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PLoS One. 2017 Oct 4;12(10):e0184981. doi: 10.1371/journal.pone.0184981. eCollection 2017.

Concomitant diastolic dysfunction further interferes with cognitive performance in moderate to severe systolic heart failure.

Author information

1
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
2
College of Nursing, Chonnam National University, Gwang-ju, Korea.
3
Department of Nursing, Doowon Technical University, Seoul, Korea.
4
Department of Internal Medicine Hanyang University Medical Center, Seoul, Korea.
5
College of Nursing, Gachon University, Incheon, Korea.

Abstract

BACKGROUND:

Studies of the relevance of cardiac functional markers to cognitive performance in heart failure (HF) have primarily focused on systolic markers. In this study, we examine whether concomitant diastolic dysfunction further interferes with cognitive performance in memory, attention, and executive function in patients with HF.

METHODS AND RESULTS:

In this cross-sectional correlational study, 82 patients completed face-to-face interviews for neuropsychological testing for cognitive evaluation. Echocardiographic data were obtained from a review of medical records. Mild to moderate (ejection fraction [EF] ≥ 30%) and severe (EF < 30%) systolic dysfunction were present in 55 (67.1%) and 27 (32.9%) patients, respectively, while 21 (26.3%) had diastolic dysfunction (E/e' > 15). Those patients who had severe systolic dysfunction had significantly lower attention scores (Digit Span Test [DST] backward, t = 2.62, p = 0.011), while those with concomitant severe diastolic dysfunction had significantly lower verbal fluency (t = 2.84, p = 0.006) and executive function (Korean-Trail Making Test Part B) (t = -2.14, p = 0.036) scores than those without severe diastolic dysfunction. After controlling for age and education, systolic patients with HF with concomitant severe diastolic dysfunction had worse cognitive performance in verbal fluency than those without severe diastolic dysfunction (F = 4.33, p = 0.041, partial eta = 0.057). Concomitant moderate to severe systolic and severe diastolic dysfunction further reduced verbal fluency (F = 8.42, p = 0.005, partial eta = 0.106).

CONCLUSIONS:

Cognitive performance, particularly executive function, was worse in patients with HF with systolic dysfunction when diastolic dysfunction was concomitantly present. Routine monitoring of and surveillance for diastolic dysfunction and cognitive screening are warranted in the management of patients with HF.

PMID:
28977012
PMCID:
PMC5627914
DOI:
10.1371/journal.pone.0184981
[Indexed for MEDLINE]
Free PMC Article

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