J Korean Med Sci.  2023 Oct;38(39):e334. 10.3346/jkms.2023.38.e334.

A Correlative Relationship Between Heart Failure and Cognitive Impairment: A Narrative Review

• Park MS
• Kim EJ

• KMID: 2546921
• DOI: http://doi.org/10.3346/jkms.2023.38.e334

Abstract

Heart failure (HF) is a chronic condition affecting millions of people worldwide. While the cardinal manifestations of HF are related to the cardiovascular system, it has become progressively evident that mild cognitive impairment (MCI) is also a significant complication of the disease. In fact, a significant number of patients with HF may experience MCI, which can manifest as deficits in attention, memory, executive function, and processing speed. The mechanisms responsible for cognitive dysfunction in HF are intricate and multifactorial.Possible factors contributing to this condition include decreased cerebral blood flow, thrombogenicity associated with HF, systemic inflammatory conditions, and proteotoxicity.MCI in HF has significant clinical implications, as it is linked to poorer quality of life, increased morbidity and mortality, and higher healthcare costs. Additionally, MCI can disrupt self-care behaviors, adherence to medication, and decision-making abilities, all of which are crucial for effectively managing HF. However, there is currently no gold standard diagnostic tool and follow-up strategy for MCI in HF patients. There is limited knowledge on the prevention and treatment of MCI. In conclusion, MCI is a common and clinically important complication of HF. Considering the substantial influence of MCI on patient outcomes, it is imperative for healthcare providers to be cognizant of this issue and integrate cognitive screening and management strategies into the care of HF patients.

Keyword

Heart Failure; Cognitive Dysfunction; Mild Cognitive Impairment

Figure

• 

  Fig. 1 The bi-directional relationship between mild cognitive impairment and heart failure.CO = cardiac output, CBF = cerebral blood flow, ANS = autonomic nerve system, BBB = blood-brain barrier, HF = heart failure.

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