Neurological complications of heart failure

Area of Science:

• Cardiology
• Neurology
• Gerontology

Background:

• Heart failure (HF) is a leading global cause of mortality, with rising patient numbers.
• HF arises from cardiovascular aging interacting with risk factors, comorbidities, and disease modifiers.
• Bidirectional interaction between the failing heart and neuronal injury necessitates tailored management.

Purpose of the Study:

• To explore the neurological complications associated with heart failure.
• To understand the relationship between cardiac function and brain health.
• To identify patient groups benefiting from specific therapies like anticoagulation.

Main Methods:

• Review of existing literature on heart failure and neurological outcomes.
• Analysis of neuroimaging findings in HF patients.
• Examination of stroke prevalence and types in HF populations.
• Assessment of cognitive function in HF patients.

Main Results:

• Decreased cardiac output correlates with reduced brain volumes.
• Cerebral blood flow normalization can occur post-heart transplantation in severe HF.
• HF patients exhibit increased risks of ischemic and hemorrhagic strokes, with atrial fibrillation (AF) being a key factor in ischemic events.
• Silent ischemic lesions are prevalent in HF patients, detected via advanced neuroimaging.
• Cognitive impairment ranges from mild memory issues to dementia.

Conclusions:

• Neurological complications, including stroke and cognitive impairment, are significant concerns in heart failure.
• Atrial fibrillation in HF patients warrants long-term anticoagulant therapy for stroke prevention.
• Further research is needed to fully characterize hemorrhagic stroke risks and optimize neuroprotection in HF.