Peculiarities of the Cognitive Functioning of Patients with Cardiovascular Disease Preparing for Heart Transplantation and Coronary Artery Bypass Grafting

The problem of changes in brain activity in patients with somatic diseases in connection with the main pathology and due to surgical treatment is of particular importance in regard to an increase in the proportion of the population with cardiovascular diseases. The issue is significant with respect to the challenges of social rehabilitation of patients. The article discusses the results of a study of the cognitive functioning of patients with various cardiovascular diseases at the stage of preparation for high tech operations on the vessels of the heart. In total, 98 patients took part in the study, including 35 patients with chronic heart failure (CHF) III–IV functional classes (FC) (according to the New York Heart Association — NYHA) and systolic dysfunction of the left ventricle (LV), whose average age was 50.97 ± 11.24 years, and 63 patients with coronary heart disease (CHD), the average age was 55.95 ± 5.97. The study was carried out using a psychodiagnostic complex, including clinical, psychological, and experimental psychological research methods, which included the “method of series connections” (in the original “Trail Making Test — TMT”); subtests of “Similarity” and “Koos Cubes” from “the Wechsler Adult Intelligence Scale” Research; pathopsychological tests “10 words”, “Memorization of Stories”, “Simple Analogies”; “Test of Visual Retention” by A. Benton; “Scab Interference Test”. The results of a comparative analysis of socio-demographic, individual psychological characteristics, as well as the main indicators of the cognitive sphere of patients with CHF and CHD, preparing for heart transplantation (HT) and coronary artery bypass grafting (CABG), are presented respectively. It was shown that patients with CHF demonstrate lower results in the main parameters of cognitive functioning (memory, attention, thinking) (p ≤ 0.05), more often complain of subjective deterioration in memory and attention, have more optimistic ideas about future treatment prospects, and the outcome of the upcoming heart surgery. The results obtained contribute to a deeper understanding of the specifics of neurocognitive deficiency and its causes, and also allow for the optimization of rehabilitation measures taking into account the data obtained.

Fomin I. V., Belenkov Yu. N., Mareev V. Yu., Ageev F. T., Badin Yu. V., Galyavich A. S., Danielyan M. O., Kamalov G. M., Kolbin A. A., Kechedzhieva S. G., Makarova V. G., Makarova N. V., Malenkova V. Yu., Sayfutdinov R. I., Tarlovskaya E. I., Khokhlov R. A., Scherbinina E. V., Yakushin S. S. The Prevalence of Chronic Heart Failure in the European Part of the Russian Federation — EPOA-CHF data. Serdechnaia nedostatochnost’, 2006, vol. 7 (3), pp. 112–115. (In Russian)

Belenkov Yu. N., Mareev V. Yu., Ageev F. T., Fomin I. V., Badin Yu. V., Polyakov D. S., Danielyan M. O., Artemyeva E. G., Malenkova V. Yu., Poroshina E. A., Smirnova E. A., Tarlovskaya E. I., Scherbinina E. V., * This project was supported by the grants of the President of the Russian Federation for state support of young Russian scientists, project no. МК-1933.2019.6. Yakushin S. S. Etiological Reasons for the Formation of Heart Failure in the European Part of the Russian Federation (Hospital Stage). Serdechnaia nedostatochnost’, 2011, vol. 12 (6), pp. 333–338. (In Russian)

Roger V. L., Weston S. A., Redfield M. M., Hellermann-Homan J. P., Killian J., Yawn B. P., Jacobsen S. J. Trends in Heart Failure Incidence and Survival in a Community–Based Population. JAMA, 2004, vol. 292 (3), pp. 344–350. https://doi.org/10.1001/jama.292.3.344.

Tribouilloy C., Rusinaru D., Mahjoub H., Tartière J. M., Kesri-Tartière L., Godard S., Peltier M. Prognostic Impact of Diabetes Mellitus in Patients with Heart Failure and Preserved Ejection Fraction: a Prospective Five-year Study. Heart, 2008, vol. 94, pp. 1450–1455.

