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Prognostic value of cognitive tests in chronic heart failure with reduced left ventricular ejection fraction

Session Poster Session 3

Speaker Anastasiia Solonovych

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Comorbidities
  • Session type : Poster Session

Authors : A Solonovych (Kiev,UA), A V Liashenko (Kiev,UA), I L Revenko (Kiev,UA), L G Voronkov (Kiev,UA)

Authors:
A Solonovych1 , A V Liashenko1 , I L Revenko1 , L G Voronkov1 , 1NSC Institute of Cardiology M.D. Strazhesko, Heart Failure Department - Kiev - Ukraine ,

Citation:

Background. Cognitive impairment (CI) is the most common co-morbidity in patients (pts) with chronic heart failure (CHF). CI is an important factor which reduces quality of life, adherence to therapy and, consequently, clinical prognosis in this pts. Nevertheless, prognostic informativity of different cognitive tests and their combination remains unclear.

Purpose.  to study the prognostic meaning of different cognitive tests and their combinations in pts with CHF and reduced left ventricular ejection fraction (rLV EF).

Methods. 124 stable CHF pts aged 18 to 75 years NYHA II-IV were examined. Cognitive function was assessed by using standard MMSE, Shulte tests and the HADS questionnaire. CI was defined as MMSE= 26 points. The observation period was 27,5 months. All-cause mortality and combined death-or-readmission event were estimated by Kaplan-Meier curves.

Results. It was shown that the MMSE has high validity related to prediction of survival and the onset of combined death-or-readmission event in pts with CHF and rLV EF (p=0.043 and p=0.026, respectively). After adjustment the compared groups by age and NYHA class the above-mentioned statistically significant differences were preserved (p = 0.025 and p = 0.049, respectively).  Schulte test showed low predictive value related to survival and reliable validity - to combined death-or-readmission event, which, however, was reduced after age and NYHA class adjustment (p = 0.798 and p = 0.240, respectively). Inclusion in the predictive algorithm the HADS depression subscale allowed to increase the significance of differences in survival and the onset of combined death-or-readmission event (p = 0.006 and p = 0.001, respectively) between CI and non-CI pts.

Conclusion. MMSE scale is informative regarding the prediction of survival and the onset of combined death-or-readmission event in patients with CHF and rLVEF even after adjustment the compared groups by age and NYHA class. Schulte test does not have above-mentioned prognostic informativity. However, inclusion in the prognostic algorithm HADS depression subscale increases statistical confidence in the compared groups.

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