Journal Article

DZNE-2026-00884

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Longitudinal trajectories of neurodegenerative biomarkers in the blood of patients with chronic heart failure.

Traub, J. ; Frey, A. ; Homola, G. ; Morbach, C. ; Frantz, S. ; Pham, M. ; Störk, S. ; Stoll, G. ; Otto, M. ; Oeckl, P. (Last author)DZNE*

2026
Wiley Chichester

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Please use a persistent id in citations: doi:10.1093/eschf/xvag202

Abstract: Chronic heart failure (HF) is associated with mild cognitive impairment (MCI), vascular dementia, and Alzheimer's disease. Blood-based neurodegenerative biomarkers may support early risk stratification and outcome prediction in HF.In the prospective Cognition.Matters-HF cohort study, serum neurofilament light chain (NfL), glial fibrillary acidic protein, and phosphorylated tau protein-181, as well as plasma amyloid-β peptides (Aβ38, Aβ40, Aβ42) and β-synuclein, were quantified longitudinally over 36 months using ultrasensitive immunoassays and immunoprecipitation mass spectrometry. Cerebral magnetic resonance imaging and standardized domain-specific cognitive testing were performed. Multivariable logistic regression was used to assess associations with future MCI, brain structural changes, and 5-year all-cause mortality.Among 104 patients with chronic HF (10% female, age 64 ± 10 years), all biomarkers except NfL increased significantly over 3 years (P < .05). Median annual percentage changes were 36.6% for phosphorylated tau protein-181, 4.6% for glial fibrillary acidic protein, 2.6% for β-synuclein, 0.6% for Aβ38, 0.5% for Aβ40, and 0.3% for Aβ42. After adjusting for clinical confounders, increases in Aβ38 and Aβ42 independently associated with future MCI, pathological white matter hyperintensity progression (>5% per year), and 5-year mortality (all P < .05). Glial fibrillary acidic protein levels and phosphorylated tau protein-181 trajectories were independently associated with pathological brain atrophy (>0.3% per year).In clinically stable patients with chronic HF, longitudinal increases in circulating amyloid-β peptides associated with cognitive decline, structural brain changes, and mortality. Serial biomarker assessment provided stronger prognostic information than baseline measurements alone. Replication in larger cohorts is required.

Keyword(s): Humans (MeSH) ; Female (MeSH) ; Biomarkers: blood (MeSH) ; Male (MeSH) ; Heart Failure: blood (MeSH) ; Heart Failure: complications (MeSH) ; Prospective Studies (MeSH) ; Middle Aged (MeSH) ; Amyloid beta-Peptides: blood (MeSH) ; Chronic Disease (MeSH) ; Neurofilament Proteins: blood (MeSH) ; Glial Fibrillary Acidic Protein: blood (MeSH) ; tau Proteins: blood (MeSH) ; Follow-Up Studies (MeSH) ; Magnetic Resonance Imaging (MeSH) ; Aged (MeSH) ; Prognosis (MeSH) ; Neurodegenerative Diseases: blood (MeSH) ; Neurodegenerative Diseases: etiology (MeSH) ; Longitudinal Studies (MeSH) ; Chronic heart failure ; Glial fibrillary acidic protein ; Mild cognitive impairment ; Neurodegenerative blood biomarkers ; Neurofilament light chain ; β-synuclein ; Biomarkers ; Amyloid beta-Peptides ; Neurofilament Proteins ; Glial Fibrillary Acidic Protein ; tau Proteins ; neurofilament protein L

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Contributing Institute(s):

1. Translational Mass Spectrometry and Biomarker Research (AG Öckl)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2026

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