title: Effect of Permanent Atrial Fibrillation on Cognitive Function in Patients With Chronic Heart Failure.
abstract: In patients with chronic heart failure (HF), cognitive impairment (CI) is associated with poorer treatment adherence and higher readmission and mortality rates. Previous studies suggest that atrial fibrillation (AF) could impair cognitive function. This study sought to assess the association between permanent AF (permAF) and CI in patients with HF. We evaluated cognitive function in 881 patients with stable HF (73 ± 11 years, 44% women, 48% with preserved ejection fraction) using the Mini-Mental State Examination test (n = 876) and the Pfeiffer's Short Portable Mental Status Questionnaire (n = 848). CI was defined as a Mini-Mental State Examination score <24 or Short Portable Mental Status Questionnaire (errors) >2. The independent association between permAF and CI was assessed by binary logistic regression analysis. A total of 295 patients (33.5%) had CI, in 5.1% of cases moderate/severe. Patients with permAF had more frequently any degree of CI (43% vs 31%), and moderate/severe CI (8% vs 5%). In the multivariate analysis, CI was associated with permAF (odds ratio 1.54, 95% C.I. 1.05 to 2.28), an older age, female gender, diabetes mellitus, chronic kidney disease, previous stroke, New York Heart Association class III/IV, and lower systolic blood pressure. No interaction was found for AF and CI between patients with reduced and preserved ejection fraction. In conclusion, the presence of permAF is independently associated with CI in patients with HF, both with reduced and preserved ejection fraction. Given the clinical impact of CI in the HF population, active assessment of cognitive function is particularly warranted in patients with HF with permAF.
authors.affiliation: School of Medicine, Department of Medicine, Universitat Pompeu Fabra/Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Coma
authors.affiliation: Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Maria Jesús
authors.initials: MJ
authors.lastname: González-Moneo
authors.affiliation: Cardiology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; Heart Diseases Biomedical Research Group, Inflammatory and Cardiovascular Disorders Program, Hospital del Mar Medical Research Insititute (IMIM), Parc de Salut Mar, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Enjuanes
authors.affiliation: Cardiology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.
authors.forename: Paula Poveda
authors.initials: PP
authors.lastname: Velázquez
authors.affiliation: Cardiology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.
authors.forename: Deva Bas
authors.initials: DB
authors.lastname: Espargaró
authors.affiliation: Cardiology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.
authors.forename: Bernardo Andrés
authors.initials: BA
authors.lastname: Pérez
authors.affiliation: Heart Diseases Biomedical Research Group, Inflammatory and Cardiovascular Disorders Program, Hospital del Mar Medical Research Insititute (IMIM), Parc de Salut Mar, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Tajes
authors.affiliation: Heart Diseases Biomedical Research Group, Inflammatory and Cardiovascular Disorders Program, Hospital del Mar Medical Research Insititute (IMIM), Parc de Salut Mar, Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Garcia-Elias
authors.affiliation: Cardiology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; Heart Diseases Biomedical Research Group, Inflammatory and Cardiovascular Disorders Program, Hospital del Mar Medical Research Insititute (IMIM), Parc de Salut Mar, Barcelona, Spain.
authors.forename: Núria
authors.initials: N
authors.lastname: Farré
authors.affiliation: Group of Neurofunctionality of Brain and Language, Neuroscience Research Program, Hospital del Mar Medical Research Insititute (IMIM), Parc de Salut Mar, Barcelona, Spain.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Sánchez-Benavides
authors.affiliation: School of Medicine, Department of Medicine, Universitat Pompeu Fabra/Universitat Autònoma de Barcelona, Barcelona, Spain; Cardiology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; Heart Diseases Biomedical Research Group, Inflammatory and Cardiovascular Disorders Program, Hospital del Mar Medical Research Insititute (IMIM), Parc de Salut Mar, Barcelona, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Martí-Almor
authors.affiliation: School of Medicine, Department of Medicine, Universitat Pompeu Fabra/Universitat Autònoma de Barcelona, Barcelona, Spain; Cardiology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; Heart Diseases Biomedical Research Group, Inflammatory and Cardiovascular Disorders Program, Hospital del Mar Medical Research Insititute (IMIM), Parc de Salut Mar, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Comin-Colet
authors.affiliation: Cardiology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; Heart Diseases Biomedical Research Group, Inflammatory and Cardiovascular Disorders Program, Hospital del Mar Medical Research Insititute (IMIM), Parc de Salut Mar, Barcelona, Spain. Electronic address: bbenito@pardesalutmar.cat.
authors.forename: Begoña
authors.initials: B
authors.lastname: Benito
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications* / Q000503:physiopathology; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000503:physiopathology; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013318:Stroke Volume