Skip to main content

Advertisement

SpringerLink
Log in

Atrial fibrillation and cognitive function in patients with heart failure: a systematic review and meta-analysis

  • Published:
Heart Failure Reviews Aims and scope Submit manuscript

Abstract

Cognitive impairment and dementia are established complications of heart failure (HF) in adult patients and impair medication adherence and self-care. Atrial fibrillation (AF) is suggested to play an independent role in the cognitive decline in patients with HF. The objective of this systematic review was to assess the effect of AF on cognitive function in these patients. Medline (PubMed), Scopus, and the CENTRAL databases were queried from their inception up to April 30, 2016. The search included primary research articles evaluating the effect of AF on cognition in HF patients. There were five eligible studies, including a total of 1670 patients with HF; of these, 449 (26.9%) had AF. Different AF types were studied, including persistent, paroxysmal, or permanent. Four cognitive tests were used to assess cognitive function (Mini-Mental State Examination, Short Portable Mental Status Questionnaire, Modified Mini-Mental Examination, and Montreal cognitive assessment tool). Using the inverse variance method and a random effects model, we observed that presence of AF was significantly associated with increased risk of cognitive impairment in HF patients (odds ratio [OR], 1.94; 95% confidence interval [CI], 1.30–2.87), although with significant heterogeneity (I 2 = 39%). This heterogeneity can be attributed to the different populations and types of AF studied as well as to varying cognitive assessment methods. Concomitant AF may exacerbate cognitive dysfunction in HF patients. However, data are sparse and heterogeneous. Well-designed, prospective studies are needed to (a) establish a causative link and (b) identify the underlying mechanism in order to design appropriate interventions to attenuate risk of cognitive impairment in patients with HF.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Chen J, Normand SL, Wang Y, Krumholz HM (2011) National and regional trends in heart failure hospitalization and mortality rates for Medicare beneficiaries, 1998-2008. JAMA 306:1669–1678

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Gomez-Sanchez MA, Jaarsma T, Kober L, Lip GY, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, Ronnevik PK, Rutten FH, Schwitter J, Seferovic P, Stepinska J, Trindade PT, Voors AA, Zannad F, Zeiher A, ESC Committee for Practice Guidelines (2012) ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 33:1787–1847

    Article  PubMed  Google Scholar 

  3. Roger VL (2013) Epidemiology of heart failure. Circ Res 113:646–659

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, Ikonomidis JS, Khavjou O, Konstam MA, Maddox TM, Nichol G, Pham M, Piña IL, Trogdon JG, American Heart Association Advocacy Coordinating Committee, Council on Arteriosclerosis, Thrombosis and Vascular Biology, Council on Cardiovascular Radiology and Intervention, Coundil on Clinical Cardiology, Council on Epidemiology and Prevention, Stroke Council (2013) Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail 6:606–619

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Qiu C, Winblad B, Marengoni A, Klarin I, Fastbom J, Fratiglioni L (2006) Heart failure and risk of dementia and Alzheimer disease: a population-based cohort study. Arch Intern Med 166:1003–1008

    Article  PubMed  Google Scholar 

  6. Kure CE, Rosenfeldt FL, Scholey AB, Pipingas A, Kaye DM, Bergin PJ, Croft KD, Wesnes KA, Myers SP, Stough C (2016) Relationships among cognitive function and cerebral blood flow, oxidative stress, and inflammation in older heart failure patients. J Card Fail 22:548–559

    Article  CAS  PubMed  Google Scholar 

  7. Gure TR, Blaum CS, Giordani B, Koelling TM, Galecki A, Pressler SJ, Hummel SL, Langa KM (2012) Prevalence of cognitive impairment in older adults with heart failure. J Am Geriatr Soc 60:1724–1729

    Article  PubMed  PubMed Central  Google Scholar 

  8. Abete P, Della-Morte D, Gargiulo G, Basile C, Langellotto A, Galizia G, Testa G, Canonico V, Bonaduce D, Cacciatore F (2014) Cognitive impairment and cardiovascular diseases in the elderly. A heart-brain continuum hypothesis. Ageing Res Rev 18:41–52

