Study On Chronic Heart Failureand The Relation To Cognitive Impairment

Objective This paper is to explore the relationship of heart failurecourse,ejection fraction NT-proBNP, cardiothoracic ratio to the cognitiveimpairment. Furthermore, it probes into the influence of the cognitiveimpairment on the quality of life on the patients with chronic heart failure.Itaims to provide clinic references to delaying dementia disease andimproving the quality of life of the patients with heart failure.Methods196patients with cardiovascular disease are enrolled in ourstudy, who are chosen from The Cardiovascular Department of the SecondAffiliated Hospital to Chongqing University of Medical Science from June2010to February2012.There are84cases with coronary artery disease,97cases with hypertension,7cases with dilated cardiomyopathy and8caseswith valvular heart disease.98patients are in CHF group and98patients withcardiovascular diseases uncomplicated CHF are in no-CHF group，then theauthor tries to compare cognitive patterns of the two groups byMoCA.Also,To analyze the relationship of heart failure course,ejectionfraction, NT-proBNP, cardiothoracic ratio to the scores of MoCA and to assess the quality of life between CHF patients with CI and CHF patientsuncomplicated CI.Results1The percent of cognitive impairment in CHF group is67.35%,no-CHF group is40.82%,There is significant difference between them（χ~2=13.8885，P<0.05).The rate of CI77.5%in60above is significanthigher than the22.22%in aged60and below(χ~2=20.417,P<0.05).Theincidence of cognitive impairment is66.67%between61-70,86.67%between71-80,80%in aged80above,.There are no significant differencesamong them（χ~2=23.2214,P>0.00833).2The mean scores of MoCA is23.00±7.00in CHF group,which is lower than26.00±4.00scores in no-CHFgroup (Z=-4.3108,P<0.05).It is found that the CHF group impairs in thefields of focusing, calculation, language, abstract thinking, delayed recall,the visual space executive function and delayed recall executive function areapparently worse than the no-CHF group (Zvisual=-4.9199，Zdelayed=-3.1255，P<0.05)3The mean scores of NYHA-I is27.00±4.00, NYHA-II is26.00±3.00,NYHA-III is21.00±5.00, NYHA-IV is19.00±6.00. Patientswith NYHA-III and NYHA-IV had significantly lower scores than thosewith NYHA-II and NYHA2-I(=61.5512,P<0.05).Regression analysissuggests cardiothoracic ratio has not Linear correlation with MoCA scores（R2=0.2086,P<0.05).There is no correlation among Heart failure course,EF, NT-proBNP and scores of MoCA（rsheart=-0.15329rsEF=0.17184,rs=-0.37097,P>0.05).The mean scores of MLHFQ is50.00±18.00in CHF patients with CI group,The MLHFQ scores of CHF patients uncomplicatedCI is38.50±14.00.There is significant difference between them(Z=-3.5761,P<0.05). It is found that there is significant difference of socialrestriction, physical limit and mood recall compared to the control group(tphysical=-2.69,Zsocial=-2.5255,tmood=-8.08，P<0.05). While there is nostatistical differences in economy hospital scores (Z=-0.5209,P>0.05).Conclusion1Patients with Cardiovascular disease are oftenaccompanied by CI,while cardiovascular diseases complicated CHF havehigher rate than cardiovascular diseases uncomplicated CHF in the cognitiveimpairment incidence. As patients get older,the incident of CI is higher andafter60years, the cognition of patients decline rapidly. Cognitiveimpairment in patients with CHF gradually become a psychologicalproblem.2It is found that many cognitive impairment domains are damagedin the CHF group,the ability of visual space,executive capacity and delayedrecall of CHF group decrease obviously.So,the two index maybe sensitivefor assessingthe cognitive impairment ofpatients withCHFand CHF maybebe a possible cause of cognitive dysfunction.3The more poor heart functionis,the more worse cognitive functionthe patients have,so clinicalphysiciansshould pay more attention to the psychological field of serious heart functionpatience.Patients with large heart have poor cognition.Cardiothoracic ratiocan be used as a simple reference index of cognitive function of the CHFpatients.4The cognitive impairment of CHF patients will influence the quality of life of them, especially in social restrictions, physical limit andemotional recall.