Journal article
Cognitive Dysfunction in Advanced Heart Failure and Prospective Cardiac Assist Device Patients
The Annals of thoracic surgery, v 81(5), pp 1738-1744
2006
PMID: 16631665
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Extended periods of hypoperfusion in an advanced heart failure (HF) places patients at high risk for neurobehavioral compromise, which has not been studied systematically. It is also not clear how intravenous inotropic therapy and mechanical cardiac assist devices (MCAD) affect cognitive function.
This prospective cross-sectional cognitive preliminary study evaluated 252 potential heart transplant candidates assessing functions in memory, motor, and processing speed. Patients were divided into three HF groups based on severity of disease: group 1 outpatients (n = 113), group 2 in-patients requiring inotropic infusion (n = 83), and group 3 inpatients likely requiring MCAD support (n = 56). Aggregate z-scores for memory, motor, and processing speed and independent samples
t tests assessed intergroup differences on 13 cognitive measures.
A broad pattern of cognitive impairment was observed within the advanced HF group; fewer deficits were found in group 1 outpatients and more severe deficits in group 3 MCAD subjects. A difference in motor functions was observed as the earliest abnormality, with group 3 showing significant changes compared with group 1. The most dramatic changes were seen in domain mental processing speed along with specific verbal and visual memory functions, which were slower in group 3 compared with groups 1 and 2.
Cognitive deficits are common in advanced HF and worsen with increasing severity of HF. Appropriately designed and randomized studies will be needed to demonstrate if earlier MCAD implantation is warranted to arrest cognitive dysfunction and better postimplantation adaptation.
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Details
- Title
- Cognitive Dysfunction in Advanced Heart Failure and Prospective Cardiac Assist Device Patients
- Creators
- Ralph J Petrucci - College of Medicine, Drexel University, Philadelphia, PennsylvaniaKaren C Truesdell - Department of Clinical and Health Psychology, Drexel University, Philadelphia, PennsylvaniaAnne Carter - College of Medicine, Drexel University, Philadelphia, PennsylvaniaNaomi E Goldstein - Department of Clinical and Health Psychology, Drexel University, Philadelphia, PennsylvaniaMegan M Russell - Department of Clinical and Health Psychology, Drexel University, Philadelphia, PennsylvaniaDanielle Dilkes - Department of Clinical and Health Psychology, Drexel University, Philadelphia, PennsylvaniaJane M Fitzpatrick - College of Medicine, Drexel University, Philadelphia, PennsylvaniaCarole E Thomas - College of Medicine, Drexel University, Philadelphia, PennsylvaniaMargaret E Keenan - Behavioral Medicine, Christiana Care Health System, Wilmington, DelawareLewis A Lazarus - Voorhees, New JerseyNancy D Chiaravalloti - Neuropsychology Department, Kessler Rehabilitation Research and Educational Corporation, West Orange, New JerseyJoseph J Trunzo - Psychology Department, Bryant College, Smithfield, Rhode IslandJohan W Verjans - College of Medicine, University of California-Irvine, Irvine, CaliforniaElena C Holmes - Cardio-Thoracic Surgery, Lankenau Hospital, Wynnewood, PennsylvaniaLouis E Samuels - Cardio-Thoracic Surgery, Lankenau Hospital, Wynnewood, PennsylvaniaJagat Narula - College of Medicine, University of California-Irvine, Irvine, California
- Publication Details
- The Annals of thoracic surgery, v 81(5), pp 1738-1744
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); [Retired Faculty]
- Web of Science ID
- WOS:000237001700028
- Scopus ID
- 2-s2.0-33646822946
- Other Identifier
- 991014878390304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Respiratory System
- Surgery