Clinical and hemodynamic predictors of cognitive dysfunction in patients with coronary heart disease

Main Article Content

O. O. Nudchenko
M. M. Dolzhenko

Abstract

The aim – to determine the clinical and hemodynamic risk factors for the development of cognitive dysfunction in patients with coronary heart disease.
Materials and methods. 110 patients with a history of acute myocardial infarction, unstable angina pectoris, or coronary artery revascularization were included in the study. Depending on the diastolic function, the patients were divided into three groups: I group – normal diastolic function, II group – impaired relaxation, III group – pseudonormalization or restriction. Cognitive function was assessed on the MMSE, MoCA scales, Frontal Assessment Battery (FAB), Trial Making Test and Rey audio-verbal test.
Results and discussion. The average number of points on the MMSE scale with an increase in the severity of diastolic dysfunction (DD) decreased and amounted to 25.40±2.58 in the I group, 24.95±2.69 in the II group, and 22.30±3.17 in the III group (p1,3<0.0001, p2,3=0.001); on the MoCA scale it equaled to 23.47±3.41 in the I group, 22.09±3.48 in the II group and 19.85±5.19 in the III group (p1,2=0.039, p1,3=0.004, p2,3>0.05). A negative correlation of average degree (r=–0.35, p<0.05) between MMSE score and the type of DD was revealed, and a negative correlation of the strong degree (r=–0.50, p<0.00001) – between MMSE score and left ventricular filling pressure (LVFP). The MoCA scale showed a moderate degree negative correlation (r=–0.30, p=0.0018) with DD and a strong degree negative correlation (r=–0.41, p<0.05) with LVFP. A negative correlation of a weak degree was also revealed between the score on the FAB and LVFP (r=–0.24, p<0.05). It was found that the number of points on the MMSE scale reliably correlates with smoking status, left atrium indexed volume and left ventricular myocardial mass index (r=0.23, r=–0.25, r=–0.25, respectively). The values of the left atrium volume index and left ventricular myocardial mass index correlated with the score on the MoCA scale (r=–0.25, r=–0.18, respectively). The likelihood of development of cognitive dysfunction increased with an increase in glycated hemoglobin (OR 2.65, 95 % CI 1.08–6.48, p=0.033), diastolic function worsening (OR 3.18, 95 % CI 1.18–8.59, p=0.023) and an increase in LVFP (OR 6.03, 95 % CI 2.32–15.69, p=0.0002) on the MMSE scale, and with a worsening of diastolic function (OR 2.86, 95 % CI 1.18–6.94, p=0.020) on the MoCA scale. According to the results of direct multiple logistic regression, it was revealed that among all the indicators, only LVFP significantly affected the total number of points on the MMSE scale (OR 1.28, 95 % CI 1.11–1.47, p=0.0007).
Conclusions. It was revealed that the diastolic function has a significant influence on the state of cognitive function. A negative correlation was noted between the type of DD, LVFP, and the scores on the scales of cognitive functions. The likelihood of cognitive dysfunction on the MMSE scale increased with an increase in glycated hemoglobin, diastolic function worsening, increase in LVFP, diastolic function worsening (on the MoСA scale). According to the results of multiple regression, only LVFP significantly affected the total number of points on the MMSE scale.

Article Details

Keywords:

diastolic dysfunction, left ventricular filling pressure, cognitive dysfunction, coronary heart disease

References

Ехокардіографічна оцінка діастолічної функції лівого шлуночка: проект оновлених рекомендацій Асоціації кардіологів України та Всеукраїнської асоціації фахівців з ехокар­­­діо­­графії // Аритмологія.– 2017.– № 4 (23).– С. 5-43.

Кількісна оцінка ехокардіографічних показників порожнин серця. Рекомендації робочої групи з функціональної діагностики Асоціації кардіологів України та Всеукраїнської асоціації фахівців з ехокардіографії // Аритмологія.– 2012.– № 4.– С. 44–71.

Коваленко В.Н., Долженко М.Н., Нудченко А.О. и др. Сравнительная характеристика профилактики сердечно-сосудистых заболеваниий в Украине и Европе по данным исследования EUROASPIRE IV: госпитальная линия // Укр. кардіол. журн.– 2015.– № 4.– C. 17–24.

Abete P., Della-Morte D., Gargiulo G. et al. Cognitive impairment and cardiovascular diseases in the elderly. A heart-brain continuum hypothesis // Ageing Res. Rev.– 2014.– Vol. 18.– P. 41–52. doi: https://doi.org/10.1016/j.arr.2014.07.003.

