OBJECTIVE Cognitive deficits are common in patients with heart failure (HF), and can negatively affect self-care, predict rehospitalizations, and increase mortality rates 5-fold. Inflammation can produce vascular pathology, reducing cerebral blood flow to brain regions necessary for optimal cognitive function. The purpose of the investigation was to identify a pattern of peripheral blood inflammation-related biomarkers associated with cognitive impairment in patients with HF. METHODS Forty-five outpatients (median age = 67 years, SD = 9.9) were recruited from University of California, San Diego (UCSD) and Veterans Affairs San Diego Healthcare Systems (VASDHS), diagnosed with New York Heart Association Stages I-III HF. Participants were administered the Montreal Cognitive Assessment (MoCA) as a measure of global cognitive impairment, and blood was analyzed for plasma biomarkers, interferon-γ, tumor necrosis factor-α (TNFα), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), brain-derived neurotrophic factor (BDNF), interleukin-8 (IL-8), matrix metallopeptidase-9 (MMP-9), IL-6, C-reactive protein (CRP), and serum amyloid-A (SAA). RESULTS Almost half the patients scored below the threshold on the MoCA, indicating at least mild cognitive impairment. A factor analysis produced three biomarker factors: vascular inflammatory factor-1: TNFα, sICAM1, sVCAM1; neuroinflammatory factor-2: BDNF, MMP-9, IL-8; peripheral inflammatory factor-3: IL-6, CRP, SAA. Only vascular inflammatory factor-1 was significantly associated with cognitive function (MoCA) (ΔR2 = 0.214, beta = -0.468, p = 0.008). CONCLUSIONS In this cohort with HF, vascular inflammation appears related to poorer cognitive function. This could indicate targets for treatment to reduce cognitive deficits in HF. However, this is a preliminary study, and further research is needed.

中文翻译：

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心力衰竭患者与认知功能相关的微分周围炎症因子。

目的认知功能障碍在心力衰竭（HF）患者中很常见，可能对自我保健产生负面影响，预测重新住院，并使死亡率增加5倍。炎症会产生血管病变，减少脑血流向最佳认知功能所需的脑区域。研究的目的是确定与HF患者认知障碍相关的外周血炎症相关生物标志物的模式。方法从加利福尼亚大学圣地亚哥分校（UCSD）和退伍军人事务圣地亚哥医疗系统（VASDHS）招募了四十五名门诊患者（中位年龄= 67岁，SD = 9.9），诊断为纽约心脏协会I-III期HF 。参与者接受了蒙特利尔认知评估（MoCA），以衡量全球认知障碍，并分析血液中的血浆生物标志物，干扰素-γ，肿瘤坏死因子-α（TNFα），可溶性细胞间粘附分子-1（sICAM-1），可溶性血管细胞粘附分子-1（sVCAM-1），脑源性神经营养因子（BDNF），白介素8（IL-8），基质金属肽酶9（MMP-9），IL-6，C反应蛋白（CRP）和血清淀粉样蛋白A（SAA）。结果几乎一半的患者得分低于MoCA阈值，表明至少有轻度认知障碍。因子分析产生了三种生物标志物因子：血管炎性因子-1：TNFα，sICAM1，sVCAM1；神经炎因子2：BDNF，MMP-9，IL-8；外周炎性因子3：IL-6，CRP，SAA。仅血管炎性因子1与认知功能（MoCA）显着相关（ΔR2= 0.214，β= -0.468，p = 0.008）。结论在这个与HF的队列中，血管炎症似乎与较差的认知功能有关。这可能表明减少HF认知缺陷的治疗目标。但是，这是初步研究，需要进一步研究。