant relations between ACE-R Fluency and Log-BNP and other interesting associations between 6MWT and both ACE-R Memory subtest and psychomotor speed (Fig 1). This link between the distance covered on the 6MWT, which decreases with age, could reflect the influence that a CHF condition can exert on attention, memory and motor efficiency of CHF patients, synthesizing a general cognitive-motor slowing [12,38]. This hypothesis finds further support in our regression model, where Log-BNP and psychomotor speed independently predicted distance covered at the 6MWT.…”

Section: N(%)supporting

confidence: 64%

“…In fact, affective and emotional dysregulation are common in preclinical and prodromal dementia syndromes, often revealing in advance neurodegenerative changes and a progressive cognitive decline [ 35 ]. Other relations frequently described in literature can be found between cognitive impairment and clinical variables [ 36 ] between psychological/neuropsychological factors and clinical variables [ 13 ] or between psychological/neuropsychological factors and functional variables [ 37 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

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Psychomotor speed as a predictor of functional status in older chronic heart failure (CHF) patients attending cardiac rehabilitation

et al. 2020

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Background The association among psychological, neuropsychological dysfunctions and functional/clinical variables in Chronic Heart Failure (CHF) has been extensively addressed in literature. However, only a few studies investigated those associations in the older population. Purpose To evaluate the psychological/neuropsychological profile of older CHF patients, to explore the interrelation with clinical/functional variables and to identify potential independent predictors of patients' functional status. Methods This study was conducted with a multi-center observational design. The following assessments were performed:

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Section: N(%)supporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Psychomotor speed as a predictor of functional status in older chronic heart failure (CHF) patients attending cardiac rehabilitation

et al. 2020

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“…Alterations in neuronal structure, loss of synapses, and dysfunction of neuronal networks are physiological processes associated with normal aging [23]. In HF patients, the occurrence of CI has often been viewed as coincidental events, because the prevalence of both HF and CI increases with age [4,10,43–47].…”

Section: Discussionmentioning

confidence: 99%

Cognitive impairment in heart failure is associated with altered Wnt signaling in the hippocampus

Toledo

Lucero

Andrade

et al. 2019

Aging

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Age represents the highest risk factor for death due to cardiovascular disease. Heart failure (HF) is the most common cardiovascular disease in elder population and it is associated with cognitive impairment (CI), diminishing learning and memory process affecting life quality and mortality in these patients. In HF, CI has been associated with inadequate O2 supply to the brain; however, an important subset of HF patients displays CI with almost no alteration in cerebral blood flow. Importantly, nothing is known about the pathophysiological mechanisms underpinning CI in HF with no change in brain tissue perfusion. Here, we aimed to study memory performance and learning function in a rodent model of HF that shows no change in blood flow going to the brain. We found that HF rats presented learning impairments and memory loss. In addition, HF rats displayed a decreased level of Wnt/β-catenin signaling downstream elements in the hippocampus, one pathway implicated largely in aging diseases. Taken together, our results suggest that in HF rats CI is associated with dysfunction of the Wnt/β-catenin signaling pathway. The mechanisms involved in the alterations of Wnt/β-catenin signaling in HF and its contribution to the development/maintenance of CI deserves future investigations.

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“…Recent data have shown that HF and depression may not share common brain involvement and may have specific cognitive deficits. 67…”

Section: Figurementioning

confidence: 99%

“…fatigue). 67 Different questionnaires have been validated for the screening of clinically significant depressive symptoms 68 ( Table 2). In clinical practice, the Patient Health Questionnaire-2 (PHQ-2) is a simple and effective tool for the screening of depressive symptoms that evaluates depressed mood and anhedonia on a six-point scale.…”

Section: Diagnosismentioning

confidence: 99%

Depression and heart failure: the lonely comorbidity

Sbolli

Fiuzat

Cani

et al. 2020

European J of Heart Fail

138

107

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Depression is a frequent and debilitating comorbidity that affects heart failure (HF) patients. Up to 30% of HF patients suffer from depression and even more have depressive symptoms. Moreover, depression carries a risk for HF, especially in high‐risk groups, and is significantly associated with worse quality of life and clinical outcomes. The pathophysiology of depression and HF is poorly understood, but both diseases share several mechanisms and risk factors, including dysregulation of platelet reactivity, inflammation, neuroendocrine function, arrhythmias, high‐risk behaviours, and social factors. Current HF guidelines advise to screen HF patients for depression and several screening questionnaires are available. Ultimately, the diagnosis of depression is based on DSM‐5 criteria. Depression treatment consists of non‐pharmacological and pharmacological therapies. Non‐pharmacological therapies, such as exercise training and cognitive‐behavioural therapy, have been shown to have beneficial effects on depressive symptoms. Selective serotonin reuptake inhibitors, the mainstay of antidepressant therapy, appear to be safe in HF but have not shown superiority over placebo in HF in short‐ and long‐term randomized clinical trials. New therapies to treat depression are under investigation and may offer the opportunity to improve depression management in HF, including N‐methyl‐D‐aspartate receptor antagonists, repetitive transcranial magnetic stimulation and omega‐3 supplementation. New technologies may offer several advantages for the screening and diagnosis of depression but they remain to be tested in future research. In this review, we examine the intersection of depression and HF, summarize the epidemiology and pathophysiology, and discuss new opportunities to diagnose and treat HF patients with depression.

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Cognitive Deficits and Related Brain Lesions in Patients With Chronic Heart Failure

Abstract: HF patients exhibit cognitive deficits in the domains of attention and memory. MTA but not white matter lesion load seems to be related to cognitive impairment.

Cited by 76 publications

References 24 publications

Psychomotor speed as a predictor of functional status in older chronic heart failure (CHF) patients attending cardiac rehabilitation

Psychomotor speed as a predictor of functional status in older chronic heart failure (CHF) patients attending cardiac rehabilitation

Cognitive impairment in heart failure is associated with altered Wnt signaling in the hippocampus

Depression and heart failure: the lonely comorbidity

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