    Article  PubMed  Google Scholar 

  9. Cameron J, Worrall-Carter L, Page K, Riegel B, Lo SK, Stewart S (2010) Does cognitive impairment predict poor self-care in patients with heart failure? Eur J Heart Fail 12:508–515

    Article  PubMed  Google Scholar 

  10. Alosco ML, Spitznagel MB, Cohen R, Sweet LH, Colbert LH, Josephson R, Waechter D, Hughes J, Rosneck J, Gunstad J (2012) Cognitive impairment is independently associated with reduced instrumental activities of daily living in persons with heart failure. J Cardiovasc Nurs 27:44–50

    Article  PubMed  PubMed Central  Google Scholar 

  11. Lloyd-Jones DM, Wang TJ, Leip EP, Larson MG, Levy D, Vasan RS, D’Agostino RB, Massaro JM, Beiser A, Wolf PA, Benjamin EJ (2004) Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation 110:1042–1046

    Article  PubMed  Google Scholar 

  12. Anter E, Jessup M, Callans DJ (2009) Atrial fibrillation and heart failure: treatment considerations for a dual epidemic. Circulation 119:2516–2525

    Article  PubMed  Google Scholar 

  13. Maisel WH, Stevenson LW (2003) Atrial fibrillation in heart failure: epidemiology, pathophysiology, and rationale for therapy. Am J Cardiol 91:2D–8D

    Article  PubMed  Google Scholar 

  14. Liao JN, Chao TF, Liu CJ, Wang KL, Chen SJ, Tuan TC, Lin YJ, Chang SL, Lo LW, Hu YF, Chung FP, Tsao HM, Chen TJ, Lip GY, Chen SA (2015) Risk and prediction of dementia in patients with atrial fibrillation—a nationwide population-based cohort study. Int J Cardiol 199:25–30

    Article  PubMed  Google Scholar 

  15. Kalantarian S, Stern TA, Mansour M, Ruskin JN (2013) Cognitive impairment associated with atrial fibrillation: a meta-analysis. Ann Intern Med 158:338–346

    Article  PubMed  PubMed Central  Google Scholar 

  16. Marzona I, O’Donnell M, Teo K, Gao P, Anderson C, Bosch J, Yusuf S (2012) Increased risk of cognitive and functional decline in patients with atrial fibrillation: results of the ONTARGET and TRANSCEND studies. CMAJ 184:E329–E336

    Article  PubMed  PubMed Central  Google Scholar 

  17. Yang H, Niu W, Zang X, Lin M, Zhao Y (2016) The association between atrial fibrillation and cognitive function in patients with heart failure. Eur J Cardiovasc Nurs.

    Google Scholar 

  18. Pulignano G, Del Sindaco D, Tinti MD, Di Lenarda A, Alunni G, Senni M, Tarantini L, Cioffi G, Barbati G, Minardi G, Murrone A, Ciurluini P, Uguccioni M, Investigators I-HS (2016) Atrial fibrillation, cognitive impairment, frailty and disability in older heart failure patients: in memoriam Giovanni Gaschino. J CardiovascMed (Hagerstown) 17:616–623

    Article  CAS  Google Scholar 

  19. Coma M, Gonzalez-Moneo MJ, Enjuanes C, Velazquez PP, Espargaro DB, Perez BA, Tajes M, Garcia-Elias A, Farre N, Sanchez-Benavides G, Marti-Almor J, Comin-Colet J, Benito B (2016) Effect of permanent atrial fibrillation on cognitive function in patients with chronic heart failure. Am J Cardiol 117:233–239

    Article  PubMed  Google Scholar 

  20. Alosco ML, Spitznagel MB, Sweet LH, Josephson R, Hughes J, Gunstad J (2015) Atrial fibrillation exacerbates cognitive dysfunction and cerebral perfusion in heart failure. Pacing Clin Electrophysiol 38:178–186

    Article  PubMed  Google Scholar 

  21. Debette S, Bauters C, Leys D, Lamblin N, Pasquier F, de Groote P (2007) Prevalence and determinants of cognitive impairment in chronic heart failure patients. Congest Heart Fail 13:205–208

