Sacre JW, et al. – In this current study, researchers determined mild cognitive impairment and its relations to subclinical cardiac dysfunction in patients with chronic heart disease yet to develop the clinical syndrome of chronic heart failure (CHF). Findings reported a prevalence of mild cognitive impairment in patients with subclinical chronic heart disease at high–risk of CHF. In addition, data showed independent associations with left-ventricular (LV) diastolic dysfunction that indicated a link between cardiac and cognitive functioning beyond shared risk factors.

Methods

• Researchers screened 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) for mild cognitive impairment [Montreal cognitive assessment (MoCA) score <26] and these patients underwent echocardiographic/clinical profiling.
• They assessed 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.

Results

• Findings revealed that patients with mild cognitive impairment (n = 161; 43%) demonstrated a higher age-adjusted prevalence of diastolic dysfunction (37% vs. 24%; P < 0.05).
• Researchers found that 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.
• Results showed that specific deficits in the cognitive domains of executive functioning and visuo-constructional abilities were also independently predicted by diastolic dysfunction (P < 0.05).