Markousis-Mavrogenis George, Noutsias Michel, Rigopoulos Angelos G, Giannakopoulou Aikaterini, Gatzonis Stergios, Pons Roser Maria, Papavasiliou Antigoni, Vartela Vasiliki, Bonou Maria, Kolovou Genovefa, Aggeli Constantina, Christidi Aikaterini, Bacopoulou Flora, Tousoulis Dimitris, Mavrogeni Sophie
Onassis Cardiac Surgery Center, 17674 Athens, Greece.
Department of Internal Medicine A (Division of Cardiology, Angiology, Nephrology and Intensive Medical Care), University Hospital Ruppin-Brandenburg (UKRB) of the Medical School of Brandenburg (MHB), Fehrbelliner Strasse 38, D-16816 Neuruppin, Germany.
J Clin Med. 2022 Jul 11;11(14):4009. doi: 10.3390/jcm11144009.
Heart failure (HF) patients frequently develop brain deficits that lead to cognitive dysfunction (CD), which may ultimately also affect survival. There is an important interaction between brain and heart that becomes crucial for survival in patients with HF. Our aim was to review the brain/heart interactions in HF and discuss the emerging role of combined brain/heart magnetic resonance imaging (MRI) evaluation. A scoping review of published literature was conducted in the PubMed EMBASE (OVID), Web of Science, Scopus and PsycInfo databases. Keywords for searches included heart failure, brain lesion, brain, cognitive, cognitive dysfunction, magnetic resonance imaging cardiovascular magnetic resonance imaging electroencephalogram, positron emission tomography and echocardiography. CD testing, the most commonly used diagnostic approach, can identify neither subclinical cases nor the pathophysiologic background of CD. A combined brain/heart MRI has the capability of diagnosing brain/heart lesions at an early stage and potentially facilitates treatment. Additionally, valuable information about edema, fibrosis and cardiac remodeling, provided with the use of cardiovascular magnetic resonance, can improve HF risk stratification and treatment modification. However, availability, familiarity with this modality and cost should be taken under consideration before final conclusions can be drawn. Abnormal CD testing in HF patients is a strong motivating factor for applying a combined brain/heart MRI to identify early brain/heart lesions and modify risk stratification accordingly.
心力衰竭（HF）患者常出现导致认知功能障碍（CD）的脑功能缺陷，这最终可能也会影响生存率。脑与心之间存在重要的相互作用，这对HF患者的生存至关重要。我们的目的是回顾HF中的脑/心相互作用，并讨论联合脑/心磁共振成像（MRI）评估的新作用。在PubMed EMBASE（OVID）、科学网、Scopus和PsycInfo数据库中对已发表的文献进行了范围综述。搜索关键词包括心力衰竭、脑病变、脑、认知、认知功能障碍、磁共振成像、心血管磁共振成像、脑电图、正电子发射断层扫描和超声心动图。CD检测作为最常用的诊断方法，既无法识别亚临床病例，也无法确定CD的病理生理背景。联合脑/心MRI有能力在早期诊断脑/心病变，并可能促进治疗。此外，利用心血管磁共振提供的有关水肿、纤维化和心脏重塑的有价值信息，可以改善HF风险分层和调整治疗方案。然而，在得出最终结论之前，应考虑其可用性、对这种检查方式的熟悉程度和成本。HF患者CD检测异常是应用联合脑/心MRI识别早期脑/心病变并相应调整风险分层的一个重要推动因素。
