Ozyuncu N, et al. - Whether acute decompensated phase is related to an increased rate of recent silent cerebral infarcts (SCI) in reduced ejection fraction heart failure (HF) patients was investigated in this study with 147 heart failure patients (mean age was 72) with sinus rhythm who sought hospitalization for acute decompensation. Researchers detected recent SCI by measuring neuron specific enolase (NSE), a sensitive neuronal ischemia marker. On admission and on the third day of compensation, they obtained decompensated and compensated phase blood samples for NSE, respectively. At decompensated state, positive NSE levels were detected in significantly more patients. Smoking, new onset atrial fibrillation, spontaneous echo contrast of left ventricle, and aneurismatic apex were identified as multivariate predictors for recent SCI. NSE elevation was protected against by using statin. Findings revealed a significant association of decompensated heart failure with increased levels of NSE, which suggests silent neuronal injury.