    Article  PubMed  Google Scholar 

  22. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Reprint--preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Phys Ther 89:873–880

    PubMed  Google Scholar 

  23. Higgins JPT, Green S (2011). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. http://handbook.cochrane.org. Accessed 1 May 2016

  24. Sterne, JAC, Higgins, JPT, Reeves, BC on behalf of the development group for ROBINS-I (2016) A tool for assessing Risk Of Bias In Non-randomized Studies of Interventions. http://www.riskofbias.info. Accessed 15 May 2016

  25. Pan A, Kumar R, Macey PM, Fonarow GC, Harper RM, Woo MA (2013) Visual assessment of brain magnetic resonance imaging detects injury to cognitive regulatory sites in patients with heart failure. J Card Fail 19:94–100

    Article  PubMed  PubMed Central  Google Scholar 

  26. Pressler SJ, Subramanian U, Kareken D, Perkins SM, Gradus-Pizlo I, Sauve MJ, Ding Y, Kim J, Sloan R, Jaynes H, Shaw RM (2010) Cognitive deficits in chronic heart failure. Nurs Res 59:127–139

    Article  PubMed  PubMed Central  Google Scholar 

  27. Hajduk AM, Lemon SC, McManus DD, Lessard DM, Gurwitz JH, Spencer FA, Goldberg RJ, Saczynski JS (2013) Cognitive impairment and self-care in heart failure. Clin Epidemiol 5:407–416

    Article  PubMed  PubMed Central  Google Scholar 

  28. Caplan JP et al (2010) Delirious patients. In: Stern TA et al (eds) Massachusetts General Hospital handbook of general hospital psychiatry. Saunders/Elsevier, Philadelphia

    Google Scholar 

  29. Muldoon MF, Ryan CM, Matthews KA, Manuck SB (1997) Serum cholesterol and intellectual performance. Psychosom Med 59(4):382–387

    Article  CAS  PubMed  Google Scholar 

  30. Evans I, Thornton H, Chalmers I (2006) Testing treatments: better research for better healthcare. British Library, London

    Google Scholar 

  31. Rees J (2002) Complex disease and the new clinical sciences. Science 296(5568):698–700

    Article  CAS  PubMed  Google Scholar 

  32. Ioannidis JP (2005) Contradicted and initially stronger effects in highly cited clinical research. JAMA 294(2):218–228

    Article  CAS  PubMed  Google Scholar 

  33. Cacciatore F, Testa G, Langellotto A, Galizia G, Della-Morte D, Gargiulo G, Bevilacqua A, Del Genio MT, Canonico V, Rengo F, Abete P (2012) Role of ventricular rate response on dementia in cognitively impaired elderly subjects with atrial fibrillation: a 10-year study. Dement Geriatr Cogn Disord 34(3–4):143–148

    Article  PubMed  Google Scholar 

  34. Cacciatore F, Mazzella F, Abete P, Viati L, Galizia G, D’Ambrosio D, Gargiulo G, Russo S, Visconti C, Morte DD, Ferrara N (2007) Mortality and heart rate in the elderly: role of cognitive impairment. Exper Aging Res 33(2):127–144

    Article  Google Scholar 

  35. Abete P, Testa G, Della-Morte D, Gargiulo G, Galizia G, De Santis D, Magliocca A, Basile C, Cacciatore F (2013) Treatment for chronic heart failure in the elderly: current practice and problems. Heart Fail Rev 18(4):529–551

    Article  PubMed  Google Scholar 

  36. Moser DK, Doering LV, Chung ML (2005) Vulnerabilities of patients recovering from an exacerbation of chronic heart failure. Am Heart J 150(5):984–9e7

    Article  PubMed  Google Scholar 

  37. Marti CN, Georgiopoulou VV, Giamouzis G, Cole RT, Deka A, Tang WW, Dunbar SB, Smith AL, Kalogeropoulos AP, Butler J (2013) Patient-reported selective adherence to heart failure self-care recommendations: a prospective cohort study: the Atlanta cardiomyopathy consortium. Congest Heart Fail 19(1):16–24

