scholarly journals Clinical and hemodynamic predictors of cognitive dysfunction in patients with coronary heart disease

2020 ◽  
Vol 26 (6) ◽  
pp. 38-52
Author(s):  
O. O. Nudchenko ◽  
M. M. Dolzhenko
Keyword(s):  
Cognitive Function ◽  
Diastolic Function ◽  
Left Atrium ◽  
Cognitive Dysfunction ◽  
Negative Correlation ◽  
Glycated Hemoglobin ◽  
Mmse Score ◽  
Left Ventricular ◽  
Myocardial Mass ◽  
Left Ventricular Myocardial Mass

The aim – to determine the clinical and hemodynamic risk factors for the development of cognitive dysfunction in patients with coronary heart disease.Materials and methods. 110 patients with a history of acute myocardial infarction, unstable angina pectoris, or coronary artery revascularization were included in the study. Depending on the diastolic function, the patients were divided into three groups: I group – normal diastolic function, II group – impaired relaxation, III group – pseudonormalization or restriction. Cognitive function was assessed on the MMSE, MoCA scales, Frontal Assessment Battery (FAB), Trial Making Test and Rey audio-verbal test.Results and discussion. The average number of points on the MMSE scale with an increase in the severity of diastolic dysfunction (DD) decreased and amounted to 25.40±2.58 in the I group, 24.95±2.69 in the II group, and 22.30±3.17 in the III group (p1,3<0.0001, p2,3=0.001); on the MoCA scale it equaled to 23.47±3.41 in the I group, 22.09±3.48 in the II group and 19.85±5.19 in the III group (p1,2=0.039, p1,3=0.004, p2,3>0.05). A negative correlation of average degree (r=–0.35, p<0.05) between MMSE score and the type of DD was revealed, and a negative correlation of the strong degree (r=–0.50, p<0.00001) – between MMSE score and left ventricular filling pressure (LVFP). The MoCA scale showed a moderate degree negative correlation (r=–0.30, p=0.0018) with DD and a strong degree negative correlation (r=–0.41, p<0.05) with LVFP. A negative correlation of a weak degree was also revealed between the score on the FAB and LVFP (r=–0.24, p<0.05). It was found that the number of points on the MMSE scale reliably correlates with smoking status, left atrium indexed volume and left ventricular myocardial mass index (r=0.23, r=–0.25, r=–0.25, respectively). The values of the left atrium volume index and left ventricular myocardial mass index correlated with the score on the MoCA scale (r=–0.25, r=–0.18, respectively). The likelihood of development of cognitive dysfunction increased with an increase in glycated hemoglobin (OR 2.65, 95 % CI 1.08–6.48, p=0.033), diastolic function worsening (OR 3.18, 95 % CI 1.18–8.59, p=0.023) and an increase in LVFP (OR 6.03, 95 % CI 2.32–15.69, p=0.0002) on the MMSE scale, and with a worsening of diastolic function (OR 2.86, 95 % CI 1.18–6.94, p=0.020) on the MoCA scale. According to the results of direct multiple logistic regression, it was revealed that among all the indicators, only LVFP significantly affected the total number of points on the MMSE scale (OR 1.28, 95 % CI 1.11–1.47, p=0.0007).Conclusions. It was revealed that the diastolic function has a significant influence on the state of cognitive function. A negative correlation was noted between the type of DD, LVFP, and the scores on the scales of cognitive functions. The likelihood of cognitive dysfunction on the MMSE scale increased with an increase in glycated hemoglobin, diastolic function worsening, increase in LVFP, diastolic function worsening (on the MoСA scale). According to the results of multiple regression, only LVFP significantly affected the total number of points on the MMSE scale.

scholarly journals Study of cognitive functions in major idiopathic interstitial pneumonias

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Mohamed W. Zakaria ◽  
Reem I. El-Korashy ◽  
Mostafa O. Shaheen ◽  
Samah Selim ◽  
Kwashi J. Amum
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Mini Mental State Examination ◽  
Mmse Score ◽  
Control Group ◽  
Healthy Individuals ◽  
Co Morbidity ◽  
Impaired Lung Function ◽  
State Examination

