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Study Group on Heart and Brain Interaction in Patients with Heart Failure

The Study Group on Heart and Brain Interaction in Patients with Heart Failure was established in December 2014. With this decision the HFA recognised the advancing challenge of heart failure as a systemic syndrome involving multiple tissues and organ interactions. Experts of specific aspects in the interplay between the heart and the brain are assembled in this group to develop a systematic approach to this inter-organ interaction in the context of heart failure.

The need for this initiative - scientific and clinical

Heart failure has emerged in recent years as an increasingly complex and inclusive syndrome. HF is understand today as a truly systemic syndrome with multiple organ interactions and whole body systems contributing to the symptomatic status of the patients, disease progression and prognosis. Moreover, improved care in acute cardiac events and the advancing age of the modern society results in a significant rise in the prevalence of HF. Patients are now seen in hospitals and ambulant clinics and followed by cardiologist for longer periods in a state of reasonably stable and compensated condition of HF. Consequently, long-term complications and sequela of HF are increasingly coming to the fore and the picture of the typical HF patient is shifting towards a multi-morbid and interdisciplinary patient.

To address this shift in the clinical presentation of HF patients, interdisciplinary strategies need to be established and to promoted. The current initiative is intended to increase the awareness of the relevance of the heart - brain interaction for disease onset, symptomatic status, disease progression and, ultimately, outcome. The transfer of these recent advances into medical guidance and treatment advice is a highly relevant task and is imperative to meet both medical and health economic needs of the evolving modern society.

A specific scientific body corporate within the European Society of Cardiology is warranted to address this development and to promote research, clinical and educational initiatives. The HFA addresses this need by establishing the study group on heart an brain interaction in heart failure.


The working group will focus on the myocardial – cerebral interaction in the context of heart failure. This interaction includes the mutual and feedback interference of both organs in the setting of heart failure in the context of acute treatment, primary preventive medicine, and secondary and long term prevention of complications.


The aim of the working group is to improve the knowledge and awareness of the pathophysiologic mechanisms and the clinical relevance of the interrelated signals between the brain and the heart and their impact on

  • disease occurrence
  • symptomatic status
  • disease progression
  • outcome.

To achieve these aims the Study Group recognises the importance and need of the following:

  • establish a pan-European network of scientists interested in the heart brain interaction heart failure
  • identify the unmet needs and unresolved questions on a pathophysiologic level, the level of clinical praxis guidelines for interdisciplinary treatment of HF patients
  • prepare a position paper on the impact of the heart – brain interaction covering the wide spectrum of this interaction

Specific topics to be addressed in this initiative (developing work)

  • Stroke and anticoagulation in HF (with and without atrial fibrillation)
  • Cerebro-cardiac signalling after stroke (TNT elevation, TakoTsubo)
  • Reflex signalling
  • Heart failure and cognitive impairment
  • Heart failure and depression
  1. Neuro-psychologic – cardiac interaction in cardiovascular interventions (CABG, PCI,  HF Ablation, Device implantation)
  2. Implants to prevent cardioembolic embolism (PFO, LAA) / novel implants impacting cardioembolism (Mitraclip, TAVI)


A workshop was held in Berlin in November 2015 in Berlin. Current evidence on several pressing topics in the field were summarised. Moreover, gaps in the evidence and future needs in the understanding cardio-cerebral interactions were addressed. The result from this workshop will be published to provide an overview on current evidence but also on unmet needs and to identify targets for future work in clinical and pathophysiologic investigations.

Further activities will include:

  1. providing a position paper on the current insights and knowledge, available evidence and therapeutic implications of the heart – brain interaction.
  2. identify unmet needs and emerging questions on the relevance and impact of the heart-brain interaction.
  3. Provide a platform for dissemination and interaction for clinical and research activities focussed in the interaction between myocardial and cerebral functions in patients with heart failure.
  4. endorse common activities for interdisciplinary projects combining expertise from cardiology and neurology.
  5. close the gap between cardiologic and neurologic perspectives on common cardio-cerebrovascular clinical problems.


Prof. Andrew Coats (Warwick, UK)

Prof. Wolfram Doehner (Berlin, Germany)

Study Group Members  
Y. Cavusoglu  (Ekisehir, TR)
M. Iacoviello (Bari, IT)
U. Laufs (Homburg, DE)
S. Rosen (London, UK)
D. Ural (Istanbul, TR)
C. Vitale (Rome,IT)
M. Piepoli (Piacenza, IT)
KG. Tsivgoulis (Athens, GR)


Affiliate Members  
R. Bestetti (Ribeirao Preto, BR)
J. Celutkiene (Vlnuius, LI)
D. Glavas (Split, HR)
G. Haeusler (Berlin, DE)
F. Lara Roquette (Sao Paulo, BR)
R. Marmol (Guayaquil, Ecuador) 
A. Mbakwem (Lagos, NG)
M. Pena Duque (MX)
B. Yilmaz (Sivas, TR)