Kryukov N. N., Nikolaevskij E. N., Polyakov V. P. Coronary Heart Disease (Modern Sspects of the Clinic, Diagnosis, Treatment, Prevention, Medical Rehabilitation, Examination) . Samara, Sodruzhestvo Publ., 2010. (In Russian)

van Dijk D., Keizer A. M., Diephuis J. C., Durand C., Vos L. J., Hijman R. Neurocognitive Dysfunction After Coronary Artery Bypass Surgery: a Systematic Review. The Journal of Thoracic and Cardiovascular Surgery, 2000, vol. 120 (4), pp. 632–639. https://doi.org/10.1067/mtc.2000.108901.

Mathew J. P., Grocott H. P., Phillips-Bute B., Stafford-Smith M., Laskowitz D. T., Rossignol D., Blumenthal J. A., Newman M. F. Lower Endotoxin Immunity Predicts Increased Cognitive Dysfunction in Elderly Patients After Cardiac Surgery. Stroke, 2003, vol. 34 (2), pp. 508–513. https://doi.org/10.1161/01. str.0000053844.09493.58.

Bürker B. S., Gude E., Gullestad L., Grov I., Relbo Authen A., Andreassen A. K., Havik O. E., Dew M. A., Fiane A. E., Haraldsen I. R., Malt U. F., Andersson S. Cognitive Function Among Long–term Survivors of Heart Transplantation. Clinical Transplantation, 2017, vol. 31 (12), p. e13143.

Newman S. P., Harrison M. J. Coronary–artery Bypass Surgery and the Brain: Persisting Concerns. The Lancet. Neurology, 2002, vol. 1 (2), pp. 119–125. https://doi.org/10.1016/s1474-4422(02)00043-1.

Bokeriya L. A., Morchadze B. D., Sigaev I. Yu. Surgical Access Options for Repeated Operations of Direct Myocardial Revascularization. Byulleten’ NTSSSKH im. A. N.Bakuleva RAMN «Serdechno-sosudistye zabolevaniia», 2007, vol. 8 (3), p. 36. (In Russian)

Roach G. W., Kanchuger M., Mangano C. M., Newman M., Nussmeier N., Wolman R., Aggarwal A., Marschall K., Graham S. H., Ley C. Adverse Cerebral Outcomes After Coronary Bypass Surgery. Multicenter Study of Perioperative Ischemia Research Group and the Ischemia Research and Education Foundation Investigators. The New England Journal of Medicine, 1996, vol. 335 (25), pp. 1857–1863. https://doi. org/10.1056/NEJM199612193352501.

Bürker B. S., Gullestad L., Gude E., Relbo Authen A., Grov I., Hol P. K., Andreassen A. K., Arora S., Dew M. A., Fiane A. E., Haraldsen I. R., Malt U. F., Andersson S. Cognitive Function After Heart Transplantation: Comparing Everolimus‐based and Calcineurin Inhibitor‐based Regimens. Clinical Transplantation, 2017, vol. 31, p. e12927. https://doi.org/10.1111/ctr.12927.

Tolstorozhikh T. A., Strakhova N. V., Krasnorutskaya O. N., Ostroushko N. I. Cognitive Status of Patients with Coronary Heart Disease Depending on the Level of Comorbidity. Prikladnye informatsionnye aspekty meditsiny, 2019, vol. 1, pp. 98–105. (In Russian)

Solonovich A. S., Voronkov L. G. Cognitive Dysfunction in Patients with Chronic Heart Failure and a Reduced Left Ventricular Ejection Fraction with Hypertension. Arterial’naia gypertenziia, 2019, vol. 3 (65), pp. 135–139. (In Russian)

Kotova J. A., Zuikova A. A., Pashkov A. N., Strakhova N. V., Krasnorutskaya O. N. Markers of Oxidative Stress in Patients with Coronary Heart Disease. International Journal of Biomedicine, 2018, vol. 2, pp. 115–117.

