Callegari S, Majani G, Giardini A, Pierobon A, Opasich C, Cobelli F, Tavazzi L
Psychology Unit, Fondazione S. Maugeri, Clinica del Lavoro e della Riabilitazione, IRCCS, Scientific Institute of Montescano, PV, Italy.
Monaldi Arch Chest Dis. 2002 May;58(1):19-25.
In spite of its clinical importance, cognitive functioning is not always taken into account in studies on patients with chronic heart failure. The aim of the present study is to analyse the relationship between cognitive impairment and cardiovascular variables in a sample of patients with chronic heart failure for assessment or candidated for heart transplant.
Sixty-four male patients with chronic heart failure in NYHA class I-III, in a stable clinical condition, underwent cardiological evaluation and neuropsychological assessment by means of a wide battery of tests: Spinnler and Tognoni's tests and WAIS scale.
Compared to the normative group, only 9% of patients did not have impairment in any cognitive function. 26% of patients had impairment of one cognitive function, and 30% of four or more cognitive functions. The cognitive functions that were most often impaired were short-term verbal memory, short-term visual spatial memory, differed verbal memory and verbal learning and visual spatial logical ability. On the whole, no statistical significant relationship was found between cognitive scores and the considered cardiovascular variables.
Our data support the need to take into account the risk of cognitive impairment in CHF patients, regardless of age, disease severity or functional status. The high prevalence of short-term verbal memory impairment has important implications in clinical practice, since CHF patients should be actively involved in the medical management of their disease. Memory deficits could compromise patient's adherence to treatment as well as doctor-patient interactions. The practical consequences of these difficulties require some changes in doctors' behaviour and suggest the need for specific medical staff member training.
尽管认知功能具有临床重要性，但在慢性心力衰竭患者的研究中，认知功能并非总是被纳入考虑范围。本研究的目的是分析慢性心力衰竭患者样本中认知障碍与心血管变量之间的关系，这些患者用于评估或作为心脏移植的候选者。
64名纽约心脏协会（NYHA）心功能I - III级、临床状况稳定的男性慢性心力衰竭患者，接受了一系列广泛的检查进行心脏评估和神经心理学评估：斯皮勒和托尼奥尼测试以及韦氏成人智力量表。
与正常对照组相比，只有9%的患者在任何认知功能方面没有损害。26%的患者有一种认知功能受损，30%的患者有四种或更多认知功能受损。最常受损的认知功能是短期言语记忆、短期视觉空间记忆、差异言语记忆、言语学习和视觉空间逻辑能力。总体而言，在认知得分与所考虑的心血管变量之间未发现统计学上的显著关系。
我们的数据支持在慢性心力衰竭患者中需要考虑认知障碍风险，无论年龄、疾病严重程度或功能状态如何。短期言语记忆损害的高患病率在临床实践中具有重要意义，因为慢性心力衰竭患者应积极参与其疾病的医疗管理。记忆缺陷可能会损害患者对治疗的依从性以及医患互动。这些困难的实际后果需要医生行为的一些改变，并表明需要对医务人员进行特定培训。
