Cognitive function in patients with symptomatic dilated cardiomyopathy before and after cardiac transplantation

• Published in: Journal of the American College of Cardiology Vol. 14; no. 7; pp. 1666 - 1672
• Main Authors: Richard Schall, R., Petrucci, Ralph J., Brozena, Susan C., Cavarocchi, Nicholas C., Jessup, Mariell
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.12.1989; Elsevier Science
• Subjects: Adult; Age Factors; Biological and medical sciences; Cardiology. Vascular system; Cardiomyopathy, Dilated - psychology; Cardiomyopathy, Dilated - surgery; Cognition; Female; Heart; Heart Transplantation; Humans; Male; Medical sciences; Middle Aged; Myocarditis. Cardiomyopathies; Heart; Human; Surgery; Hypertrophic cardiomyopathy; Cardiovascular disease; Psychometrics; Homotransplantation; Myocardial disease; Cognitive system
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/0735-1097(89)90013-2

Pre- and postoperative cognitive performance of candidates for heart transplantation was examined by means of an extensive battery of neuropsychological measures. A total of 54 patients completed the preoperative cognitive protocol, 20 of whom also completed postoperative testing. Age (<50 or >-50 years of age) and the primary cause of cardiac deterioration (idiopathic, ischemic disease or rheumatic/ congenital defects) were the major classification variables. The main findings of this study were: 1) Preoperative neuropsychological measures revealed a high frequency of impaired performance, particularly in measures of memory, higher level processing of information and motor speed. A pattern consistent with diffuse rather than focal or lateralized cerebral deficits was observed. Significant differences were not found on the basis of the cause of cardiac disease, but some were observed for age (the older group was more impaired). 2) A comparison of pre- and postoperative cognitive scores failed to show significant cognitive improvement despite greatly improved physical health. The cause of cardiac deterioration was not differentially associated with postoperative cognitive performance, and there was equivocal evidence for age effects. These findings may have implications for the selection of transplant recipients and the timing of transplantation surgery.