Zotov M. V. Cognitive Impairment and the Possibility of Their Compensation in Patients with Schizophrenia with Varying Degrees of Severity of the Defect: Author. PhD dissertation (Psychology) . St. Petersburg, 1998. (In Russian)

Rubinstein S. Ya. Experimental Methods of Pathopsychology and the Experience of Their Use in the Clinic: a Practical Guide. Moscow, Aprel’ Press, 2004. (In Russian)

Bleicher V. M., Kruk I. V., Bokov S. N. Clinical Pathopsychology: a Guide for Doctors and Clinical Psychologists. 2nd ed., revised and supplemented. Moscow, MPSI Publ.; Voronezh, MODEK Publ., 2006. (In Russian)

Wasserman L. I. Methods of Neuropsychological Diagnosis: a Practical Guide. St. Petersburg, Stroylespechat’ Publ., 1997. (In Russian) 20. Derevnina E. S., Akimova N. S., Martynovich T. V., Makarov N. S., Konshina L. E., Schwartz Yu. G. Cognitive Impairment in Atrial Fibrillation with Cardiovascular Disease. Annaly ariytmologii, 2013, vol. 10 (2), pp. 87–94. https://doi.org/10.15275/annaritmol.2013.2.4. (In Russian)

Zueva I. B., Vanaeva K. I., Sanets E. L., Piotrovskaya V. R., Genikhovich E. L., Kirillova V. I., Shlyakhto E. V. Correlation of Cardiovascular Risk Factors with Cognitive Functions in Middle–aged Patients. Arterial’naia gypertenziia, 2011, vol. 17 (5), pp. 432–441. https://doi.org/10.18705/1607- 419X2011-17-5-432-440. (In Russian)

Rockwood K., Wentzel C., Hachinski V., Hogan D. B., MacKnight C., McDowell I. Prevalence and Outcomes of Vascular Cognitive Impairment. Neurology, 2000, vol. 54 (2), pp. 447–451. https://doi. org/10.1212/ wnl.54.2.447.

Kim J. S., Hwang S. Y., Shim J. L., Jeong M. H. Cognitive Function and Self–care in Patients with Chronic Heart Failure. Korean Circulation Journal, 2015, vol. 45 (4), pp. 310–316. https://doi.org/10.4070/ kcj.2015.45.4.310.

Bu X., Lyu R., Ji S., Liang T., Guo X. Cognitive Function and Factors Related to Cognitive Function in Hospitalized Patients with Chronic Heart Failure. Chinese Journal of Cardiovascular Disease, 2014, vol. 42 (9), pp. 736–739.

Bornstein R. A., Starling R. C., Myerowitz P. D., Haas G. J. Neuropsychological Function in Patients with End-stage Heart Failure Before and After Cardiac Transplantation. Acta Neurologica Scandinavica, 1995, vol. 91, pp. 260–265.

Pressler S. J., Subramanian U., Kareken D., Perkins S. M., Gradus-Pizlo I., Sauvé M. J., Ding Y., Kim J., Sloan R., Jaynes H., Shaw R. M. Cognitive Deficits in Chronic Heart Failure. Western Journal of Nursing Research, 2010, vol. 59, pp. 127–139.

Dardiotis E., Giamouzis G., Mastrogiannis D., Vogiatzi C., Skoularigis J., Triposkiadis F., Hadjigeorgiou G. M. Cognitive Impairment in Heart Failure. Cardiology Research and Practice, 2012, pp. 58–63.

Hajduk A. M., Lemon S. C., McManus D. D., Lessard D. M., Gurwitz J. H., Spencer F. A., Goldberg R. J., Saczynski J. S. Cognitive Impairment and Self–care in Heart Failure. Clinical Epidemiology, 2013, vol. 5, pp. 407–416.

Riegel B., Christopher S., Glaser D., Moelter T. Patterns of Change in Cognitive Function Over Six Months in Adults with Chronic Heart Failure. Cardiology Research and Practice, 2012, vol. 2 (14), pp. 63–75.

Leto L., Feola M. Cognitive Impairment in Heart Failure Patients. Journal of Geriatric Cardiology, 2014, vol. 11 (4), pp. 316–328. https://doi.org/10.11909/j.issn.1671-5411.2014.04.007.

Bauer L., Pozehl B. Measurement of Cognitive Function in Chronic Heart Failure: a Feasibility Study. Applied Nursing Research, 2011, vol. 24 (4), pp. 223–228. https://doi.org/10.1016/j.apnr.2009.12.002.