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Factors Associated With Cognitive Impairment in Heart Failure With Preserved Ejection Fraction

Kenneth M Faulkner, Victoria Vaughan Dickson, Jason Fletcher

    The Journal of Cardiovascular Nursing
    |July 11, 2020
    PubMed

    Insights

    Cognitive impairment is common in heart failure with preserved ejection fraction (HFpEF). Abnormal cardiac hemodynamics, like worse diastolic function, were linked to poorer cognitive performance in HFpEF patients.

    Area of Science:

    • Cardiology
    • Neurology
    • Gerontology

    Background:

    • Cognitive impairment is frequent in heart failure (HF), particularly in heart failure with preserved ejection fraction (HFpEF), and is linked to increased mortality.
    • The underlying mechanisms of cognitive decline in HFpEF remain unclear.

    Purpose of the Study:

    • To investigate the relationship between abnormal cardiac hemodynamics and cognitive impairment in individuals diagnosed with HFpEF.
    • To compare neurocognitive function across HFpEF, heart failure with reduced ejection fraction (HFrEF), and control groups.

    Main Methods:

    • Secondary analysis of Atherosclerosis Risk in Communities study data.
    • Inclusion of participants without stroke or dementia at visit 5.
    • Comparison of neurocognitive test scores using multivariate models, adjusting for sociodemographics, comorbidities, medications, and echocardiographic measures. Multiple imputation handled missing data.

    Main Results:

    • Individuals with HFpEF demonstrated worse scores in attention, language, executive function, and global cognitive function compared to those without heart failure.
    • No significant differences in neurocognitive scores were found between HFpEF and HFrEF groups.
    • Poorer diastolic function correlated with diminished performance in memory, attention, and language. Higher cardiac index was associated with worse attention test performance.

    Conclusions:

    • Cognitive impairment is prevalent in HFpEF, affecting multiple cognitive domains.
    • The findings underscore the need for cognitive screening in heart failure patients.
    • While an association between abnormal cardiac hemodynamics and cognitive impairment in HFpEF was observed, other contributing factors are likely involved.
    Abstract

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