Heart failure and the heart-brain axis

Area of Science:

• Cardiology
• Neurology
• Neuroscience

Background:

• Heart failure (HF) involves complex interactions between the heart and central nervous system (CNS).
• These interactions can lead to mutual functional impairment, affecting both cardiac and cerebral health.
• The clinical significance of this cardiac-cerebral comorbidity is often under-recognized in diagnosis and treatment.

Purpose of the Study:

• To discuss the pathophysiologic aspects of heart-CNS interactions in HF.
• To examine the impact of HF on cerebral functions, including stroke, cognitive decline, and depression.
• To review current treatment options for cerebral dysfunction in HF patients.

Main Methods:

• Review of existing literature on heart-CNS interactions in heart failure.
• Discussion of neurophysiological and neurochemical mechanisms involved.
• Analysis of clinical implications and treatment strategies.

Main Results:

• HF can cause cerebral injuries like stroke, cognitive impairment, and depression.
• Impaired brain function can exacerbate myocardial injury and HF progression.
• Brainstem functions, neurohormonal control, and cardiovascular reflexes are implicated in HF's cardiac-cerebral dialogue.

Conclusions:

• The interplay between the heart and CNS is critical in HF pathophysiology.
• Cerebral complications significantly impact HF severity, progression, and mortality.
• Integrated diagnostic and therapeutic approaches are needed to address cardiac-cerebral interactions in HF.