title: Neuropsychological profile in a large group of heart transplant candidates.
abstract: BACKGROUND
  Recent studies have reported that patients with end-stage heart disease can have cognitive deficits ranging from mild to severe. Little is known, however, about the relationship between cognitive performance, neurophysiological characteristics and relevant clinical and instrumental indexes for an extensive evaluation of patients with heart failure, such as: left ventricular ejection fraction (LVEF) and other haemodynamic measures, maximum oxygen uptake during cardiopulmonary exercise testing, comorbidities, major cardiovascular risk factors and disease duration. Our purpose was to outline the cognitive profiles of end-stage heart disease patients in order to identify the cognitive deficits that could compromise the quality of life and the therapeutic adherence in end-stage heart disease patients, and to identify the variables associated with an increased risk of cognitive deficits in these patients.
  
  
  METHODS
  207 patients with end-stage cardiac disease, candidates for heart transplant, were assessed by complete neuropsychological evaluation and by electroencephalographic recording with EEG spectral analysis.
  
  
  RESULTS
  Pathological scores in one or more of the cognitive tests were obtained by 86% of the patients, while 36% performed within the impaired range on five or more tests, indicating poor performance across a broad range of cognitive domains. The executive functions were the cognitive domain most impaired (70%). Poor performances were not related to the aetiology of heart disease, but rather to cerebral dysfunction secondary to haemodynamic impairment and to comorbidities.
  
  
  CONCLUSIONS
  Severe heart failure induces significant neurophysiological and neuropsychological alterations, which may produce an impairment of cognitive functioning and possibly compromise the quality of life of patients and the therapeutic adherence.
authors.affiliation: Department of General Psychology, University of Padua, Padua, Italy. daniela.mapelli@unipd.it
authors.forename: Daniela
authors.initials: D
authors.lastname: Mapelli
authors.forename: Lara
authors.initials: L
authors.lastname: Bardi
authors.forename: Marco
authors.initials: M
authors.lastname: Mojoli
authors.forename: Biancarosa
authors.initials: B
authors.lastname: Volpe
authors.forename: Gino
authors.initials: G
authors.lastname: Gerosa
authors.forename: Piero
authors.initials: P
authors.lastname: Amodio
authors.forename: Luciano
authors.initials: L
authors.lastname: Daliento
mesh_terms: D005260:Female; D006331:Heart Diseases / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008570:Memory, Short-Term; D008875:Middle Aged; D009482:Neurophysiology; D009483:Neuropsychological Tests; D016903:Drug Monitoring