Anna Frey1, Roxane Sell2, György A Homola3, Carolin Malsch4, Peter Kraft5, Ignaz Gunreben6, Caroline Morbach7, Bálint Alkonyi3, Eric Schmid3, Isabella Colonna8, Edith Hofer8, Wolfgang Müllges6, Georg Ertl7, Peter Heuschmann9, László Solymosi3, Reinhold Schmidt8, Stefan Störk7, Guido Stoll10. 1. Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Germany, Würzburg, Germany; Department of Medicine I, University Hospital Würzburg, Würzburg, Germany. Electronic address: frey_a@ukw.de. 2. Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Germany, Würzburg, Germany; Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany. 3. Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Germany, Würzburg, Germany; Department of Neuroradiology, University Hospital Würzburg, Würzburg, Germany. 4. Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Germany, Würzburg, Germany; Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany. 5. Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Germany, Würzburg, Germany; Department of Neurology, University Hospital Würzburg, Würzburg, Germany; Department of Neurology, Hospital Main-Spessart, Lohr, Germany. 6. Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Germany, Würzburg, Germany; Department of Neurology, University Hospital Würzburg, Würzburg, Germany. 7. Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Germany, Würzburg, Germany; Department of Medicine I, University Hospital Würzburg, Würzburg, Germany. 8. Department of Neurology, Medical University of Graz, Graz, Austria. 9. Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Germany, Würzburg, Germany; Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany; Clinical Trial Center, University Hospital Würzburg, Würzburg, Germany. 10. Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Germany, Würzburg, Germany; Department of Neurology, University Hospital Würzburg, Würzburg, Germany. Electronic address: stoll_g@ukw.de.
Abstract
OBJECTIVES: This study sought to determine the spectrum of brain lesions seen in heart failure (HF) patients and the extent to which lesion type contributes to cognitive impairment. BACKGROUND: Cognitive deficits have been reported in patients with HF. METHODS: A total of 148 systolic and diastolic HF patients (mean age 64 ± 11 years; 16% female; mean left ventricular ejection fraction 43 ± 8%) were extensively evaluated within 2 days by cardiological, neurological, and neuropsychological testing and brain magnetic resonance imaging (MRI). A total of 288 healthy, sex- and age-matched subjects sampled from the Austrian Stroke Prevention Study served as MRI controls. RESULTS: Deficits in reaction times were apparent in 41% of patients and deficits in verbal memory in 46%. On brain MRI, patients showed more advanced medial temporal lobe atrophy (MTA) (Scheltens score) compared to controls (2.1 ± 0.9 vs. 1.0 ± 0.6; p < 0.001). The degree of MTA was strongly associated with the severity of cognitive impairment, whereas the extent of white matter hyperintensities was similar in patients and controls. Moreover, patients had a 2.7-fold increased risk for presence of clinically silent lacunes. CONCLUSIONS: HF patients exhibit cognitive deficits in the domains of attention and memory. MTA but not white matter lesion load seems to be related to cognitive impairment.
OBJECTIVES: This study sought to determine the spectrum of brain lesions seen in heart failure (HF) patients and the extent to which lesion type contributes to cognitive impairment. BACKGROUND:Cognitive deficits have been reported in patients with HF. METHODS: A total of 148 systolic and diastolic HFpatients (mean age 64 ± 11 years; 16% female; mean left ventricular ejection fraction 43 ± 8%) were extensively evaluated within 2 days by cardiological, neurological, and neuropsychological testing and brain magnetic resonance imaging (MRI). A total of 288 healthy, sex- and age-matched subjects sampled from the Austrian Stroke Prevention Study served as MRI controls. RESULTS: Deficits in reaction times were apparent in 41% of patients and deficits in verbal memory in 46%. On brain MRI, patients showed more advanced medial temporal lobe atrophy (MTA) (Scheltens score) compared to controls (2.1 ± 0.9 vs. 1.0 ± 0.6; p < 0.001). The degree of MTA was strongly associated with the severity of cognitive impairment, whereas the extent of white matter hyperintensities was similar in patients and controls. Moreover, patients had a 2.7-fold increased risk for presence of clinically silent lacunes. CONCLUSIONS: HF patients exhibit cognitive deficits in the domains of attention and memory. MTA but not white matter lesion load seems to be related to cognitive impairment.
Authors: Susan J Pressler; Miyeon Jung; Irmina Gradus-Pizlo; Marita G Titler; Dean G Smith; Sujuan Gao; Kittie Reid Lake; Heather Burney; David G Clark; Kelly L Wierenga; Susan G Dorsey; Bruno Giordani Journal: J Card Fail Date: 2021-11-08 Impact factor: 6.592
Authors: Amy M Pastva; Christina E Hugenschmidt; Dalane W Kitzman; M Benjamin Nelson; Gretchen A Brenes; Gordon R Reeves; Robert J Mentz; David J Whellan; Haiying Chen; Pamela W Duncan Journal: J Card Fail Date: 2020-09-18 Impact factor: 5.712