ArticleEuropean journal of medical research2019
Effects of MitraClip on cognitive and psychological function in heart failure patients: the sicker the better.
Article in European journal of medical research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Cognitive impairment in patients with heart failure: molecular mechanism and therapy.Heart failure reviews · 2023Review
- Cognitive Dysfunction in Heart Failure: Pathophysiology and Implications for Patient Management.Current heart failure reports · 2022Review
- Dynamics of Cognitive Function in Patients with Heart Failure Following Transcatheter Mitral Valve Repair.Journal of clinical medicine · 2022Article
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Authors and funding
11 authors.
Funding
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Abstract
purposeCognitive impairment and reduced quality of life is a common condition in patients with heart failure (HF). Percutaneous mitral valve repair using (PMVR) MitraClip (MC) has emerged as a promising interventional tool, reducing all-cause mortality and hospitalization as well as increasing cognitive functioning and quality of life. However, the benefit of HF patients with severely depressed cognitive functioning remains unknown.
methodsWe assessed cognitive functioning (figural memory-FGT, executive function-TOL, TMT B), psychosocial functioning (depression-PHQ-9, quality of life-SF36), and clinical parameters (echocardiography, 6-min walk test distance, and cardiac biomarkers) 1 day before (t0) and 6 weeks after (t1) MC intervention in HF patients (n = 40). First, paired sample t tests were conducted to uncover improvements in cognitive functioning post-MC intervention. Second, the COGBAT Norm-sample, a representative age-matched healthy sample, was used to compare participants' individual scores. Third, bivariate linear regressions were calculated for all key predictors of the detected improvements in cognitive functioning post-MC intervention (t1-t0).
resultsFollowing the MC intervention, we found significant improvements in figural memory, executive functioning, and psychosocial functioning. Most of the patients with depressed executive functioning before the MC intervention showed post-intervention test scores within the normal range (> 50th percentile; t0 22.5% vs. t1 60%) as compared to the normative COGBAT sample. Regression analyses revealed that lower baseline scores in planning ability before the MC intervention (t0) were associated with greater planning ability (TOL; B = - 0.78, 95% CI - 1.04 to - 0.53), figural memory (FGT; B = - 0.26, 95% CI - 0.44 to - 0.07), and cognitive flexibility (TMT B; B = - 0.36, 95% CI - 0.50 to - 0.23) improvement post-MC intervention (t1-t0). Psychosocial functioning and age were not associated with these improvements.
conclusionsPatients with depressed executive functioning showed the greatest benefit from the MC intervention regarding cognitive functioning. Age and psychological functioning seem less important for cognitive performance improvements post-MC intervention. Hence, severely depressed cognitive functioning in patients is not a contraindication for PMVR using MitraClip.
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