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Relation between cognitive impairment and blood pressure before psychological stress in right heart failure patients

Session Poster Session 4

Speaker Carlos Zepeda Dominguez

Congress : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure - Clinical
  • Session type : Poster Session
  • FP Number : P2063

Authors : L Pachicano-Romero (Mexico City,MX), V Pelaez-Hernandez (Mexico City,MX), A Orea-Tejeda (Mexico City,MX), GL Luna-Rodriguez (Mexico City,MX), C Pineda-Sanchez (Mexico City,MX), LA Martinez-Bautista (Mexico City,MX), KL Rosales-Castillo (Mexico City,MX), CR Zepeda-Dominguez (Mexico City,MX), L Garcia-Flores (Mexico City,MX), AA Ibarra-Fernandez (Mexico City,MX), A Flores-Vargas (Mexico City,MX), L Hernandez-Urquieta (Mexico City,MX), A Jimenez-Valentin (Mexico City,MX), R Davila-Ramos (Mexico City,MX), MF Salgado-Fernandez (Mexico City,MX)

L Pachicano-Romero1 , V Pelaez-Hernandez1 , A Orea-Tejeda1 , GL Luna-Rodriguez1 , C Pineda-Sanchez1 , LA Martinez-Bautista1 , KL Rosales-Castillo1 , CR Zepeda-Dominguez1 , L Garcia-Flores1 , AA Ibarra-Fernandez1 , A Flores-Vargas1 , L Hernandez-Urquieta1 , A Jimenez-Valentin1 , R Davila-Ramos1 , MF Salgado-Fernandez1 , 1National Institute of Respiratory Disease, Department of Cardiology - Mexico City - Mexico ,


Introduction. Right heart failure (RHF) patients can have dysfunction in several areas, highlighting autonomic and cognitive alterations, due to damage that affects cerebral perfusion and the central nervous system. This syndrome, frequently in comorbidity with COPD, is one of the main type of chronic noncommunicable diseases. However, the characteristics of RHF patients are rarely studied.

Purpose: To describe the relationship between the psychophysiological response of systolic blood pressure (SBP) and diastolic blood pressure (DBP) before psychological stress and cognitive impairment (CI) patients with RHF secondary to COPD.

Methods: Comparative cross-sectional study included 35 patients with RHF participated. They were classified by level of CI with the Montreal Cognitive Assessment (MOCA): Without CI (G1,> 26 points, n=5, 63.57±15.95 years old, 60% men), mild CI (G2, 20-25 points, n=14, 66.16±14.77 years old, 57% women) and moderate CI (G3, <19 points n=16, 66±15.12 years old, 75% women). They were evaluated with a psychophysiological stress profile of three phases of five minutes each with an eight-channel biological feedback system Procomp Infiniti, brand Thought Technology and with Omron baumanometer, model HEM-7320: baseline (BL), arithmetic stressor (AE) and recovery (R), registering SBP and DBP. ANOVA analysis and Pearson test correlation were performed in the SSPS v25 software.

Results: Significant differences were found (p <0.05) between the groups (G1 / G2 / G3) in the SBP during the three phases: BL: 118.77 ± 32.65 / 112.07 ± 12.52 / 139.58 ± 31.31, AE: 122.36 ± 32.78 / 115.20 ± 9.94 /138.91±28.98, R: 115.88 ± 34.08 / 108.47 ± 12.86 / 136.22 ± 28.02. Not so (p< 0.05) in the DBP values: BL: 70.27 ± 12.67 / 71.57 ± 10.09 / 77.79 ± 19.84, AE: 70.26 ± 13.12 / 73.66 ± 13.39 / 80.85 ± 19.33, R: 66.85 ± 14.41 / 67.88 ± 11.71 /75.85±19.75. There was a negative correlation between SBP and MOCA: BL: rP = -.44, p <0.05, AE: rP = -.40, p <0.05, R: rP = -.44, p <0.05. The correlation between DBP and MOCA was not significant (p <0.05).

Conclusions: The higher the SBP the lower the score in the MOCA, indicating higher CI. Patients with higher CI had a psychophysiological pattern less adaptive to psychological stress, with little or no reactivity to the stimulus.

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