Cognitive impairment in patients with coronary arteries disease and diastolic dysfunction

Abstract

Aim of the study – to assess the prevalence of cognitive impairment in patients with coronary heart disease and determine the relationship between the presence of cognitive impairment and left ventricular diastolic dysfunction.Materials and methods. 110 patients with a history of acute myocardial infarction, unstable angina, or revascularization of the coronary arteries were included. Depending on the diastolic function, the patients were divided into three groups: Group I – normal diastolic function; Group II – diastolic dysfunction, impaired relaxation; Group III – pseudonormalization or restriction patterns of diastolic dysfunction. The level of cognitive functions was determined according to the MMSE, MoCA scales, and the frontal assessment battery (FAB) scale.Results. The were no significant differences in age, duration of cardiovascular diseases, the levels of systolic and diastolic blood pressure in office measurement, lipidogram indices between groups. A significant difference between in the left ventricular mass index, diameter and left atrium volume index, end-diastolic and end-systolic volume indexes between groups was noted. The left ventricular ejection fraction was significantly higher in group I compared with groups II and III. Assessment of cognitive function by the MMSE scale showed, that 17.6 % of patients have no cognitive impairment. Mild cognitive impairment was detected in 51.9 % of patients, mild dementia was detected in 25 %, and moderate dementia - in 5.5 % of the examined. On the MoCA scale, cognitive impairment was observed in 74 % of patients. In the first group, the average score on the MMSE scale was 25.45±2.62, in the second - 24.95±2.69, in the III - 22.30±3.17 (p1.3 <0.0001, p2.3 <0.0005). On the MoCA scale, the corresponding values were 15.66±1.95, 15.47±2.30, 14.35±3.45 (p1.3=0.01, p2.3 <0.05). Average scores on the FAB scale did not differ significantly between groups. A significant negative correlation of the average degree between the indicator E/e’ and scores on the MMSE, MoCA and FAB scales was found (r=-0.51, r=-0.42, r=-0.41, respectively).Conclusions. Cognitive impairment occurs in 92.4 % of patients with coronary artery disease. The presence of diastolic dysfunction of pseudonormalization or restriction patterns is associated with significantly worse indicators of cognitive function, while the indicator E/e’, that reflects left ventricle filling pressure, significantly correlates with scores on the scales of cognitive impairment.