Related Experiment Video
Updated: Jan 11, 2026
07:30
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
3.4K
Cerebrovascular compromise and cognitive decline driven by chronic heart failure
Chenjia Zhao1, Fengjun Du2, Xiaoxia Hou3
1Department of Electrocardiogram, Gusu College of Nanjing Medical University, Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital), Suzhou, China.
Frontiers in Neurology
|November 13, 2025
Summary
Chronic heart failure with reduced left ventricular ejection fraction (LVEF) is linked to cerebral small vessel disease (CSVD) and cognitive decline. Lower LVEF correlates with more severe CSVD and worse cognitive function.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Chronic heart failure (CHF) impacts multiple organ systems, including the brain.
- Cerebral small vessel disease (CSVD) is a common finding in patients with heart conditions.
- The relationship between reduced left ventricular ejection fraction (LVEF) in CHF and cognitive impairment needs further elucidation.
Purpose of the Study:
- To investigate the association between chronic heart failure (CHF) with varying left ventricular ejection fraction (LVEF) levels and cerebral small vessel disease (CSVD).
- To assess the impact of LVEF on cognitive function in patients with CHF.
- To explore the relationship between white matter integrity, CSVD, and cognitive performance in CHF patients.
Main Methods:
- A cohort of 73 patients with CHF was divided into LVEF≥50% and LVEF<50% groups.
- Brain MRI, including diffusion tensor imaging (DTI) analyzed with tract-based spatial statistics (TBSS), was performed.
- Neurocognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and its subdomains.
Main Results:
- Patients with LVEF<50% had significantly lower MoCA scores (p<0.001) and a higher prevalence of white matter hyperintensities (WMH) (OR=0.228, p=0.042).
- Reduced LVEF correlated positively with overall MoCA scores and specific cognitive domains (visuospatial/executive function, attention, delayed recall).
- TBSS revealed decreased fractional anisotropy (FA) and increased mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) in the LVEF<50% group, correlating with cognitive deficits.
Conclusions:
- Chronic heart failure, particularly with reduced LVEF, is associated with CSVD and cognitive impairment.
- Decreased LVEF is a significant predictor of white matter changes and poorer cognitive outcomes in CHF patients.
- These findings highlight the importance of assessing brain health in CHF patients, especially those with reduced LVEF.
Related Concept Videos
01:26Imbalances in Cardiac Output
2.3K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
2.3K
01:17Pathophysiology of Heart Failure
2.7K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
2.7K
01:29Heart Failure II: Pathophysiology
695
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
695
01:27Heart Failure I: Introduction
671
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
671
01:17Ischemic Heart Disease: Overview
2.8K
Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
2.8K
01:26Heart Failure III: Clinical Manifestations
457
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
457