Neuropsychological functioning in heart transplant candidates

Area of Science:

• Neuroscience
• Cardiology
• Psychology

Background:

• End-stage congestive heart failure (CHF) significantly impacts patient health.
• Understanding the effects of CHF on cognitive function is crucial for heart transplant candidates.
• Neurological co-morbidities can further complicate the assessment of CHF's impact on the brain.

Purpose of the Study:

• To provide age-stratified neuropsychological test data for heart transplant candidates.
• To compare patients with and without neurological co-morbidities to isolate CHF effects on brain functioning.
• To assess cognitive abilities including intellectual, memory, executive, language, attentional, and psychomotor functions.

Main Methods:

• Neuropsychological assessment of 956 end-stage CHF patients between 1988-2011.
• Comparison of subgroups with and without neurological co-morbidities using independent t-tests and chi-square tests.
• Concurrent collection of cardiac measures and MMPI-2 findings.

Main Results:

• Significant cognitive impairments were typical across all assessed domains and age groups.
• 28% of patients had neurological co-morbidities (e.g., CVA, cardiac arrest).
• Patients with neurological co-morbidities showed lower scores in processing speed, memory, and executive functions, but the deficit pattern was similar across groups.

Conclusions:

• End-stage heart disease/heart failure is associated with global, mild to moderate cognitive impairment.
• Cognitive impairment is present regardless of age or neurological co-morbidities.
• Likely contributing factors include cerebrovascular hypoperfusion, multiorgan failure, systemic co-morbidities, and lifestyle issues.