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

• Published in: PloS one Vol. 12; no. 10; p. e0184981
• Main Authors: Shin, Mi-Seung, An, Minjeong, Kim, Sunhwa, Shim, Jae Lan, Park, Jin-Kyu, Kim, JinShil
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 04.10.2017; Public Library of Science (PLoS)
• Subjects: Aged; An, Jae; Attention; Biology and Life Sciences; Cardiology; Cognition; Cognitive ability; Correlation analysis; Cross-Sectional Studies; Dementia; Diastole; Executive function; Family medical history; Female; Heart; Heart diseases; Heart failure; Heart Failure, Systolic - physiopathology; Heart Failure, Systolic - psychology; Humans; Internal medicine; Male; Markers; Measuring techniques; Medical records; Medicine and Health Sciences; Memory; Middle Aged; Nursing; Patients; Psychology; Research and Analysis Methods; Social Sciences; Studies
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0184981

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. 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). 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.