Heart Failure-Induced Brain Injury.
Heart failure (HF) is a systemic illness with grave implications for bodily functions. The brain, among other vital organs, often suffers insults as a result of HF, and both anatomic and functional brain abnormalities were found in the HF population. This injury was demonstrated across a wide range of clinical conditions and cardiac functions and was shown to affect patients' outcomes. Although reduced cardiac output and high burden of cardiovascular risk factors are the prevailing explanations for these findings, there are data showing the involvement of neurohormonal, nutritional, and inflammatory mechanisms in this complex process. Here, the authors review the suggested pathophysiology behind brain injury in HF, describe its effect on patients' outcomes, offer a diagnostic approach, and discuss possible therapeutic options.
Department of Cardiology, Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Cardiology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: ofer.havakuk@med.usc.edu.
Ofer
O
Havakuk
Huntington Medical Research Institute, Los Angeles, California.
Kevin S
KS
King
Department of Cardiology, Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
Luanda
L
Grazette
Department of Cardiology, Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
Andrew J
AJ
Yoon
Department of Cardiology, Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
Michael
M
Fong
Department of Neurology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Noa
N
Bregman
Department of Cardiology, Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
Uri
U
Elkayam
Department of Cardiology, Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; Huntington Medical Research Institute, Los Angeles, California.
Robert A
RA
Kloner
D001921:Brain / Q000473:pathology; D001930:Brain Injuries / Q000209:etiology* / Q000473:pathology / Q000523:psychology; D002560:Cerebrovascular Circulation; D060825:Cognitive Dysfunction / Q000209:etiology; D006333:Heart Failure / Q000150:complications*; D006801:Humans
cerebral blood flow; cognitive impairment; depression