Author + information
- Ibrahim El-Battrawy, MD∗ (, )
- Martin Borggrefe, MD and
- Ibrahim Akin, MD
- ↵∗First Department of Medicine, DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg, Mannheim, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
The paper by Frey et al. (1) published in JACC: Heart Failure focusing on cognitive deficits in chronic heart failure (HF) elicited great interest among researchers in our working group. The authors concluded that HF patients exhibit cognitive deficits in the domains of attention and memory. Medial temporal lobe atrophy, but not white matter lesion load, seems to be related to cognitive impairment.
Certainly, it is important to acknowledge that sacubitril and valsartan are used in chronic HF patients. Despite the promising results of the PARADIGM-HF (Prospective Comparison of ARNI [Angiotensin Receptor–Neprilysin Inhibitor] with ACEI [Angiotensin-Converting–Enzyme Inhibitor] to Determine Impact on Global Mortality and Morbidity in Heart Failure) trial in chronic HF patients, this might provoke cognitive impairment and Alzheimer’s disease (2,3). One important aspect of the pathophysiology of this observation is beta-amyloid accumulation due to neprilysin inhibition. However, a genetic role has been suggested. Taking these data together, we are missing information on the number of patients who have been treated with sacubitril and valsartan in the present study.
Therefore, more evidence about the role of sacubitril and valsartan on the observed results of the present study are warranted before making any final conclusions.
Please note: The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- 2018 American College of Cardiology Foundation