Effects of MitraClip on cognitive and psychological function in heart failure patients

• Verfasst von: Terhoeven, Valentin [VerfasserIn]
• Verfasst von: Nikendei, Christoph [VerfasserIn]
• Verfasst von: Cranz, Anna [VerfasserIn]
• Verfasst von: Weisbrod, Matthias [VerfasserIn]
• Verfasst von: Geis, Nicolas [VerfasserIn]
• Verfasst von: Raake, Philip [VerfasserIn]
• Verfasst von: Katus, Hugo [VerfasserIn]
• Verfasst von: Herzog, Wolfgang [VerfasserIn]
• Verfasst von: Friederich, Hans-Christoph [VerfasserIn]
• Verfasst von: Schultz, Jobst-Hendrik [VerfasserIn]
• Verfasst von: Pleger, Sven Torsten [VerfasserIn]
• Titel: Effects of MitraClip on cognitive and psychological function in heart failure patients
• Titelzusatz: the sicker the better
• Verf.angabe: Valentin Terhoeven, Christoph Nikendei, Anna Cranz, Matthias Weisbrod, Nicolas Geis, Philip W. Raake, Hugo A. Katus, Wolfgang Herzog, Hans-Christoph Friederich, Jobst-Hendrik Schultz and Sven T. Pleger
• E-Jahr: 2019
• Jahr: 22 February 2019
• Umfang: 8 S.
• Fussnoten: Gesehen am 23.07.2019
• Titel Quelle: Enthalten in: European journal of medical research
• Ort Quelle: London : BioMed Central, 2000
• Jahr Quelle: 2019
• Band/Heft Quelle: 24(2019), Artikel-ID 14, Seite 1-8
• ISSN Quelle: 2047-783X
• DOI: doi:10.1186/s40001-019-0371-z
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1669630617

Abstract

Purpose: Cognitive 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. Methods: We 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). Results: Following 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. Conclusions: Patients 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.