    Article  PubMed  Google Scholar 

  38. Wu JR, Moser DK, De Jong MJ, Rayens MK, Chung ML, Riegel B, Lennie TA (2009) Defining an evidence-based cutpoint for medication adherence in heart failure. Am Heart J 157(2):285–291

    Article  PubMed  Google Scholar 

  39. Testa G, Cacciatore F, Galizia G, Della-Morte D, Mazzella F, Gargiulo G, Langellotto A, Raucci C, Ferrara N, Rengo F, Abete P (2011) Depressive symptoms predict mortality in elderly subjects with chronic heart failure. Eur J Clin Investig 41(12):1310–1317

    Article  Google Scholar 

  40. Cacciatore F, Abete P, Ferrara N, Calabrese C, Napoli C, Maggi S, Varricchio M, Rengo F (1998) Congestive heart failure and cognitive impairment in an older population. J Am Geriatr Soc 46(11):1343–1348

    Article  CAS  PubMed  Google Scholar 

  41. Mazzella F, Cacciatore F, Galizia G, Della-Morte D, Rossetti M, Abbruzzese R, Langellotto A, Avolio D, Gargiulo G, Ferrara N, Rengo F (2010) Social support and long-term mortality in the elderly: role of comorbidity. Arch Gerontol Geriatr 51(3):323–328

    Article  PubMed  Google Scholar 

  42. McEntee ML, Cuomo LR, Dennison CR (2009) Patient-, provider-, and system-level barriers to heart failure care. J Cardiovasc Nurs 24(4):290–298

    Article  PubMed  Google Scholar 

  43. Vogels RL, Scheltens P, Schroeder-Tanka JM, Weinstein HC (2007) Cognitive impairment in heart failure: a systematic review of the literature. Eur J Heart Fail 9(5):440–449

    Article  PubMed  Google Scholar 

  44. Pressler SJ, Kim J, Riley P, Ronis DL, Gradus-Pizlo I (2010) Memory dysfunction, psychomotor slowing, and decreased executive function predict mortality in patients with heart failure and low ejection fraction. J Card Fail 16:750–760

    Article  PubMed  PubMed Central  Google Scholar 

  45. Zuccala G, Pedone C, Cesari M, Onder G, Pahor M, Marzetti E, Lo Monaco MR, Cocchi A, Carbonin P, Bernabei R (2003) The effects of cognitive impairment on mortality among hospitalized patients with heart failure. Am J Med 115:97–103

    Article  PubMed  Google Scholar 

  46. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Judd SE, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Mackey RH, Magid DJ, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER III, Moy CS, Mussolino ME, Neumar RW, Nichol G, Pandey DK, Paynter NP, Reeves MJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Wong ND, Woo D, Turner MB, American Heart Association Statistics Committee and Stroke Statistics Subcommittee (2014) Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation 129:e28–e292

    Article  PubMed  Google Scholar 

  47. Rogers JK, Pocock SJ, McMurray JJ, Granger CB, Michelson EL, Ostergren J, Pfeffer MA, Solomon SD, Swedberg K, Yusuf S (2014) Analysing recurrent hospitalizations in heart failure: a review of statistical methodology, with application to CHARM-Preserved. Eur J Heart Fail 16:33–40

    Article  PubMed  Google Scholar 

  48. Qiu C, Xu W, Winblad B, Fratiglioni L (2010) Vascular risk profiles for dementia and Alzheimer’s disease in very old people: a population-based longitudinal study. J Alzheimers Dis 20:293–300

    PubMed  Google Scholar 

  49. Hjelm C, Brostrom A, Dahl A, Johansson B, Fredrikson M, Stromberg A (2014) Factors associated with increased risk for dementia in individuals age 80 years or older with congestive heart failure. J Cardiovasc Nurs 29:82–90

    Article  PubMed  Google Scholar 

  50. Huynh QL, Negishi K, Blizzard L, Saito M, De Pasquale CG, Hare JL, Leung D, Stanton T, Sanderson K, Venn AJ, Marwick TH (2016) Mild cognitive impairment predicts death and readmission within 30 days of discharge for heart failure. Int J Cardiol 221:212–217