Abstract Background Cognitive dysfunction in idiopathic interstitial pneumonia (IIP) is an important clinical co-morbidity that is associated with impaired lung function. The aim of the work is to assess cognitive function in major IIP and to find out the relation between cognitive dysfunction and the oxygenation parameters. Results Fifty individuals were involved in the study; 30 patients with major IIP and 20 healthy individuals. Patients with IIP had significantly lower mini mental state examination (MMSE) score compared to the control group (P < 0.001). Wechsler Deterioration Index (WDI) revealed that 33.3% (n = 10) of the patients with IIP had sure cognitive impairment and 26.6% (n = 8) had ongoing cognitive deterioration. Patients with idiopathic pulmonary fibrosis (IPF) had lower cognitive function than other IIP. Conclusion There is an impairment of cognitive function in patients with major IIP, particularly in IPF, as measured by WDI and MMSE. Further large studies are needed to assess the possible predictors of cognitive impairment and their effects on the patients’ outcome.

scholarly journals P1829CARDIOVASCULAR DISORDERS IN CHILDREN WITH CHRONIC KIDNEY DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Aigul Nugmanova ◽  
Nuriya Meriken ◽  
Saule Dikanbayeva ◽  
Zeinep Zhumagulova ◽  
Zhuldyz Baidauletova ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Clinical Laboratory ◽  
Interventricular Septum ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Myocardial Mass ◽  
Cardiac Events ◽  
Initial Stage ◽  
Echocardiographic Examination ◽  
Left Ventricular Myocardial Mass

Abstract Background and Aims Pathology of the cardiovascular system is the leading cause of death in patients with CKD, while determining the causes of the formation of cardiac events is often difficult. Method We conducted an analysis of echocardiography data performed by 50 children with CKD. On the echoCG, the final systolic and diastolic sizes of the left ventricle (FSS and FDS), the final systolic and diastolic volumes of the left ventricle (FSV and FDV) were determined; measured the thickness of the interventricular septum (IVS) and the posterior wall of the left ventricle (PWLV). Left ventricular myocardial mass (LVMM) was determined by the formula proposed by R. Devereux and N. Reichek: LVMM = 1.04x (/ IVS+PWLV+FDS/3-FDS3) - 13.6where, IVS - thickness of IVS in diastole,PWLV-thickness of PWLV in diastole, FDS-final diastolic size of the left ventricle. Results We conducted an analysis of echocardiography data performed by 50 children with CKD. On the echoCG, the final systolic and diastolic sizes of the left ventricle (FSS and FDS), the final systolic and diastolic volumes of the left ventricle (FSV and FDV) were determined; measured the thickness of the interventricular septum (IVS) and the posterior wall of the left ventricle (PWLV). Left ventricular myocardial mass (LVMM) was determined by the formula proposed by R. Devereux and N. Reichek: LVMM = 1.04x (/ IVS+PWLV+FDS/3-FDS3) - 13.6where, IVS - thickness of IVS in diastole,PWLV-thickness of PWLV in diastole, FDS-final diastolic size of the left ventricle. Conclusion The mechanisms of damage to the heart and blood vessels in patients with CKD begin to function already in the initial stage of renal failure and increase as it progresses. The need to know the data of clinical, laboratory and instrumental examination methods at the terminal stage of CKD is dictated, first of all, by the possibility of exposure to them. An important stimulus for conducting an echocardiographic examination is the early detection and correction of cardiovascular disorders, in connection with the prospect of increasing the survival of patients after kidney transplantation.

Abstract 15469: Malnutrition and Cognitive Dysfunction in the Elderly Patients With Acute Heart Failure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Michiaki NAGAI ◽  
Keigo Dote ◽  
Masaya Kato ◽  
Noboru Oda ◽  
Eiji Kunita ◽  
...  
Keyword(s):  
Heart Failure ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Cognitive Dysfunction ◽  
Mmse Score ◽  
The Elderly ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Stable Phase ◽  
Conut Score

