CHARACTERISTICS OF COGNITIVE FUNCTIONS DURING THE RECOVERY PERIOD AFTER ISCHEMIC STROKES IN PATIENTS WITH IMPAIRED CARDIAC RHYTHM AND CONDUCTION

Abstract

Introduction. Disturbances of cardiac rhythm and conduction are risk factors for cognitive impairments.
 Aim: to determine peculiarities of the cognitive status in patients with impaired heart rhythm and conduction during the recovery period after ischemic non-lacunar strokes.
 Material and methods. This study included 52 patients with atrial fibrillation, 18 patients with atrioventricular block 2-3 degrees, and 24 patients with sinus rhythm who had an ischemic non-lacunar stroke during the last 6 months. Cognitive status was measured using the MMSE, MoCA, ADAS-cog scales, the Clock Drawing Test, the “5 Words” test, and the frontal assessment battery.
 Results. According to the MoCA scale, patients with atrial fibrillation and atrioventricular block were significantly more often diagnosed with post-stroke cognitive impairments (71.2% and 77.8%, respectively) compared with patients having sinus rhythm (37.5%). Among patients with cognitive impairments by the MoCA scale, the presence of atrial fibrillation was associated with a significant decrease in MoCA scale scores, compared with sinus rhythm (18.0 (17.0-22.0) versus 22.0 (18.0-23.0)). In patients with sinus rhythm, the clock-drawing test had higher scores (8.0 (7.0-9.0)) compared to cases with atrial fibrillation (7.0 (5.8-8.0)). Patients with sinus rhythm had higher values of the frontal assessment battery (15.0 (14.0-15.0)) compared to atrial fibrillation (13.0 (12.0-14.0)) and atrioventricular blocks (14.0 (13.0- 15.0)).
 Conclusions. During the first 6 months after schemic non-lacunar strokes, patients with impaired heart rhythm and conduction demonstrated a significant prevalence of cognitive impairments by the MoCA scale and significantly worse scores of cognitive tests for executive functions.