title: Cognitive function in patients with decompensated heart failure: the Cognitive Impairment in Heart Failure (CogImpair-HF) study.
abstract: OBJECTIVE
  The objective of this study was to examine cognitive and psychological processes systematically in patients with decompensated chronic heart failure (CHF) and to document changes in cognitive function after compensation. Executive functions, episodic memory, and attention are impaired in patients with stable CHF, influencing health behaviour and disease management. Cognitive function and psychological co-morbidities are associated with hospitalization, disability, and mortality.
  
  
  RESULTS
  Cognitive performance, self-perceived quality of life, and depression were compared in 20 patients with decompensated CHF [ejection fraction (EF) 27 ± 8%, N-terminal pro brain natriuretic peptide (NT-proBNP) 10 880 pg/mL, interquartile range (4495-13 683)] before and after compensation, 20 age- and gender-matched stable CHF patients [New York Heart Association (NYHA) III-IV, EF 32 ± 10%, NT-proBNP 1881 pg/mL (323-1502)], and 20 healthy controls (EF 70 ± 5%). Patients with decompensated CHF showed significantly poorer performance in terms of short-term memory, working memory, executive control, and processing speed (P < 0.05) compared with stable CHF patients. Compensation improved the cognitive performance of decompensated CHF patients up to the level of patients with stable CHF. Compared with healthy controls, both patient groups were affected with respect to episodic memory (P < 0.0001) and fluid intelligence (P < 0.01).
  
  
  CONCLUSIONS
  Decompensated heart failure patients are highly impaired in cognitive functioning, which improves but does not normalize after compensation. Neuropsychological diagnostics delivers important details for daily life activities and might identify individuals deserving special care.
authors.affiliation: Universitätsklinikum des Saarlandes, Klinik für Innere Medizin III (Kardiologie, Angiologie, Internistische Intensivmedizin), Kirrbergerstraße, Homburg/Saar, Germany. ingrid.kindermann@uks.eu
authors.forename: Ingrid
authors.initials: I
authors.lastname: Kindermann
authors.forename: Denise
authors.initials: D
authors.lastname: Fischer
authors.forename: Julia
authors.initials: J
authors.lastname: Karbach
authors.forename: Andreas
authors.initials: A
authors.lastname: Link
authors.forename: Katrin
authors.initials: K
authors.lastname: Walenta
authors.forename: Christine
authors.initials: C
authors.lastname: Barth
authors.forename: Christian
authors.initials: C
authors.lastname: Ukena
authors.forename: Felix
authors.initials: F
authors.lastname: Mahfoud
authors.forename: Volker
authors.initials: V
authors.lastname: Köllner
authors.forename: Michael
authors.initials: M
authors.lastname: Kindermann
authors.forename: Michael
authors.initials: M
authors.lastname: Böhm
mesh_terms: D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology; D003863:Depression / Q000209:etiology* / Q000523:psychology; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000150:complications* / Q000523:psychology; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011788:Quality of Life / Q000523:psychology; D013318:Stroke Volume; D016277:Ventricular Function, Left