Cardiorespiratory Fitness Mediates Cognitive Performance in Chronic Heart Failure Patients and Heart Transplant Recipients.

Miloudza Olmand,Vincent Gremeaux,Louis Bherer,Michel White,Lucie Blondeau,Béatrice Bérubé,Anil Nigam,Mathieu Gayda,Martin Juneau,Christine Gagnon,Florent Besnier,Paula Aver Bretanha Ribeiro

doi:10.3390/ijerph17228591

Abstract

We compared cognitive profiles in chronic heart failure patients (HF), heart transplant recipients (HT) and healthy controls (HC) and examined the relationship between cardiorespiratory fitness (O2peak), peak cardiac output (COpeak) and cognitive performance. Stable HT patients (n = 11), HF patients (n = 11) and HC (n = 13) (61.5 ± 8.5 years) were recruited. Four cognitive composite scores targeting different cognitive functions were computed from neuropsychological tests: working memory, processing speed, executive functions and verbal memory. Processing speed and executive function scores were higher, which indicates lower performances in HF and HT compared to HC (p < 0.05). O2peak and first ventilatory threshold (VT1) were lower in HF and HT vs. HC (p < 0.01). COpeak was lower in HF vs. HT and HC (p < 0.01). Processing speed, executive function and verbal memory performances were correlated with O2peak, VT1 and peak cardiac hemodynamics (p < 0.05). Mediation analyses showed that O2peak and VT1 mediated the relationship between group and processing speed and executive function performances in HF and HT. COpeak fully mediated executive function and processing speed performances in HF only. O2peak and COpeak were related to cognitive performance in the entire sample. In addition, O2peak and VT1 fully mediated the relationship between group and executive function and processing speed performances.

Highlights

Cognitive impairment (CI) affects up to 50% of patients with heart failure (HF) [1]
We examined the relationship between cardiorespiratory fitness, peak output and their mediation on cognitive performance in heart failure patients (HF) and heart transplant recipients (HT) patients compared to healthy controls (HC)
Our results demonstrate that cognitive performance is reduced in HF and HT patients compared to HC, for processing speed and executive function domains

Summary

Introduction

Cognitive impairment (CI) affects up to 50% of patients with heart failure (HF) [1]. It is independently associated with mortality [2], poor quality of life, reduced functional capacity [3] and an overwhelming economic burden in Western countries [4,5]. HF-related CI is correlated with the severity of the disease [6]. Mainly affects episodic memory, executive functions and processing speed [7]. Res. Public Health 2020, 17, 8591; doi:10.3390/ijerph17228591 www.mdpi.com/journal/ijerph

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