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Expert Opinion-Cognitive Decline in Heart Failure: More Attention is Needed

Jelena Čelutkienė1, Arūnas Vaitkevičius2, Silvija Jakštienė3

  • 1Department of Cardiovascular Diseases, Vilnius University, Vilnius, Lithuania.

Cardiac Failure Review
|August 9, 2017
PubMed

Insights

Cognitive decline affects up to 80% of heart failure patients, particularly during acute decompensation. Early screening for cognitive dysfunction is crucial for managing heart failure outcomes.

Area of Science:

  • Cardiology
  • Neurology
  • Geriatrics

Background:

  • Cognitive decline is common in heart failure (HF) patients, impacting prognosis.
  • Prevalence reaches 80% in acute decompensation, linked to HF severity.
  • Hypertension, atrial fibrillation, stroke, and poor hemodynamics are key contributors.

Purpose of the Study:

  • To review the prevalence and contributing factors of cognitive decline in heart failure.
  • To explore the pathophysiological mechanisms linking HF and cognitive impairment.
  • To highlight neuroimaging findings and affected cognitive domains.

Main Methods:

  • Literature review of studies on cognitive function in heart failure patients.
  • Analysis of etiological factors, including cardiovascular and cerebrovascular conditions.
  • Examination of neuroimaging findings and clinical assessments.

Main Results:

  • Heart failure is associated with significant cognitive dysfunction, especially in acute decompensation.
  • Pathogenic links include cerebral hypoperfusion, blood-brain barrier disruption, oxidative stress, and inflammation.
  • Neuroimaging often reveals white matter changes, infarcts, and brain volume loss.

Conclusions:

  • Cognitive decline is a critical issue in heart failure management.
  • Understanding the underlying mechanisms is essential for targeted interventions.
  • Routine cognitive screening in HF patients is recommended for improved clinical care.

Keywords:
Cognitive impairmentadherenceadverse outcomescognitive domainsheart failurepatient self-care

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