Cognitive Deficit in Heart Failure and the Benefits of Aerobic Physical Activity

Maria Luíza de Medeiros Rêgo, Daniel Aranha Rego Cabral, Eduardo Bodnariuc Fontes, Maria Luíza de Medeiros Rêgo, Daniel Aranha Rego Cabral, Eduardo Bodnariuc Fontes

Abstract

Heart Failure is a clinical syndrome prevalent throughout the world and a major contribution to mortality of cardiac patients in Brazil. In addition, this pathology is strongly related to cerebral dysfunction, with a high prevalence of cognitive impairment. Many mechanisms may be related to cognitive loss, such as cerebral hypoperfusion, atrophy and loss of gray matter of the brain, and dysfunction of the autonomic nervous system. The literature is clear regarding the benefits of aerobic physical activity in healthy populations in the modulation of the autonomic nervous system and in brain functions. Studies have shown that in the population of patients with heart failure, exercise is associated with an improvement in cognitive function, as well as in cardiac autonomic regulation. However, little emphasis has been given to the mechanisms by which aerobic physical activity can benefit brain functioning, the autonomic nervous system and result in better cognitive performance, particularly in patients with heart failure. Therefore, the present work presents the ways in which brain areas responsible for cognition also act in the modulation of the autonomic nervous system, and emphasizes its importance for the understanding of cognitive impairment in relation to the pathophysiology of heart failure. It is also described the way in which aerobic physical activity can promote benefits when it is integrated into the therapy, associated to a better prognosis of the clinical picture of these patients.

Conflict of interest statement

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Aerobic physical activity promotes an increase in the concentrations of VEGF and BDNF, which can improve cognitive processes, increase the parasympathetic tone, and decrease the sympathetic activation. This condition may decrease peripheral vascular resistance and lead to increased cerebral blood flow in the prefrontal cortex, positively interfering with cognitive ability. With increased cerebral blood flow in the prefrontal cortex, there may be an inhibition of the amygdala promoting a vagal increase and sympathetic decrease, feedback system. VEGF: vascular endothelial growth factor; BDNF: brain-derived neurotrophic factor

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