Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Oct 4;12(10):e0184981.
doi: 10.1371/journal.pone.0184981. eCollection 2017.

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

Mi-Seung Shin  1 , Minjeong An  2 , Sunhwa Kim  3 , Jae Lan Shim  3 , Jin-Kyu Park  4 , JinShil Kim  5
Affiliations

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

Mi-Seung Shin et al. PLoS One. .

Abstract

Background: 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.

Methods and results: 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).

Conclusions: 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.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. Leto L, Feola M. Cognitive impairment in heart failure patients. J Geriatr Cardiol. 2014; 11(4): 316–28. doi: 10.11909/j.issn.1671-5411.2014.04.007 - DOI - PMC - PubMed
    1. Pressler SJ, Subramanian U, Kareken D, Perkins SM, Gradus-Pizlo I, Sauvé MJ, et al. Cognitive deficits in chronic heart failure. Nurs Res.2010; 59(2): 127–39. doi: 10.1097/NNR.0b013e3181d1a747 - DOI - PMC - PubMed
    1. Gure TR, Blaum CS, Giordani B, Koelling TM, Galecki A, Pressler SJ, et al. Prevalence of cognitive impairment in older adults with heart failure. J Am Geriatr Soc.2012; 60(9): 1724–29. doi: 10.1111/j.1532-5415.2012.04097.x - DOI - PMC - PubMed
    1. Eggermont LH, de Boer K, Muller M, Jaschke AC, Kamp O, Scherder EJ. Cardiac disease and cognitive impairment: a systematic review. Heart.2012; 98(18):1334–40. doi: 10.1136/heartjnl-2012-301682 - DOI - PubMed
    1. Ausili D, Rebora P, Di Mauro S, Riegel B, Valsecchi MG, Paturzo M, et al. Clinical and socio-demographic determinants of self-care behaviours in patients with heart failure and diabetes mellitus: A multicentre cross-sectional study. Int J Nurs Stud.2016; 63:18–27. doi: 10.1016/j.ijnurstu.2016.08.006 - DOI - PubMed