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Updated: Jun 6, 2025

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

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Impact of cognitive impairment on heart failure prognosis: insights into central nervous system mechanism

Zhiyong Shi1, Mingkai Yun1, Binbin Nie2

  • 1Department of Nuclear Medicine, Molecular Imaging Lab, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

EJNMMI Research
|November 28, 2024
PubMed

Insights

Cognitive impairment in heart failure patients is linked to autonomic nervous system dysfunction and increased risk of major arrhythmic events. This study reveals how brain metabolism and heart rhythm disturbances contribute to poor outcomes in heart failure with reduced ejection fraction patients.

Area of Science:

  • Cardiology
  • Neurology
  • Nuclear Medicine

Background:

  • Heart failure (HF) patients with cognitive impairment (CI) have poorer prognoses, with mechanisms beyond self-management issues.
  • The central nervous system regulates both CI and the autonomic nervous system (ANS), suggesting a link.

Purpose of the Study:

  • To investigate the relationship between cognitive function, ANS-related brain region metabolism, and major arrhythmic events (MAEs) in heart failure with reduced ejection fraction (HFrEF) patients.

Main Methods:

  • Retrospective analysis of 72 HFrEF patients.
  • Utilized myocardial perfusion imaging and 18F-FDG PET/CT for heart and brain imaging.
  • Assessed cognitive function using the Mini-Mental State Examination and evaluated QTc interval.

Main Results:

  • 17.8% of patients experienced MAEs.
  • MAEs were associated with decreased cognitive function, prolonged QTc intervals, and hypometabolism in the hippocampus and caudate nuclei.
  • Cognitive function, QTc interval, and brain metabolism were significantly correlated, with ANS dysfunction mediating MAE risk.

Conclusions:

  • Autonomic nervous system dysfunction, indicated by altered brain metabolism and reduced central autonomic network connectivity, increases MAE risk in HFrEF patients with CI.
Abstract

Keywords:
18F-FDG PETBrain networkBrain–heart axisCognitive impairmentHeart failureQTc interval

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