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Communication Regarding the Myocardial Ischemia/Reperfusion and Cognitive Impairment: A Narrative Literature Review
Haiqing Chang1,2, Erya Chen1,2, Tao Zhu1,2
1Department of Anesthesiology, West China Hospital, Sichuan University, Sichuan, China.
Insights
Myocardial ischemia/reperfusion injury (MI/RI) impacts cognitive function, potentially linking heart issues to Alzheimer's disease. Extracellular vesicles may transport harmful substances from the heart to the brain, affecting cognition.
Area of Science:
- Cardiovascular Research
- Neuroscience
- Pathophysiology
Background:
- Coronary artery disease (CAD) causes insufficient heart blood supply, treated by reperfusion strategies.
- Reperfusion therapies can induce myocardial ischemia/reperfusion injury (MI/RI), leading to complications.
- Emerging evidence links MI/RI to cognitive dysfunction and Alzheimer's disease (AD) pathology.
Purpose of the Study:
- To review the association between MI/RI and cognitive function.
- To explore pathophysiological mechanisms linking cardiac events to brain changes.
- To discuss the role of extracellular vesicles and potential neuroprotective strategies.
Main Methods:
- Literature review focusing on MI/RI and cognitive impairment.
- Analysis of mechanisms including systemic inflammation and cerebral hypoperfusion.
- Examination of extracellular vesicle-mediated cardio-cerebral communication.
Main Results:
- MI/RI can trigger neuroinflammation and cerebral under-perfusion.
- Brain pathology post-MI/RI resembles Alzheimer's disease.
- Extracellular vesicles may transfer harmful substances from heart to brain, impairing cognition.
Conclusions:
- MI/RI significantly impacts cognitive function.
- Understanding cardio-cerebral communication is key to preventing cognitive decline.
- Neuroprotective interventions and treatments for MI/RI-associated cognitive dysfunction are crucial.
Abstract:
Coronary artery disease is a prevalent ischemic disease that results in insufficient blood supply to the heart muscle due to narrowing or occlusion of the coronary arteries. Various reperfusion strategies, including pharmacological thrombolysis and percutaneous coronary intervention, have been developed to enhance blood flow restoration. However, these interventions can lead to myocardial ischemia/reperfusion injury (MI/RI), which can cause unpredictable complications. Recent research has highlighted a compelling association between MI/RI and cognitive function, revealing pathophysiological mechanisms that may explain altered brain cognition. Manifestations in the brain following MI/RI exhibit pathological features resembling those observed in Alzheimer's disease (AD), implying a potential link between MI/RI and the development of AD. The pro-inflammatory state following MI/RI may induce neuroinflammation via systemic inflammation, while impaired cardiac function can result in cerebral under-perfusion. This review delves into the role of extracellular vesicles in transporting deleterious substances from the heart to the brain during conditions of MI/RI, potentially contributing to impaired cognition. Addressing the cognitive consequence of MI/RI, the review also emphasizes potential neuroprotective interventions and pharmacological treatments within the MI/RI model. In conclusion, the review underscores the significant impact of MI/RI on cognitive function, summarizes potential mechanisms of cardio-cerebral communication in the context of MI/RI, and offers ideas and insights for the prevention and treatment of cognitive dysfunction following MI/RI.
