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Blood-based neurodegenerative biomarkers may support early risk stratification and outcome prediction in HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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-\u03b2 peptides (A\u03b238, A\u03b240, A\u03b242) and \u03b2-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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 104 patients with chronic HF (10% female, age 64 \u00b1 10 years), all biomarkers except NfL increased significantly over 3 years (P &amp;lt; .05). Median annual percentage changes were 36.6% for phosphorylated tau protein-181, 4.6% for glial fibrillary acidic protein, 2.6% for \u03b2-synuclein, 0.6% for A\u03b238, 0.5% for A\u03b240, and 0.3% for A\u03b242. After adjusting for clinical confounders, increases in A\u03b238 and A\u03b242 independently associated with future MCI, pathological white matter hyperintensity progression (&amp;gt;5% per year), and 5-year mortality (all P &amp;lt; .05). Glial fibrillary acidic protein levels and phosphorylated tau protein-181 trajectories were independently associated with pathological brain atrophy (&amp;gt;0.3% per year).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In clinically stable patients with chronic HF, longitudinal increases in circulating amyloid-\u03b2 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag202","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T11:38:42Z","timestamp":1784374722000},"source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal trajectories of neurodegenerative biomarkers in the blood of patients with chronic heart failure"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8092-5967","authenticated-orcid":false,"given":"Jan","family":"Traub","sequence":"first","affiliation":[{"name":"Department of Internal Medicine I, University Hospital W\u00fcrzburg , W\u00fcrzburg ,","place":["Germany"]},{"name":"Comprehensive Heart Failure Center, University Hospital W\u00fcrzburg, W\u00fcrzburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Frey","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 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