43 research outputs found
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
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Cognitive function in ambulatory patients with systolic heart failure: Insights from the warfarin versus aspirin in reduced cardiac ejection fraction (warcef) trial
Ā© 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 ILālĪ±āInduced Epithelial Cell ILā6 Secretion
Trauma and infection activated a murine mucosal ILā6 response in different ways: the ILā6 response to bacteria was sensitive to Cyclosporin A (CsA); the ILā6 response to trauma was not. The aim of the present study was to identify possible activators of the CsAāinsensitive ILā6 secretion at the epithelial cell level. Two human epithelial cell lines from the kidney (A498) and bladder (J82) were exposed to Escherichia coli Hu734, interleukinālĪ± (ILālĪ±) and tumour necrosis factor a (TNFāĪ±). The E. coli strain had been used for the in vivo experiments which led to this study, and ILālĪ± and TNFāĪ± were likely to be released during infections and trauma. The secretion of ILā6 into the supernatants was compared between cells stimulated in the presence or absence of CsA. E. coli Hu734, ILālĪ± and TNFāĪ± stimulated an ILā6 response in the two epithelial cell lines. The ILālĪ±āinduced ILā6 response was rapid, and the secreted ILā6 levels were significantly higher than those induced by E. coli Hu734 or TNFāĪ±. The ILā6 response to ILā lĪ± was insensitive to CsA. By contrast, the ILā6 response to E. coli Hu734 and TNFāĪ± was inhibited by CsA. These results demonstrated that the inhibitory effect of CsA depends on the stimulus triggering the ILā6 response. ILālĪ± may play a role in the induction of traumaāassociated CsAāinsensitive ILā6 secretion