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TL;DR
Seven of the included studies reported negative results on proposed mechanisms.
Frontiers in Cardiovascular Medicine · 3 authors, 1 centre
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Seven of the included studies reported negative results on proposed mechanisms.
Narrative synthesis identified three pathophysiological themes: brain changes including atrophy, grey and white matter alterations, decreased cerebral blood flow, neuroinflammation, and hippocampal gene changes; systemic changes including inflammation, oxidative stress, and altered serum biomarkers such as NT-proBNP; and combined brain-heart mechanisms. Seven studies reported negative results on proposed mechanisms. Limitations include inclusion of non-human studies, a large proportion of cross-sectional designs limiting causal inference, and compromised quality in some included studies. Most included participants had moderate heart failure severity and heart failure with reduced ejection fraction, suggesting findings may be most relevant to these subgroups. The authors recommend future research examining the bi-directional brain-heart relationship and the use of standardized cognitive screening tools alongside brain imaging in heart failure patients.