    Article  PubMed  Google Scholar 

  51. Cameron JD, Gallagher R, Pressler SJ, McLennan SN, Ski CF, Tofler G, Thompson DR (2016) Sensitivity and specificity of a five-minute cognitive screening test in patients with heart failure. J Card Fail 22:99–107

    Article  PubMed  Google Scholar 

  52. Cline CM, Bjorck-Linne AK, Israelsson BY, Willenheimer RB, Erhardt LR (1999) Non-compliance and knowledge of prescribed medication in elderly patients with heart failure. Eur J Heart Fail 1:145–149

    Article  CAS  PubMed  Google Scholar 

  53. Pressler SJ, Subramanian U, Kareken D, Perkins SM, Gradus-Pizlo I, Sauve MJ, Ding Y, Kim J, Sloan R, Jaynes H, Shaw RM (2010) Cognitive deficits and health-related quality of life in chronic heart failure. J Cardiovasc Nurs 25:189–198

    Article  PubMed  PubMed Central  Google Scholar 

  54. Gaita F, Corsinovi L, Anselmino M, Raimondo C, Pianelli M, Toso E, Bergamasco L, Boffano C, Valentini MC, Cesarani F, Scaglione M (2013) Prevalence of silent cerebral ischemia in paroxysmal and persistent atrial fibrillation and correlation with cognitive function. J Am Coll Cardiol 62:1990–1997

    Article  PubMed  Google Scholar 

  55. Stewart MW, Traylor AC, Bratzke LC (2015) Nutrition and cognition in older adults with heart failure: a systematic review. J Gerontol Nurs 41:50–59

    Article  PubMed  Google Scholar 

  56. Ketterer MW et al. (2016) Cognitive impairment and reduced early readmissions in congestive heart failure. Am J Accountable Care. www.ajmc.com. Accessed 20 September 2016

  57. Davis KK, Allen JK (2013) Identifying cognitive impairment in heart failure: a review of screening measures. Heart Lung 42:92–97

    Article  PubMed  Google Scholar 

  58. McLennan SN, Mathias JL, Brennan LC, Stewart S (2011) Validity of the Montreal cognitive assessment (MoCA) as a screening test for mild cognitive impairment (MCI) in a cardiovascular population. J Geriatr Psychiatry Neurol 24:33–38

    Article  CAS  PubMed  Google Scholar 

  59. Dong Y, Sharma VK, Chan BP, Venketasubramanian N, Teoh HL, Seet RC, Tanicala S, Chan YH, Chen C (2010) The Montreal Cognitive Assessment (MoCA) is superior to the Mini-Mental State Examination (MMSE) for the detection of vascular cognitive impairment after acute stroke. J Neurol Sci 299:15–18

    Article  PubMed  Google Scholar 

  60. Athilingam P, King KB, Burgin SW, Ackerman M, Cushman LA, Chen L (2011) Montreal Cognitive Assessment and Mini-Mental Status Examination compared as cognitive screening tools in heart failure. Heart Lung 40:521–529

    Article  PubMed  Google Scholar 

  61. Riegel B, Bennett JA, Davis A, Carlson B, Montague J, Robin H, Glaser D (2002) Cognitive impairment in heart failure: issues of measurement and etiology. Am J Crit Care 11:520–528

    PubMed  Google Scholar 

  62. McManus DD, Hsu G, Sung SH, Saczynski JS, Smith DH, Magid DJ, Gurwitz JH, Goldberg RJ, Go AS, Cardiovascular Research Network PRESERVE Study (2013) Atrial fibrillation and outcomes in heart failure with preserved versus reduced left ventricular ejection fraction. J Am Heart Assoc 2:e005694

    Article  PubMed  PubMed Central  Google Scholar 

  63. Alosco ML, Brickman AM, Spitznagel MB, Garcia SL, Narkhede A, Griffith EY, Raz N, Cohen R, Sweet LH, Colbert LH, Josephson R, Hughes J, Rosneck J, Gunstad J (2013) Cerebral perfusion is associated with white matter hyperintensities in older adults with heart failure. Congest Heart Fail 19:E29–E34.

