A review of the association between congestive heart failure and cognitive impairment.

Heart failure is a growing epidemic with an estimated 5 million Americans suffering from this condition. Several clinical trials have demonstrated a high correlation between congestive heart failure (CHF) and cognitive impairment. The severity of cognitive impairment correlates positively with the degree of CHF. The underlying mechanism for cognitive impairment remains unclear but appears to be related to cerebral hypoperfusion and impaired cerebral reactivity with selective impairment of verbal memory and attention domains. Furthermore, cognitive dysfunction represents one aspect of frailty, a novel concept that encompasses a range of clinical conditions that results in functional impairment in patients with heart failure. In addition, frailty independently predicts mortality in CHF patients. Cognitive impairment is a common and predictable effect of CHF that contributes with social and behavioral problems to decreased compliance to prescribed therapy and increased hospital readmissions. A multidisciplinary approach is necessary to deal with the complexity of this clinical syndrome

Cognitive function in ambulatory patients with systolic heart failure: Insights from the warfarin versus aspirin in reduced cardiac ejection fraction (warcef) trial

© 2014 Graham et al.We sought to determine whether cognitive function in stable outpatients with heart failure (HF) is affected by HF severity. A retrospective, cross-sectional analysis was performed using data from 2, 043 outpatients with systolic HF an

Cyclosporin A does not Inhibit IL‐lα‐Induced Epithelial Cell IL‐6 Secretion

Trauma and infection activated a murine mucosal IL‐6 response in different ways: the IL‐6 response to bacteria was sensitive to Cyclosporin A (CsA); the IL‐6 response to trauma was not. The aim of the present study was to identify possible activators of the CsA‐insensitive IL‐6 secretion at the epithelial cell level. Two human epithelial cell lines from the kidney (A498) and bladder (J82) were exposed to Escherichia coli Hu734, interleukin‐lα (IL‐lα) and tumour necrosis factor a (TNF‐α). The E. coli strain had been used for the in vivo experiments which led to this study, and IL‐lα and TNF‐α were likely to be released during infections and trauma. The secretion of IL‐6 into the supernatants was compared between cells stimulated in the presence or absence of CsA. E. coli Hu734, IL‐lα and TNF‐α stimulated an IL‐6 response in the two epithelial cell lines. The IL‐lα‐induced IL‐6 response was rapid, and the secreted IL‐6 levels were significantly higher than those induced by E. coli Hu734 or TNF‐α. The IL‐6 response to IL‐ lα was insensitive to CsA. By contrast, the IL‐6 response to E. coli Hu734 and TNF‐α was inhibited by CsA. These results demonstrated that the inhibitory effect of CsA depends on the stimulus triggering the IL‐6 response. IL‐lα may play a role in the induction of trauma‐associated CsA‐insensitive IL‐6 secretion