Cardiopulmonary fitness is associated with cognitive performance in patients with coronary artery disease.

OBJECTIVES

To investigate the association between cardiopulmonary fitness and cognitive performance in subjects with coronary artery disease (CAD).

DESIGN

Cross-sectional observational study.

SETTING

Outpatient cardiac rehabilitation.

PARTICIPANTS

Eighty-one subjects with CAD.

MEASUREMENTS

Cardiopulmonary fitness was assessed by measuring peak oxygen uptake (VO(2Peak) ) in a standardized exercise stress test. The fraction of the predicted age and sex norm for VO(2Peak) was computed for each patient. A battery of neuropsychological tests including the Stroop, Trail-Making Test Part B, Digit Symbol Coding, Revised Brief Visuospatial Memory Test, California Verbal Learning Test 2nd Edition, and Mini Mental State Examination (MMSE) was administered, from which composite Z-scores were computed for tasks involving executive function and memory.

RESULTS

Executive function, memory, and MMSE scores were correlated with VO(2Peak) , but only performance in the executive domain was independently associated with VO(2Peak) in multiple linear regression. In a multiple linear regression model controlling for potential clinical confounders, VO(2Peak) (β=.666, P<.001) and covariates accounted for 36% of the variance in executive function scores.

CONCLUSION

Poorer VO(2Peak) is associated with poorer cognition, particularly executive function, in subjects with CAD independent of other cardiac risk factors. Cardiopulmonary fitness may be a protective factor for cognition in patients with CAD.