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Relation of Acute Decompensated Heart Failure to Silent Cerebral Infarcts in Patients With Reduced Left Ventricular

Nil Ozyuncu1, Sadi Gulec1, Cansin Tulunay Kaya1

  • 1Cardiology Department, Ankara University School of Medicine, Ankara, Turkey.

The American Journal of Cardiology
|March 31, 2019
PubMed

Insights

Acute decompensated heart failure (HF) significantly increases the risk of silent cerebral infarcts (SCI). This study found elevated neuron-specific enolase (NSE) levels during decompensation, indicating neuronal injury in HF patients.

Area of Science:

  • Cardiology
  • Neurology
  • Biomarkers

Background:

  • Heart failure (HF) is a prothrombotic condition linked to thromboembolic events.
  • Silent cerebral infarcts (SCI) are more common in HF patients and associated with cognitive decline.
  • The acute decompensated phase of HF may heighten the risk of recent SCI.

Purpose of the Study:

  • To investigate the association between acute decompensated heart failure and recent silent cerebral infarcts.
  • To evaluate neuron-specific enolase (NSE) as a marker for neuronal injury during HF decompensation.

Main Methods:

  • Studied 147 hospitalized HF patients with sinus rhythm during acute decompensation.
  • Measured neuron-specific enolase (NSE) levels during decompensated and compensated phases.
  • Analyzed predictors of recent SCI and the effect of statin use.

Main Results:

  • A significantly higher proportion of patients had positive NSE levels during decompensation (29%) compared to compensation (4%).
  • Positive NSE levels were associated with smoking, new-onset atrial fibrillation, left ventricular spontaneous echo contrast, and aneurysmal apex.
  • Statin use demonstrated a protective effect against NSE elevation.

Conclusions:

  • Acute decompensated heart failure is significantly associated with elevated NSE levels, suggesting recent silent neuronal injury.
  • NSE serves as a potential biomarker for detecting acute neuronal damage in HF patients.
  • Identifying risk factors and protective measures for SCI in HF is crucial for improving patient outcomes.

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