Cognitive impairment in heart failure with Cheyne-Stokes respiration

• Published in: Heart (British Cardiac Society) Vol. 85; no. 1; pp. 18 - 22
• Main Authors: Staniforth, A D, Kinnear, W J M, Cowley, A J
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01.01.2001; BMJ; BMJ Publishing Group LTD
• Subjects: Aged; Arousal; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular Medicine; Cheyne-Stokes respiration; Cheyne-Stokes Respiration - complications; Cognition Disorders - diagnosis; Cognition Disorders - etiology; Cognitive ability; cognitive function; driving; Echocardiography; Family medical history; Heart; Heart failure; Heart Failure - complications; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Humans; Investigations; Medical sciences; Neuropsychological Tests; Phonetics; Reaction Time; Respiration; Sleep; Vehicles; Ventricular Function, Left; Human; Heart failure; Cognitive disorder; Pathophysiology; Respiratory disease; Clinical form; Cardiovascular disease; Exploration; Cognition; Cheyne Stokes breathing; Concomitant disease; Heart disease; Risk factor; Comparative study
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/heart.85.1.18

OBJECTIVES To document the degree of cognitive impairment in stable heart failure, and to determine its relation to the presence of Cheyne-Stokes respiration during sleep. SUBJECTS 104 heart failure patients and 21 healthy normal volunteers. METHODS Overnight oximetry was used (previously validated as a screening tool for Cheyne-Stokes respiration in heart failure). Cognitive function was assessed using a battery of neuropsychological tests. Left ventricular function was assessed by echocardiography. RESULTS Heart failure patients performed worse than the healthy volunteers in tests that measured vigilance. Reaction times were 48% slower (0.89 (0.03) sv 0.60 (0.05) s; p < 0.005) and they hit twice as many obstacles on the Steer Clear simulator (75 (6.4)v 33 (4.6); p < 0.005). Cognitive impairment within the heart failure group was unrelated to either the presence of Cheyne-Stokes respiration, the degree of left ventricular dysfunction, or indices of nocturnal oxygenation. CONCLUSIONS Vigilance was impaired in heart failure but this did not appear to be related to the presence of Cheyne-Stokes respiration during sleep. Impaired vigilance as measured on the Steer Clear test has been associated with an increased risk of motor vehicle accidents. The issue of fitness to drive in heart failure requires further attention.