THE BRAIN IN CONGESTIVE-HEART-FAILURE

In the present paper we discuss two issues about relationships between congestive heart failure and the brain. First, major acute cerebrovas cular events are very frequent among elderly people, but stroke does n ot appear io be frequently associated with congestive heart failure. S econd, some cardiovascular conditions may determine progressive damage of cerebral tissue, with consequent impairment of cognitive functions . The association of cognitive impairment and cardiovascular diseases may dramatically increase morbility and mortality risks in the elderly . Recent studies seem to show that hypotension and congestive heart fa ilure are risk factors for dementia in elderly people. In view of this data, an Italian multicentric study on congestive heart failure in ho spitalized elderly patients (CHF Italian Study I) included a brief scr eening of cognitive abilities (MMSE)I The presence of congestive heart failure induced a significant decrease of MMSE scores: mean MMSE scor e after statistical adjustment for the other variables was about one p oint lower in patients with congestive heart failure respect to elderl y patients affected by heart disease but without congestive heart fail ure. A novel multicentric study (CHF Italian Study II) has been perfor med to identify cognitive functions more specifically impaired during congestive heart failure in the elderly. Preliminary data relative to 385 patients, confined that congestive heart failure may induce a gene ralized impairment of cognitive functions. These data have relevant im plications because they demonstrate that a multidisciplinary approach is necessary in these patients, both for prevention and rehabilitation therapy. Copyright (C) 1996 Elsevier Science Ireland Ltd