Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand.
Acta Physiol (Oxf). 2021 May;232(1):e13642. doi: 10.1111/apha.13642. Epub 2021 Mar 10.
Myocardial infarction (MI) occurs when coronary blood flow is decreased due to an obstruction/occlusion of the vessels, leading to myocardial death and progression to heart failure (HF). Cognitive impairment, anxiety, depression and memory loss are the most frequent mental health problems among patients with HF. The most common cause of cognitive decline is cardiac systolic dysfunction, which leads to reduced cerebral perfusion. Several in vivo and clinical studies provide information regarding the underlying mechanisms of HF in brain pathology. Neurohormonal activation, oxidative stress, inflammation, glial activation, dendritic spine loss and brain programmed cell death are all proposed as contributors of cognitive impairment in HF. Furthermore, several investigations into the effects of various medications on brain pathology utilizing MI models have been reported. In this review, potential mechanisms involving HF-associated cognitive impairment, as well as neuroprotective interventions in HF models, are discussed and summarized. In addition, gaps in the surrounding knowledge, including the types of brain cell death and the effects of cell death inhibitors in HF, are presented and discussed. This review provides valuable information that will suggest the potential therapeutic strategies for cognitive impairment in patients with HF.
心肌梗死(MI)是由于血管阻塞导致冠状动脉血流减少引起的,导致心肌死亡并进展为心力衰竭(HF)。认知障碍、焦虑、抑郁和记忆力减退是 HF 患者最常见的心理健康问题。认知能力下降的最常见原因是心脏收缩功能障碍,这会导致脑灌注减少。一些体内和临床研究提供了有关 HF 在脑病理学中潜在机制的信息。神经激素激活、氧化应激、炎症、神经胶质细胞激活、树突棘丢失和脑程序性细胞死亡都被认为是 HF 认知障碍的原因。此外,还报道了利用 MI 模型研究各种药物对脑病理学影响的多项研究。在这篇综述中,讨论并总结了与 HF 相关的认知障碍相关的潜在机制以及 HF 模型中的神经保护干预措施。此外,还提出并讨论了围绕该主题的知识空白,包括脑内细胞死亡的类型和 HF 中细胞死亡抑制剂的作用。该综述提供了有价值的信息,可为 HF 患者的认知障碍提供潜在的治疗策略。