Cognition in Chronic Heart Failure: Advancing Knowledge for Better Prevention Through Remote Assessment

Background Cognitive impairment is an important comorbidity of chronic heart failure and may be associated with major complications. Despite ongoing advances in research and clinical management, early identification and prevention of cognitive impairment remain challenging. This study aims to provide a comprehensive description of the cognitive profile of participants with chronic heart failure using baseline data from the SYNAPSE trial. Method Fifty-three participants with chronic heart failure (age 68.58 ± 9.26; 54.7% men; 64% HFrEF with LVEF of 32.43%) who were approached and agreed to participate in the SYNAPSE trial and underwent a remote baseline neuropsychological assessment of global cognition, working and short-term memory, episodic memory, executive functioning and abstraction. Scores were computed in standardized z-scores that consider age, sex, and education, based on normative data. Results Sixty-eight percent of participants had impaired (-1.5 standard deviations from the population norms) in at least one cognitive domain. Episodic memory and executive functioning were mainly affected. Among those with no impairment, 26% of participants presented scores that fell within the low average of the population (-0.66 standard deviations). No cognitive differences were observed between men and women, or between different chronic heart failure phenotypes. Conclusions The results underline the importance of neuropsychological assessment in chronic heart failure patients. Mild cognitive impairment in chronic heart failure patients is prevalent, but even more patients are susceptible of subclinical cognitive weakness. Prevention and treatment of these deficits are of major importance for optimal disease management.