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

Wolfram Doehner, Dilek Ural, Karl Georg Haeusler, Jelena Čelutkienė, Reinaldo Bestetti, Yuksel Cavusoglu, Marco A. Peña-Duque, Duska Glavas, Massimo Iacoviello, Ulrich Laufs, Ricardo Marmol Alvear, Amam Mbakwem, Massimo F. Piepoli, Stuart D. Rosen, Georgios Tsivgoulis, Cristiana Vitale, M. Birhan Yilmaz, Stefan D. Anker, Gerasimos Filippatos, Petar Seferovic & 2 others Andrew J.S. Coats, Frank Ruschitzka

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)199-215
Number of pages17
JournalEuropean Journal of Heart Failure
Volume20
Issue number2
DOIs
StatePublished - Feb 1 2018

Fingerprint

Heart Failure
Brain
Perfusion
Atlases
Cognition
Brain Stem
Reflex
Myocardium
Hemodynamics
Stroke
Morbidity
Equipment and Supplies
Research

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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. / Doehner, Wolfram; Ural, Dilek; Haeusler, Karl Georg; Čelutkienė, Jelena; Bestetti, Reinaldo; Cavusoglu, Yuksel; Peña-Duque, Marco A.; Glavas, Duska; Iacoviello, Massimo; Laufs, Ulrich; Alvear, Ricardo Marmol; Mbakwem, Amam; Piepoli, Massimo F.; Rosen, Stuart D.; Tsivgoulis, Georgios; Vitale, Cristiana; Yilmaz, M. Birhan; Anker, Stefan D.; Filippatos, Gerasimos; Seferovic, Petar; Coats, Andrew J.S.; Ruschitzka, Frank.

In: European Journal of Heart Failure, Vol. 20, No. 2, 01.02.2018, p. 199-215.

Research output: Contribution to journalArticle

Doehner, W, Ural, D, Haeusler, KG, Čelutkienė, J, Bestetti, R, Cavusoglu, Y, Peña-Duque, MA, Glavas, D, Iacoviello, M, Laufs, U, Alvear, RM, Mbakwem, A, Piepoli, MF, Rosen, SD, Tsivgoulis, G, Vitale, C, Yilmaz, MB, Anker, SD, Filippatos, G, Seferovic, P, Coats, AJS & Ruschitzka, F 2018, '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', European Journal of Heart Failure, vol. 20, no. 2, pp. 199-215. https://doi.org/10.1002/ejhf.1100
Doehner, Wolfram ; Ural, Dilek ; Haeusler, Karl Georg ; Čelutkienė, Jelena ; Bestetti, Reinaldo ; Cavusoglu, Yuksel ; Peña-Duque, Marco A. ; Glavas, Duska ; Iacoviello, Massimo ; Laufs, Ulrich ; Alvear, Ricardo Marmol ; Mbakwem, Amam ; Piepoli, Massimo F. ; Rosen, Stuart D. ; Tsivgoulis, Georgios ; Vitale, Cristiana ; Yilmaz, M. Birhan ; Anker, Stefan D. ; Filippatos, Gerasimos ; Seferovic, Petar ; Coats, Andrew J.S. ; Ruschitzka, Frank. / 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. In: European Journal of Heart Failure. 2018 ; Vol. 20, No. 2. pp. 199-215.
@article{4be7143cf95f489bb6c0e1fced633355,
title = "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",
abstract = "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.",
author = "Wolfram Doehner and Dilek Ural and Haeusler, {Karl Georg} and Jelena Čelutkienė and Reinaldo Bestetti and Yuksel Cavusoglu and Pe{\~n}a-Duque, {Marco A.} and Duska Glavas and Massimo Iacoviello and Ulrich Laufs and Alvear, {Ricardo Marmol} and Amam Mbakwem and Piepoli, {Massimo F.} and Rosen, {Stuart D.} and Georgios Tsivgoulis and Cristiana Vitale and Yilmaz, {M. Birhan} and Anker, {Stefan D.} and Gerasimos Filippatos and Petar Seferovic and Coats, {Andrew J.S.} and Frank Ruschitzka",
year = "2018",
month = "2",
day = "1",
doi = "10.1002/ejhf.1100",
language = "English (US)",
volume = "20",
pages = "199--215",
journal = "European Journal of Heart Failure",
issn = "1388-9842",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Heart and brain interaction in patients with heart failure

T2 - overview and proposal for a taxonomy. A position paper from the Study Group on Heart and Brain Interaction of the Heart Failure Association

AU - Doehner, Wolfram

AU - Ural, Dilek

AU - Haeusler, Karl Georg

AU - Čelutkienė, Jelena

AU - Bestetti, Reinaldo

AU - Cavusoglu, Yuksel

AU - Peña-Duque, Marco A.

AU - Glavas, Duska

AU - Iacoviello, Massimo

AU - Laufs, Ulrich

AU - Alvear, Ricardo Marmol

AU - Mbakwem, Amam

AU - Piepoli, Massimo F.

AU - Rosen, Stuart D.

AU - Tsivgoulis, Georgios

AU - Vitale, Cristiana

AU - Yilmaz, M. Birhan

AU - Anker, Stefan D.

AU - Filippatos, Gerasimos

AU - Seferovic, Petar

AU - Coats, Andrew J.S.

AU - Ruschitzka, Frank

PY - 2018/2/1

Y1 - 2018/2/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85039067244&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85039067244&partnerID=8YFLogxK

U2 - 10.1002/ejhf.1100

DO - 10.1002/ejhf.1100

M3 - Article

VL - 20

SP - 199

EP - 215

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

SN - 1388-9842

IS - 2

ER -