Effect Of Angiotensin-converting Enzyme Inhibitors On Cognitive Function In Patients With Chronic Heart Failure

BackgroundChronic heart failure (CHF) and cognitive impairment (CI) are both common dysfunction in old age. They are both associated with significant mortality, impaired quality of life and disability. Also both incur heavy economic burden and consume the increasing proportion of Health and Social Service resources. Within the past several decades, awareness of the presence and impact of cognitive impairment in patients with CHF has grown. Evidence shows twenty percent to eighty percent of CHF patients are demonstrated concurrent with cognitive dysfunction and impaired mainly in working memory, psychomotor speed, executive function and other cognitive domains. CHF-induced CI is mediated by a variety of mechanisms that may be concurrent and interactional. Evidence suggests that the above abnormalities may be partially reversible with standard CHF therapy. There are few data on the effects of A.C.E. inhibitors on cognition in CHF. In this study, the elderly patients concurrent with CHF and CI were identified by screening of those with chronic heart failure. The changes in cognitive function were monitored after treatment with angiotensin-converting enzyme inhibitor. The present study intends to find out the effect of angiotensin-converting enzyme inhibitor on cognitive function in patients with chronic heart failure and assess its efficacy in improving CI, providing a basis for choosing therapeutic regimens.ObjectiveThe present study intends to investigate the effect of CHF on cognitive function and angiotensin-converting enzyme inhibitor on cognitive function in patients with chronic heart failure.Methods159patients with chronic heart failure were identified at Department of Cardiology and Department of Neurology of Jinan Central Hospital. The Mini Mental State Examination (MMSE) was administered to all subjects. MMSE score less than24was found in81patients who were then divided into ACEI group (n=50) and the control group (n=31) according to their drug therapy.Their baseline cognitive function and general clinical condition were assessed according to the MMSE. The patients were followed up for6months, during which their cognitive function was assessed. The effect of angiotensin-converting enzyme inhibitors on cognitive function in patients with chronic heart failure was evaluated.ResultsOne hundred and fifty-nine cases of newly diagnosed patients with CHF were enrolled in this study, MMSE score less than24, consistent with cognitive impairment, was found in50.9%of participants. After treatment with ACEI-based drugs, the total score and respective score of orientation, memory, attention, and calculative and language abilities in the ACEI group were all statistically significant higher than the control group (p<0.05); While the score of recall was not statistically significant higher than the control group (p>0.05). The differences of MMSE total score and respective score of memory, attention, and calculative and language abilities in the ACEI group were statistically significant before and after treatment(p<0.05); while the differences of respective score of orientation and recall previous things were not statistically significant (p>0.05)ConclusionCognitive impairment in CHF is common, affecting half of all patients.ACEI can improve cognitive function in patients with chronic heart failure mainly in orientation, memory, attention, and calculative and language abilities.