Journal
EUROPEAN JOURNAL OF HEART FAILURE
Volume 14, Issue 4, Pages 404-413Publisher
WILEY
DOI: 10.1093/eurjhf/hfs015
Keywords
Cognition; Depression; Quality of life; Heart failure; Cardiac decompensation
Categories
Funding
- German Heart Foundation
- Ministry for Economy and Science of the Saarland
- Saarland University Hospital
- Association of Leading Hospital Cardiologists (ALKK)
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The objective of this study was to examine cognitive and psychological processes systematically in patients with decompensated chronic heart failure (CHF) and to document changes in cognitive function after compensation. Executive functions, episodic memory, and attention are impaired in patients with stable CHF, influencing health behaviour and disease management. Cognitive function and psychological co-morbidities are associated with hospitalization, disability, and mortality. Cognitive performance, self-perceived quality of life, and depression were compared in 20 patients with decompensated CHF [ejection fraction (EF) 27 8, N-terminal pro brain natriuretic peptide (NT-proBNP) 10 880 pg/mL, interquartile range (449513 683)] before and after compensation, 20 age- and gender-matched stable CHF patients [New York Heart Assocation (NYHA) IIIIV, EF 32 10, NT-proBNP 1881 pg/mL (3231502)], and 20 healthy controls (EF 70 5). Patients with decompensated CHF showed significantly poorer performance in terms of short-term memory, working memory, executive control, and processing speed (P 0.05) compared with stable CHF patients. Compensation improved the cognitive performance of decompensated CHF patients up to the level of patients with stable CHF. Compared with healthy controls, both patient groups were affected with respect to episodic memory (P 0.0001) and fluid intelligence (P 0.01). Decompensated heart failure patients are highly impaired in cognitive functioning, which improves but does not normalize after compensation. Neuropsychological diagnostics delivers important details for daily life activities and might identify individuals deserving special care.
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