Alosco M., Gunstad J., Jerskey B. et al. Left Atrial Size is Independently Associated with Cognitive Function // Int. J. Neurosci.– 2013.– Vol. 123 (8).– P. 544–552. Ехокардіографічна оцінка діастолічної функції лівого шлуночка: проект оновлених рекомендацій Асоціації кардіологів України та Всеукраїнської асоціації фахівців з ехокар­­­діо­­графії // Аритмологія.– 2017.– № 4 (23).– С. 5-43.

Кількісна оцінка ехокардіографічних показників порожнин серця. Рекомендації робочої групи з функціональної діагностики Асоціації кардіологів України та Всеукраїнської асоціації фахівців з ехокардіографії // Аритмологія.– 2012.– № 4.– С. 44–71.

Коваленко В.Н., Долженко М.Н., Нудченко А.О. и др. Сравнительная характеристика профилактики сердечно-сосудистых заболеваниий в Украине и Европе по данным исследования EUROASPIRE IV: госпитальная линия // Укр. кардіол. журн.– 2015.– № 4.– C. 17–24.

Abete P., Della-Morte D., Gargiulo G. et al. Cognitive impairment and cardiovascular diseases in the elderly. A heart-brain continuum hypothesis // Ageing Res. Rev.– 2014.– Vol. 18.– P. 41–52. doi: https://doi.org/10.1016/j.arr.2014.07.003.

Alosco M., Gunstad J., Jerskey B. et al. Left Atrial Size is Independently Associated with Cognitive Function // Int. J. Neurosci.– 2013.– Vol. 123 (8).– P. 544–552. doi: https://doi.org/10.3109/00207454.2013.774396.

Cosentino F., Grant P., Aboyans V. et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD // Eur. Heart J.– 2019.– 00.– P. 1–69. doi: https://doi.org/10.1093/eurheartj/ehz486.

De Bruijn R., Portegies M., Leening M. et al. Subclinical cardiac dysfunction increases the risk of stroke and dementia: the Rotterdam Study // Neurology.– 2015.– Vol. 84 (8).– P. 833–840. doi: https://doi.org/10.1212/WNL.0000000000001289.

Dubois B., Slachevsky A., Litvan I. et al. The FAB: a Frontal Assessment Battery at bedside // Neurology.– 2000.– Vol. 55 (11).– P. 1621–1626. doi: https://doi.org/10.1212/wnl.55.11.1621.

Eggermont L.H., de Boer K., Muller M. et al. Cardiac disease and cognitive impairment: a systematic review // Heart.– 2012.– Vol. 98.– P. 1334–1340. doi: https://doi.org/10.1136/heartjnl-2012-301682.

Folstein M., Folstein S., McHugh P. Mini-mental state: A practical method for grading the cognitive state of patients for the clinician // J. Psychiatric. Research.– 1975.– Vol. 12 (3).– P. 189–198. doi: https://doi.org/10.1016/0022-3956(75)90026-6.

Gorelick P., Scuteri A., Black S. et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association // Stroke.– 2011.– Vol. 42 (9).– P. 2672–2713. doi: https://doi.org/10.1161/STR.0b013e3182299496.

Kerola T, Nieminen T, Hartikainen S. et al. B-type natriuretic peptide as a predictor of declining cognitive function and dementia – a cohort study of an elderly general population with a 5-year follow up // Ann. Med.– 2010.– Vol. 42.– P. 207–215. doi: https://doi.org/10.3109/07853891003652542.

Lang R., Badano L., Mor-Avi V. et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging // Eur. Heart J. Cardiovasc. Imaging.– 2015.– Vol. 16 (3).– P. 233–270. doi: https://doi.org/10.1093/ehjci/jev014.

Langa K., Levine D. The diagnosis and management of mild cognitive impairment: a clinical review // JAMA.– 2014.– Vol. 312.– P. 2551–2561. doi: https://doi.org/10.1001/jama.2014.13806.

Moser D., Hoth K., Robinson R. et al. Blood vessel function and cognition in elderly patients with atherosclerosis // Stroke.– 2004.– Vol. 35.– P. 369–372. doi: https://doi.org/10.1161/01.STR.0000145050.35039.51.

Nagueh S., Smiseth O., Appleton C. et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging // Eur. Heart J. Cardiovasc. Imaging.– 2016.– Vol. 17 (12).– P. 1321–1360. doi: https://doi.org/10.1093/ehjci/jew082.

Nasreddine Z., Phillips N., Bédirian V. et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment // J. Am. Geriatr. Soc.– 2005.– Vol. 53 (4).– P. 695–699. doi: https://doi.org/10.1111/j.1532-5415.2005.53221.x.

Nudchenko A., Dolzhenko M., Lurye S. et al. Blood pressure control in very-high risk patients in Ukraine and Europe by EUROASPIRE IV results comparison // J. Hypertension.– 2015.– Vol. 33.– P. e391. doi: https://doi.org/10.1097/01.hjh.0000468597.38941.aa.

