Cognitive function and adherence to treatment in patients with chronic heart failure and reduced left ventricular ejection fraction: relation and prognostic meaning

Main Article Content

L. G. Voronkov
A. S. Solonovych
A. V. Lyashenko
I. L. Revyenko
L. V. Yakushko
L. P. Paraschenyuk

Abstract

The aim – to investigate the relationship between cognitive function and adherence to treatment; to evaluate the predictive value of adherence to treatment questionnaires in patients with chronic heart failure (CHF) and reduced left ventricular ejection fraction (LVEF).
Material and methods. 124 pts with stable CHF and reduced (< 40 %) LVEF NYHA II–IV not older than 75 years were examined. Besides routine clinical examination, standard neuropsychological tests (Mini Mental State Examination – MMSE, Schulte test, the HADS scale) were used. To assess adherence to the treatment, the Moriski – Green questionnaire and the disease-specific questionnaire of heart failure department were used. Cognitive dysfunction was defined as MMSE ≤ 26 points.
Results. After distribution of pts to three groups depending on their adherence to treatment, it was found that they significantly differed in MMSE and Shulte test results. The number of points regarding adherence to treatment
(Moriski – Green questionnaire and the questionnaire of heart failure department) directly correlated with MMSE (P=0.038 and P=0.023, respectively). The group of patients with high compliance had significantly better cognitive tests results (MMSE and Schultze) than the group of patients with moderate/low compliance – this was equally relevant to both questionnaires. The construction of survival curves showed that Moriski – Green questionnaire had no reliable prognostic significance both in relation to death and combined critical event (mortality/hospitalization) (P=0.113 and P=0.401, respectively); At the same time, the disease-specific questionnaire of heart failure department showed value regarding the prediction of long-term survival and the onset of a combined critical event (P=0.046 and P=0.024, respectively).
Conclusion: More than half of pts with CHF and reduced LVEF have low and moderate adherence to treatment, which is associated with worse cognitive tests results (MMSE and Schulte). Evidence of relationship between adherence to treatment and cognitive function evaluated using our questionnaire were comparable to those obtained by Moriski – Green questionnaire. Using disease-specific questionnaire of heart failure department had a high value in predicting long-term survival and the onset of combined critical event (death or hospitalization) in patients with CHF and reduced LVEF, while the Moriski – Green questionnaire did not demonstrate the above-mentioned predictive value.

Article Details

Keywords:

Chronic heart failure, cognitive dysfunction, adherence to treatment, mortality, hospitalization.

References

L.G. Voronkov, O.O. Lutsak, P.M. Babych, A.V. Lyashenko Predictors of quality of life in patients with chronic heat failure. [ Heart Failure & Comorbidities 2. .– 2010.– № 2.– С. 12–16.

Воронков Л.Г., Солонович А.С. Когнітивна дисфункція при хронічній серцевій недостатності: механізми, наслідки, можливості корекції // Серцева недостатність та коморбідні стани.– 2017.– № 2.– С. 39–46.

Лурия А.Р. Основы нейропсихологии: учеб. пособие для студ. учреждений высш. проф. образования.– М.: Издательский центр «Академия», 2013.– 384 с.

Миронова Е.Е. Сборник психологических тестов. Часть II: Пособие.– Мн.: Женский институт ЭНВИЛА, 2006.– 146 с.

Рекомендації з діагностики та лікування хронічної серцевої недостатності / За ред. Л.Г. Воронкова, К.М. Амосової, А.Е. Багрія, Г.В. Дзяка.– К.: Моріон, 2012.– 52 с.

Beker J., Belachew Т., Mekonin А. et al. Predictors of adherence to self-care behaviour among patients with chronic heart failure attending Jimma University Specialized Hospital Chronic Follow up Clinic, South West Ethiopia // J. Cardiovasc. Dis. Diagn.– 2014.– Vol. 2.– Р. 180–185. doi: 10.4172/2329-9517.1000180.

Beyhaghі H., Reeve B.B., Rodgers J.E. et al. Psychometric Properties of the Four-Item Morisky Green Levine Medication Adherence Scale among Atherosclerosis Risk in Communities Study (ARIC) Participants // Value Health.– 2016.– Vol. 19 (8).– Р. 996–1001.

Bjelland I. et al. The validity of the Hospital Anxiety and Depression Scale. An updated literature review // J. Psychosomatic Research.– 2002.– Vol. 52 (2).– Р. 69–77.

Bland J.M. The logrank test // BMJ.– 2004.– Vol. 328 (7447).– Р. 1073. doi: 10.1136/bmj.328.7447.1073.

Čelutkienė J., Jakštienė S. et al. Expert Opinion-Cognitive Decline in Heart Failure: More Attention is Needed // Card. Fail. Rev.– 2016.– N 2 (2).– Р. 106–109. doi: 10.15420/cfr.2016:19:2.

Chriss P.M., Sheposh J., Carlson B., Riegel B. Predictors of successful heart failure self-care maintenance in the first three months after hospitalization // Behaviour Heart Lung.– 2007.– Vol. 33.– Р. 345–353.

Coutinho-Myrrha M.A., Dias R.C., Fernandes A.A. et al. Duke Activity Status Index for Cardiovascular Diseases: Validation of the Portuguese Translation // Arq. Bras. Cardiol.– 2014.– Vol. 102 (4).– Р. 383–390. doi: 10.5935/abc.20140031.

Hajduk A.M. Cognitive impairment and self-care in heart failure // Clinical. Epidemiology.– 2013.– Vol. 5.– Р. 405–415.

Kumar M.G., Khanna P., Kishore J. Understanding survival analysis: Kaplan-Meier estimate // Int. J. Ayurveda Res.– 2010.– Vol. 1 (4).– Р. 274–278. doi: 10.4103/0974-7788.76794.

Martje H.L. van der Wal, Jaarsma T., Dirk J. van Veldhuisen. Non-compliance in patients with heart failure; how can we manage it? // Eur. J. Heart Failure.– 2005.– Vol. 7 (1).– Р. 5–17.

Pressler S.G., Subramanian U., Kareken D. et al. Cognitive deficits in chronic heart failure // Nurs Res.– 2010.– Vol. 59 (2).– Р. 127–139.

Sohani Z.N., Samaan Z. Does depression impact cognitive impairment in patients with heart failure? // Card Research and Practice.– 2012.– ID 524325.

Stevens L.A., Coresh J., Greene T., Levey A.S. Assessing kidney function–measured and estimated glomerular filtration rate // N. Engl. J. Med.– 2006.– Vol. 354.– Р. 2473–2483. DOI: 10.1056/nejmra054415.

Zigmond A.S, Snaith R.P. The hospital anxiety and depression scale // Acta Psychiatrica Scandinavica.– 1983.– Vol. 67 (6) – Р. 361–370.

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