Τίτλος:
Heart and brain interaction in patients with heart failure: overview and proposal for a taxonomy. A position paper from the Study Group on Heart and Brain Interaction of the Heart Failure Association
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Heart failure (HF) is a complex clinical syndrome with multiple interactions between the failing myocardium and cerebral (dys-)functions. Bi-directional feedback interactions between the heart and the brain are inherent in the pathophysiology of HF: (i) the impaired cardiac function affects cerebral structure and functional capacity, and (ii) neuronal signals impact on the cardiovascular continuum. These interactions contribute to the symptomatic presentation of HF patients and affect many co-morbidities of HF. Moreover, neuro-cardiac feedback signals significantly promote aggravation and further progression of HF and are causal in the poor prognosis of HF. The diversity and complexity of heart and brain interactions make it difficult to develop a comprehensive overview. In this paper a systematic approach is proposed to develop a comprehensive atlas of related conditions, signals and disease mechanisms of the interactions between the heart and the brain in HF. The proposed taxonomy is based on pathophysiological principles. Impaired perfusion of the brain may represent one major category, with acute (cardio-embolic) or chronic (haemodynamic failure) low perfusion being sub-categories with mostly different consequences (i.e. ischaemic stroke or cognitive impairment, respectively). Further categories include impairment of higher cortical function (mood, cognition), of brain stem function (sympathetic over-activation, neuro-cardiac reflexes). Treatment-related interactions could be categorized as medical, interventional and device-related interactions. Also interactions due to specific diseases are categorized. A methodical approach to categorize the interdependency of heart and brain may help to integrate individual research areas into an overall picture. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology
Συγγραφείς:
Doehner, W.
Ural, D.
Haeusler, K.G.
Čelutkienė, J.
Bestetti, R.
Cavusoglu, Y.
Peña-Duque, M.A.
Glavas, D.
Iacoviello, M.
Laufs, U.
Alvear, R.M.
Mbakwem, A.
Piepoli, M.F.
Rosen, S.D.
Tsivgoulis, G.
Vitale, C.
Yilmaz, M.B.
Anker, S.D.
Filippatos, G.
Seferovic, P.
Coats, A.J.S.
Ruschitzka, F.
Περιοδικό:
European Journal of Heart Failure
Εκδότης:
John Wiley and Sons Ltd
Λέξεις-κλειδιά:
alteplase; amfebutamone; beta adrenergic receptor blocking agent; cholinesterase inhibitor; dipeptidyl carboxypeptidase inhibitor; memantine; mineralocorticoid antagonist; mirtazapine; monoamine oxidase inhibitor; sacubitril plus valsartan; serotonin noradrenalin reuptake inhibitor; serotonin uptake inhibitor; tricyclic antidepressant agent; warfarin, ablation therapy; anxiety; Article; assisted circulation; brain function; brain ischemia; brain stem; cardiac resynchronization therapy; cognitive defect; coronary artery bypass graft; depression; disease association; exercise; heart failure; heart transplantation; human; incidence; neurologic disease; nonhuman; pathogenesis; percutaneous coronary intervention; prevalence; priority journal; risk assessment; risk factor; taxonomy; thrombectomy; brain; cardiology; classification; cognition; consensus; disease exacerbation; heart failure; hemodynamics; medical society; pathophysiology; physiology, Brain; Cardiology; Cognition; Consensus; Disease Progression; Heart Failure; Hemodynamics; Humans; Societies, Medical
