Bürker Britta S, Gude Einar, Gullestad Lars, Grov Ingelin, Relbo Authen Anne, Andreassen Arne K, Havik Odd E, Dew Mary Amanda, Fiane Arnt E, Haraldsen Ira R, Malt Ulrik F, Andersson Stein
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Department of Psychiatry of Old Age, Oslo University Hospital - Ullevål, Oslo, Norway.
Clin Transplant. 2017 Dec;31(12). doi: 10.1111/ctr.13143. Epub 2017 Nov 15.
Cognitive impairment is documented early after heart transplantation (HTx), but we lack data on cognitive function beyond the fourth year post-transplant. Against the background of good long-term survival, this knowledge is necessary to improve clinical care throughout the entire post-transplant period.
We assessed cognitive function with a neuropsychological test battery in a sample of HTx recipients ≥16 years post-transplant. To improve clinical utility, we also applied adapted consensus criteria for Mild Cognitive Impairment (MCI). Furthermore, we explored sociodemographic and clinical characteristics possibly related to cognitive function.
Thirty-seven subjects were included 20.3 (±3.8) years after HTx. Mean age was 57.5 (±14.2) years, and 18.9% were women. Up to 38.9% exhibited impaired test performance (ie, performance at least 1.5 standard deviations below the normative mean) on several individual cognitive measures, especially on measures of processing speed, executive functions, memory, and language functions. One subject was diagnosed with dementia, and 30.1% qualified for MCI. Those with MCI had lower hemoglobin than those without.
A substantial proportion of long-term survivors of HTx might be cognitively impaired. The level of impairment appears comparable to what is defined as MCI in the literature. Modifiable factors related to cognitive impairment might exist.
心脏移植（HTx）后早期即有认知功能障碍的记录，但我们缺乏移植后四年以上认知功能的数据。在长期生存率良好的背景下，这些知识对于改善整个移植后时期的临床护理是必要的。
我们在一组移植后≥16年的心脏移植受者样本中，用一套神经心理学测试评估认知功能。为提高临床实用性，我们还应用了针对轻度认知障碍（MCI）的适应性共识标准。此外，我们探讨了可能与认知功能相关的社会人口学和临床特征。
纳入了37名心脏移植后20.3（±3.8）年的受试者。平均年龄为57.5（±14.2）岁，女性占18.9%。在多项个体认知测量中，高达38.9%的受试者表现受损（即表现至少比正常均值低1.5个标准差），尤其是在处理速度、执行功能、记忆和语言功能测量方面。一名受试者被诊断为痴呆，30.1%符合MCI标准。患MCI者的血红蛋白水平低于未患MCI者。
相当一部分心脏移植长期存活者可能存在认知功能障碍。障碍程度似乎与文献中定义的MCI相当。可能存在与认知功能障碍相关的可改变因素。