Introduction: Malnutrition, cognitive decline and heart failure (HF) frequently coexist in the elderly. A recent systematic review revealed that malnutrition was a possible contributing factor of cognitive impairment. Although several studies reported the association of malnutrition with poor HF prognosis, the underlying pathophysiology has been unclear. Hypothesis: We assessed the hypothesis that malnutritional status might be associated with cognitive dysfunction in the elderly with HF. In addition, we investigated whether left ventricular ejection fraction (LVEF) moderates that relationship or not. Methods: Nutritional status and cognitive function were evaluated using the geriatric nutritional risk index (GNRI), controlling nutritional status (CONUT) score and mini-mental state examination (MMSE) in 245 elderly inpatients in stable phase of HF (82.9±6.0 years old, male 49.4%). Echocardiography was performed at admission. HF with preserved EF (HFpEF) was defined according to LVEF more than 50% (n=129). Results: According to the quartile of MMSE score (< 19, ≥19 to 27≤, >27), significant associations of MMSE score were observed with GNRI (89.1 vs 95.4 vs 95.5, p=0.004) and CONUT score (3.50 vs 2.71 vs 2.61, p=0.039) among three groups. In the logistic regression analysis adjusted for the confounders including age, gender, LVEF, brain natriuretic peptide level, systolic blood pressure at admission, diuretics and antihypertensive medication use, GNRI (β=0.96, 95%CI:0.93 to 0.99, p=0.008) and CONUT score (β=1.18, 95%CI:1.01 to 1.37, p=0.03) each was significantly associated with cognitive dysfunction (defined as MMSE score <19). According to the HF phenotype, GNRI (β=0.93, 95%CI:0.88 to 0.98, p=0.01) and CONUT (β=1.55, 95%CI:1.19 to 2.02, p=0.001) each had a significant relationship with cognitive dysfunction only in the group without HFpEF. Conclusions: In conclusion , lower GNRI and higher CONUT score were shown to be significant indicators of cognitive dysfunction in the elderly HF patients. These results highlight the importance of stratifying by nutritional status for a clinical intervention of cognitive dysfunction in the elderly patients without HFpEF.

576 Green Tea Reduces Left Ventricular Myocardial Mass in Patients with Transthyretin Amyloidosis

2011 ◽  
Vol 30 (4) ◽  
pp. S193 ◽  
Author(s):  
A.V. Kristen ◽  
S. Lehrke ◽  
D. Mereles ◽  
P.A. Schnabel ◽  
C. Röcken ◽  
...  
Keyword(s):  
Green Tea ◽  
Left Ventricular ◽  
Myocardial Mass ◽  
Transthyretin Amyloidosis ◽  
Left Ventricular Myocardial Mass

scholarly journals The Association between Cognitive Impairment and Diabetic Foot Care: Role of Neuropathy and Glycated Hemoglobin

2020 ◽  
Vol 27 (1) ◽  
pp. 14-27
Author(s):  
Lorenzo Brognara ◽  
Iacopo Volta ◽  
Vito Michele Cassano ◽  
Emmanuel Navarro-Flores ◽  
Omar Cauli
Keyword(s):  
Diabetes Mellitus ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Glycemic Control ◽  
Cognitive Dysfunction ◽  
Cognitive Functions ◽  
Diabetic Foot ◽  
Glycated Hemoglobin ◽  
Diabetic Patients ◽  
Adherence To Treatment

Diabetes mellitus is associated with impairment in cognitive functions which can complicate adherence to self-care behaviors. We evaluated the incidence of cognitive impairment in patients with diabetes mellitus to determine the strength of the association between diabetic foot (a complication that occurs in about 10% of diabetic patients), adherence to the clinician’s recommendations, glycemic control, and cognitive function. A prospective study was carried out in a probabilistic sample of older patients with diabetic foot living in three nursing homes. Cognitive functions were evaluated by the MMSE (Mini-Mental State Examination), the Trail Making test (TMT), and the Michigan neuropathy screening instrument (MNSI). There were no significant associations between cognitive function and neuropathy or foot alterations, although glycated hemoglobin (HB1Ac > 7%) significantly (p < 0.05) associated with MMSE and adherence to treatment in the 1 month follow-up visit. Receiver operating characteristic curve analysis showed that both HB1Ac and the MNSI score significantly (p < 0.05) discriminate subsequent adherence to treatment for foot complication, with a sensitivity of 80.0–73.3% and specificity 70.6–64.7%, respectively. Proper control of foot complications in diabetic patients involves appropriate glycemic control and less severe neuropathy, and seems to be unrelated to cognitive dysfunction, and warrants further studies in order to tailor appropriate treatments to central and peripheral nervous system disorders. Poor glycemic control (Hb1Ac level > 7%) and a neuropathy score of 5.5 in the MNSI are the best-cut off points to discriminate poor adherence to the clinician’s recommendations for self-care behaviors in people with diabetic foot complication. In this study, we observed that foot disorders were associated with impaired global cognitive function in elderly patients (aged ≥ 65). Podiatrists and physicians should consider cognitive dysfunction as an important chronic complication in the management of diabetic foot.

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