Sacre J., Ball J., Wong C. et al. Mild cognitive impairment is associated with subclinical diastolic dysfunction in patients with chronic heart disease // Eur. Heart J. Cardiovasc. Imaging.– 2018.– Vol. 19 (3).– P. 285–292. doi: https://doi.org/10.1093/ehjci/jex169.

Schneider P., Buerger K., Teipel S. et al. Antihypertensive therapy is associated with reduced rate of conversion to Alzheimer’s disease in midregional proatrial natriuretic peptide stratified subjects with mild cognitive impairment // Biol. Psychiatry.– 2011.– Vol. 70.– P. 145–151. doi: https://doi.org/10.1016/j.biopsych.2011.01.036.

Tombaugh T., Rees L., McIntyre N. et al. Normative data for the Trail Making Test. Personal communication cited in Spreen and Strauss. A compendium of neuropsychological tests: Administration, norms and commentary (2nd ed.).– New York: Oxford University Press, 1998.

Yasar S., Lin F., Fried L. et al. Diuretic use is associated with better learning and memory in older adults in the Ginkgo Evaluation of Memory Study // Alzheimer’s Dement.– 2012.– Vol. 8.– P. 188–195. doi: https://doi.org/10.1016/j.jalz.2011.03.010.10.3109/00207454.2013.774396.

Cosentino F., Grant P., Aboyans V. et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD // Eur. Heart J.– 2019.– 00.– P. 1–69. Ехокардіографічна оцінка діастолічної функції лівого шлуночка: проект оновлених рекомендацій Асоціації кардіологів України та Всеукраїнської асоціації фахівців з ехокар­­­діо­­графії // Аритмологія.– 2017.– № 4 (23).– С. 5-43.

Кількісна оцінка ехокардіографічних показників порожнин серця. Рекомендації робочої групи з функціональної діагностики Асоціації кардіологів України та Всеукраїнської асоціації фахівців з ехокардіографії // Аритмологія.– 2012.– № 4.– С. 44–71.

Коваленко В.Н., Долженко М.Н., Нудченко А.О. и др. Сравнительная характеристика профилактики сердечно-сосудистых заболеваниий в Украине и Европе по данным исследования EUROASPIRE IV: госпитальная линия // Укр. кардіол. журн.– 2015.– № 4.– C. 17–24.

Abete P., Della-Morte D., Gargiulo G. et al. Cognitive impairment and cardiovascular diseases in the elderly. A heart-brain continuum hypothesis // Ageing Res. Rev.– 2014.– Vol. 18.– P. 41–52. doi: https://doi.org/10.1016/j.arr.2014.07.003.

Alosco M., Gunstad J., Jerskey B. et al. Left Atrial Size is Independently Associated with Cognitive Function // Int. J. Neurosci.– 2013.– Vol. 123 (8).– P. 544–552. doi: https://doi.org/10.3109/00207454.2013.774396.

Cosentino F., Grant P., Aboyans V. et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD // Eur. Heart J.– 2019.– 00.– P. 1–69. doi: https://doi.org/10.1093/eurheartj/ehz486.

De Bruijn R., Portegies M., Leening M. et al. Subclinical

cardiac dysfunction increases the risk of stroke and dementia: the Rotterdam Study // Neurology.– 2015.– Vol. 84 (8).– P. 833–840. doi: https://doi.org/10.1212/WNL.0000000000001289.

Dubois B., Slachevsky A., Litvan I. et al. The FAB: a Frontal Assessment Battery at bedside // Neurology.– 2000.– Vol. 55 (11).– P. 1621–1626. doi:https://doi.org/ 10.1212/wnl.55.11.1621.

Eggermont L.H., de Boer K., Muller M. et al. Cardiac disease and cognitive impairment: a systematic review // Heart.– 2012.– Vol. 98.– P. 1334–1340. doi: https://doi.org/10.1136/heartjnl-2012-301682.

Folstein M., Folstein S., McHugh P. Mini-mental state: A practical method for grading the cognitive state of patients for the clinician // J. Psychiatric. Research.– 1975.– Vol. 12 (3).– P. 189–198. doi: https://doi.org/10.1016/0022-3956(75)90026-6.

Gorelick P., Scuteri A., Black S. et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association // Stroke.– 2011.– Vol. 42 (9).– P. 2672–2713. doi: https://doi.org/10.1161/STR.0b013e3182299496.

Kerola T, Nieminen T, Hartikainen S. et al. B-type natriuretic peptide as a predictor of declining cognitive function and dementia – a cohort study of an elderly general population with a 5-year follow up // Ann. Med.– 2010.– Vol. 42.– P. 207–215. doi: https://doi.org/10.3109/07853891003652542.