  64. Chamberlain AM, Redfield MM, Alonso A, Weston SA, Roger VL (2011) Atrial fibrillation and mortality in heart failure: a community study. Circ Heart Fail 4:740–746

    Article  PubMed  PubMed Central  Google Scholar 

  65. Zakeri R, Chamberlain AM, Roger VL, Redfield MM (2013) Temporal relationship and prognostic significance of atrial fibrillation in heart failure patients with preserved ejection fraction: a community-based study. Circulation 128:1085–1093

    Article  PubMed  PubMed Central  Google Scholar 

  66. Zuccala G, Cattel C, Manes-Gravina E, Di Niro MG, Cocchi A, Bernabei R (1997) Left ventricular dysfunction: a clue to cognitive impairment in older patients with heart failure. J Neurol Neurosurg Psychiatry 63:509–512

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Samartzis L, Dimopoulos S, Tziongourou M, Nanas S (2013) Effect of psychosocial interventions on quality of life in patients with chronic heart failure: a meta-analysis of randomized controlled trials. J Card Fail 19:125–134

    Article  PubMed  Google Scholar 

  68. Vellone E, Pancani L, Greco A, Steca P, Riegel B (2016) Self-care confidence may be more important than cognition to influence self-care behaviors in adults with heart failure: testing a mediation model. Int J Nurs Stud 60:191–199

    Article  PubMed  Google Scholar 

  69. Galioto R, Fedor AF, Gunstad J (2015) Possible neurocognitive benefits of exercise in persons with heart failure. Eur Rev Aging Phys Act 12:6

    Article  PubMed  PubMed Central  Google Scholar 

  70. Srisuk N, Cameron J, Ski CF, Thompson DR (2016) Heart failure family-based education: a systematic review. Patient Educ Couns 99:326–338

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

None

Author information

Authors and Affiliations

  1. Society of Junior Doctors, Athens, Greece

    Pavlos G. Myserlis, Antonia Malli, Dimitrios K. Kalaitzoglou, Grigorios Kalaitzidis, Michael Miligkos & Damianos G. Kokkinidis

  2. Aristotle University of Thessaloniki Medical School, Thessaloniki, Greece

    Pavlos G. Myserlis, Grigorios Kalaitzidis & Damianos G. Kokkinidis

  3. Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece

    Antonia Malli & Dimitrios K. Kalaitzoglou

  4. Laboratory of Biomathematics, Faculty of Medicine, University of Thessaly, Larissa, Greece

    Michael Miligkos

  5. Division of Cardiology, Emory University, Atlanta, GA, USA

    Andreas P. Kalogeropoulos

Authors
  1. Pavlos G. Myserlis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Antonia Malli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dimitrios K. Kalaitzoglou
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Grigorios Kalaitzidis
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael Miligkos
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Damianos G. Kokkinidis
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Andreas P. Kalogeropoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pavlos G. Myserlis.

Ethics declarations

Funding sources

None.

Conflict of interest

Dr. A.P. Kalogeropoulos has received grants from NIH-National Heart, Lung and Blood Institute, the American Heart Association, the Centers for Disease Control and Prevention and NIH-Atlanta Clinical and Translational Science Institute. Drs. P.G. Myserlis, A. Malli, D.K. Kalaitzoglou, G. Kalaitzidis, M. Miligkos and D.G. Kokkinidis have no conflicts of interest or financial ties to disclose.

Additional information

Dimitrios K. Kalaitzoglou contributed equally with Antonia Malli.

Electronic supplementary material

ESM 1

(PDF 198 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Myserlis, P.G., Malli, A., Kalaitzoglou, D.K. et al. Atrial fibrillation and cognitive function in patients with heart failure: a systematic review and meta-analysis. Heart Fail Rev 22, 1–11 (2017). https://doi.org/10.1007/s10741-016-9587-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10741-016-9587-y

Keywords

Search

Navigation