Key result
HFpEF was associated with worse scores on tests of attention, language, executive function, and global cognitive function compared to no heart failure, though not significantly different from HFrEF.
Why the study?
Cognitive impairment is prevalent in heart failure and associated with higher mortality, but the mechanism behind it in HFpEF has not been established.
Are abnormal cardiac hemodynamics associated with cognitive impairment in individuals with HFpEF compared to those with HFrEF or no heart failure?
Observational
Yes
Are abnormal cardiac hemodynamics associated with cognitive impairment in individuals with HFpEF compared to those with HFrEF or no heart failure?
Cognitive impairment is prevalent in HFpEF across multiple domains and is weakly associated with abnormal cardiac hemodynamics, highlighting the importance of cognitive screening in heart failure patients.
Answers are grounded in this paper and cite their sources.
May warrant cognitive screening in HF; leaves open hemodynamic causality in HFpEF.
BACKGROUND: Cognitive impairment is prevalent in heart failure and is associated with higher mortality rates. The mechanism behind cognitive impairment in heart failure with preserved ejection fraction (HFpEF) has not been established. OBJECTIVE: The aim of this study was to evaluate associations between abnormal cardiac hemodynamics and cognitive impairment in individuals with HFpEF. METHODS: A secondary analysis of Atherosclerosis Risk in Communities (Atherosclerosis Risk in Communities) study data was performed. Participants free of stroke or dementia who completed in-person assessments at visit 5 were included. Neurocognitive test scores among participants with HFpEF, heart failure with reduced ejection fraction (HFrEF), and no heart failure were compared. Sociodemographics, comorbid illnesses, medications, and echocardiographic measures of cardiac function that demonstrated significant (P < .10) bivariate associations with neurocognitive test scores were included in multivariate models to identify predictors of neurocognitive test scores among those with HFpEF. Multiple imputation by chained equations was used to account for missing values. RESULTS: Scores on tests of attention, language, executive function, and global cognitive function were worse among individuals with HFpEF than those with no heart failure. Neurocognitive test scores were not significantly different among participants with HFpEF and HFrEF. Worse diastolic function was weakly associated with worse performance in memory, attention, and language. Higher cardiac index was associated with worse performance on 1 test of attention. CONCLUSIONS: Cognitive impairment is prevalent in HFpEF and affects several cognitive domains. The current study supports the importance of cognitive screening in patients with heart failure. An association between abnormal cardiac hemodynamics and cognitive impairment was observed, but other factors are likely involved.
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Faulkner et al. (2020) conducted an observational in Heart failure with preserved ejection fraction (HFpEF). Heart failure with preserved ejection fraction (HFpEF) and abnormal cardiac hemodynamics vs. Heart failure with reduced ejection fraction (HFrEF) and no heart failure was evaluated on Neurocognitive test scores (attention, language, executive function, and global cognitive function). HFpEF was associated with worse scores on tests of attention, language, executive function, and global cognitive function compared to no heart failure, though not significantly different from HFrEF.
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