Department of General Psychology, University of Padua, Padua, Italy.
PLoS One. 2011;6(12):e28313. doi: 10.1371/journal.pone.0028313. Epub 2011 Dec 13.
Recent studies have reported that patients with end-stage heart disease can have cognitive deficits ranging from mild to severe. Little is known, however, about the relationship between cognitive performance, neurophysiological characteristics and relevant clinical and instrumental indexes for an extensive evaluation of patients with heart failure, such as: left ventricular ejection fraction (LVEF) and other haemodynamic measures, maximum oxygen uptake during cardiopulmonary exercise testing, comorbidities, major cardiovascular risk factors and disease duration. Our purpose was to outline the cognitive profiles of end-stage heart disease patients in order to identify the cognitive deficits that could compromise the quality of life and the therapeutic adherence in end-stage heart disease patients, and to identify the variables associated with an increased risk of cognitive deficits in these patients.
207 patients with end-stage cardiac disease, candidates for heart transplant, were assessed by complete neuropsychological evaluation and by electroencephalographic recording with EEG spectral analysis.
Pathological scores in one or more of the cognitive tests were obtained by 86% of the patients, while 36% performed within the impaired range on five or more tests, indicating poor performance across a broad range of cognitive domains. The executive functions were the cognitive domain most impaired (70%). Poor performances were not related to the aetiology of heart disease, but rather to cerebral dysfunction secondary to haemodynamic impairment and to comorbidities.
Severe heart failure induces significant neurophysiological and neuropsychological alterations, which may produce an impairment of cognitive functioning and possibly compromise the quality of life of patients and the therapeutic adherence.
最近的研究报告称，终末期心脏病患者可能存在从轻度到重度的认知缺陷。然而，对于广泛评估心力衰竭患者的认知表现、神经生理特征以及相关的临床和仪器指标之间的关系，我们知之甚少，例如：左心室射血分数（LVEF）和其他血流动力学指标、心肺运动试验期间的最大摄氧量、合并症、主要心血管危险因素和疾病持续时间。我们的目的是概述终末期心脏病患者的认知特征，以确定可能影响终末期心脏病患者生活质量和治疗依从性的认知缺陷，并确定与这些患者认知缺陷风险增加相关的变量。
对 207 名终末期心脏病患者（心脏移植候选者）进行了全面的神经心理学评估和脑电图记录的脑电图谱分析。
86%的患者在一项或多项认知测试中获得了病理评分，而 36%的患者在五项或更多测试中得分受损，表明认知领域广泛存在较差的表现。执行功能是受损害最严重的认知领域（70%）。较差的表现与心脏病的病因无关，而是与血流动力学损害和合并症引起的脑功能障碍有关。
严重的心力衰竭会引起显著的神经生理和神经心理学改变，这可能导致认知功能障碍，并可能影响患者的生活质量和治疗依从性。
