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Mild cognitive impairment is associated with subclinical diastolic dysfunction in patients with chronic heart disease
Sacre, Julian W. Ball, Jocasta Wong, Chiew Chan, Kai Stewart, Simon Kingwell, Bronwyn A. Carrington, Melinda
Sacre, Julian W.
Ball, Jocasta
Wong, Chiew
Chan, Kai
Stewart, Simon
Kingwell, Bronwyn A.
Carrington, Melinda
Abstract
Background: To examine mild cognitive impairment and its associations with subclinical cardiac dysfunction in patients with chronic heart disease yet to develop the clinical syndrome of chronic heart failure (CHF). Methods and results: Patients from the Nurse-led Intervention for Less Chronic Heart Failure Study (n = 373 with chronic heart disease other than CHF; 64 ± 11 years, 69% men) were screened for mild cognitive impairment [Montreal cognitive assessment (MoCA) score < 26] and underwent echocardiographic/clinical profiling. We investigated associations of mild cognitive impairment and MoCA cognitive domain subscores with global cardiac status (‘normal’ vs. ‘diastolic dysfunction’ vs. ‘other cardiac abnormality’) and individual echocardiographic parameters. Patients with mild cognitive impairment (n = 161; 43%) demonstrated a higher age-adjusted prevalence of diastolic dysfunction (37% vs. 24%; P < 0.05). Multivariate logistic regression (adjusted for age, sex, and other relevant clinical factors) indicated that the odds of mild cognitive impairment were two-times higher with diastolic dysfunction (P = 0.030) and 1.7-times higher with ‘other cardiac abnormalities’ (P = 0.082) vs. normal cardiac status. In turn, mild cognitive impairment was predicted by left-ventricular (LV) filling pressure (based on the ratio of early diastolic filling and annular velocities; adjusted odds ratio 1.07 per unit increase, P = 0.022), but not LV structural parameters. Specific deficits in the cognitive domains of executive functioning and visuo-constructional abilities were also independently predicted by diastolic dysfunction (P < 0.05). Conclusion: Mild cognitive impairment is prevalent in patients with subclinical chronic heart disease at high-risk of CHF. Independent associations with LV diastolic dysfunction suggest a link between cardiac and cognitive functioning beyond shared risk factors.
Keywords
Date
2018
Type
Journal article
Journal
European Heart Journal: Cardiovascular Imaging
Book
Volume
19
Issue
3
Page Range
285-292
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
Open access
License
File Access
Controlled