Narrative review covers cardiovascular conditions and cognitive decline without reported trial data

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Frontiers in Medicine Published April 22, 2026 Medically reviewed April 25, 2026 DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Note that this narrative review lacks specific trial data for the listed cardiovascular conditions.

This publication is a narrative review that examines a wide array of cardiovascular conditions, specifically stroke, heart failure, atrial fibrillation, ischemic heart disease, myocardial ischemia, myocardial infarction, takotsubo syndrome, sudden cardiac death, and cognitive decline. The scope of the article encompasses these diverse clinical entities, yet the authors do not report a specific population, sample size, setting, or intervention/exposure for the conditions discussed. Consequently, no primary or secondary outcomes, follow-up durations, or p-values are provided in the text.

The authors synthesize arguments and qualitative conclusions regarding these conditions rather than presenting pooled effect sizes or quantitative data. Safety information, including adverse events, serious adverse events, discontinuations, and tolerability, is explicitly not reported. Similarly, the review does not provide details on funding, conflicts of interest, or specific limitations acknowledged by the authors beyond the inherent constraints of a narrative format.

Given the absence of trial-level data, the practice relevance is not quantified, and causality cannot be inferred from the text. Clinicians should interpret the qualitative arguments with caution, recognizing that this source does not offer the statistical certainty of a randomized controlled trial or systematic review. The review serves as a broad overview rather than a definitive guide for specific clinical decision-making.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedApr 2026

View Original Abstract ↓

The heart and brain are anatomically and functionally interconnected through nervous and humoral feedback mechanisms. Under physiological conditions, the heart-brain axis helps maintain cardiovascular and cerebral homeostasis. Pathology affecting one organ can profoundly impact the other, significantly worsening prognosis. The term stroke–heart syndrome refers to cardiovascular complications following acute ischemic stroke, including myocardial injury, infarction, ventricular dysfunction, arrhythmias (e.g., atrial fibrillation), heart failure, takotsubo syndrome, and sudden cardiac death. Brain damage-induced cardiac injury arises from a complex interplay of neuroinflammation, systemic immune activation, sympathetic-immune interactions, catecholamine toxicity, endothelial dysfunction, and gut–brain–heart axis involvement. Conversely, cardiac conditions, including myocardial ischemia, heart failure, and atrial fibrillation, are associated with an increased risk of stroke and cognitive decline. Myocardial ischemia can initiate systemic inflammation and neuroinflammation through sympathetic overdrive and platelet activation. Heart failure causes cerebral hypoperfusion and high thromboembolic risk, and atrial fibrillation promotes thrombus formation due to blood stasis. Atrial dysfunction and prothrombotic states may also occur independently of arrhythmia. This review summarises current evidence on the pathological interactions within the heart–brain axis, in the context of stroke, mental stress, ischemic heart disease, heart failure, and atrial fibrillation.