[Cognitive impairment and compliance in chronic heart failure]. / Kognitivnye narusheniia i priverzhennost' lecheniiu u patsientov s khronicheskoi serdechnoi nedostatochnost'iu.

AIM: To determine the factors of cognitive impairment and non-compliance in patients with chronic heart failure (CHF). MATERIAL AND METHODS: One hundred and fifty-seven patients with CHF and 32 patients without chronic heart failure (controls) were examined. Neuropsychological assessment using a 30-minutes protocol recommended by NINDS-Canadian Stroke Standards (NINDS CSS), magnetic resonance imaging, cognitive ERP and a test of compliance were used. RESULTS AND CONCLUSION: Approximately 62% of patients did not perform medical prescriptions. Non-compliance was associated with an increase in the severity of subcortical and perivenricular leukoaraiosis, a slowdown in decision-making processes (an increase in the P300 latency), worse performance on speech activity tests, optical/spatial and frontal dysfunctions and memory. Patients with non-compliance had frontal cognitive impairment (58%), memory impairment (40%) and mixed forms (21%). Cognitive impairment in patients with chronic heart failure was associated with the lower left ventricular ejection fraction and deterioration in indices of diastolic function.

[Cognitive functions in patients with chronic heart failure].

OBJECTIVE: To evaluate cognitive functions in patients with different stages of chronic heart failure (CHF) and different degrees of stenosis of precerebral arteries. MATERIAL AND METHODS: Authors examined 148 patients with CHF and 21 patients without CHF (controls). Neuropsychological assessment (NINDS-Canadian Stroke Standards - 30 minutes protocol), ultrasound scanning of the main cranial arteries and transcranial dopplerography and echocardiogram were made. RESULTS AND CONCLUSION: Patients with CHF more frequently had combined (multifocal) cognitive impairment. Patients with systolic heart failure performed significantly worse on neuropsychological tests, in particular, functional domains within the frontal lobes and "executive" dysfunction, than those with diastolic heart failure. Cognitive impairment in patients with CHF was associated with the lower left ventricular ejection fraction and deterioration in indices of diastolic function but not with carotid artery stenosis.