Lang R., Badano L., Mor-Avi V. et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging // Eur. Heart J. Cardiovasc. Imaging.– 2015.– Vol. 16 (3).– P. 233–270. doi: https://doi.org/10.1093/ehjci/jev014.

Langa K., Levine D. The diagnosis and management of mild cognitive impairment: a clinical review // JAMA.– 2014.– Vol. 312.– P. 2551–2561. doi: https://doi.org/10.1001/jama.2014.13806.

Moser D., Hoth K., Robinson R. et al. Blood vessel function and cognition in elderly patients with atherosclerosis // Stroke.– 2004.– Vol. 35.– P. 369–372. doi: https://doi.org/10.1161/01.STR.0000145050.35039.51.

Nagueh S., Smiseth O., Appleton C. et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging // Eur. Heart J. Cardiovasc. Imaging.– 2016.– ol. 17 (12).– P. 1321–1360. doi: https://doi.org/10.1093/ehjci/jew082.

Nasreddine Z., Phillips N., Bédirian V. et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for

mild cognitive impairment // J. Am. Geriatr. Soc.– 2005.– Vol. 53 (4).– P. 695–699. doi: https://doi.org/10.1111/j.1532-5415.2005.53221.x.

Nudchenko A., Dolzhenko M., Lurye S. et al. Blood pressure control in very-high risk patients in Ukraine and Europe by EUROASPIRE IV results comparison // J. Hypertension.– 2015.– Vol. 33.– P. e391. doi: https://doi.org/10.1097/01.hjh.0000468597.38941.aa.

Sacre J., Ball J., Wong C. et al. Mild cognitive impairment is associated with subclinical diastolic dysfunction in patients with chronic heart disease // Eur. Heart J. Cardiovasc. Imaging.– 2018.– Vol. 19 (3).– P. 285–292. doi: https://doi.org/10.1093/ehjci/jex169.

Schneider P., Buerger K., Teipel S. et al. Antihypertensive therapy is associated with reduced rate of conversion to Alzheimer’s disease in midregional proatrial natriuretic peptide stratified subjects with mild cognitive impairment // Biol. Psychiatry.– 2011.– Vol. 70.– P. 145–151. doi: https://doi.org/10.1016/j.biopsych.2011.01.036.

Tombaugh T., Rees L., McIntyre N. et al. Normative data for the Trail Making Test. Personal communication cited in Spreen and Strauss. A compendium of neuropsychological tests: Administration, norms and commentary (2nd ed.).– New York: Oxford University Press, 1998.

Yasar S., Lin F., Fried L. et al. Diuretic use is associated with better learning and memory in older adults in the Ginkgo Evaluation of Memory Study // Alzheimer’s Dement.– 2012.– Vol. 8.– P. 188–195. doi: https://doi.org/10.1016/j.jalz.2011.03.010.10.1093/eurheartj/ehz486.

De Bruijn R., Portegies M., Leening M. et al. Subclinical cardiac dysfunction increases the risk of stroke and dementia: the Rotterdam Study // Neurology.– 2015.– Vol. 84 (8).– P. 833–840. Ехокардіографічна оцінка діастолічної функції лівого шлуночка: проект оновлених рекомендацій Асоціації кардіологів України та Всеукраїнської асоціації фахівців з ехокар­­­діо­­графії // Аритмологія.– 2017.– № 4 (23).– С. 5-43.

Кількісна оцінка ехокардіографічних показників порожнин серця. Рекомендації робочої групи з функціональної діагностики Асоціації кардіологів України та Всеукраїнської асоціації фахівців з ехокардіографії // Аритмологія.– 2012.– № 4.– С. 44–71.

Коваленко В.Н., Долженко М.Н., Нудченко А.О. и др. Сравнительная характеристика профилактики сердечно-сосудистых заболеваниий в Украине и Европе по данным исследования EUROASPIRE IV: госпитальная линия // Укр. кардіол. журн.– 2015.– № 4.– C. 17–24.

Abete P., Della-Morte D., Gargiulo G. et al. Cognitive impairment and cardiovascular diseases in the elderly. A heart-brain continuum hypothesis // Ageing Res. Rev.– 2014.– Vol. 18.– P. 41–52. doi: https://doi.org/10.1016/j.arr.2014.07.003.

Alosco M., Gunstad J., Jerskey B. et al. Left Atrial Size is Independently Associated with Cognitive Function // Int. J. Neurosci.– 2013.– Vol. 123 (8).– P. 544–552. doi: https://doi.org/10.3109/00207454.2013.774396.

Cosentino F., Grant P., Aboyans V. et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD // Eur. Heart J.– 2019.– 00.– P. 1–69. doi: https://doi.org/10.1093/eurheartj/ehz486.

De Bruijn R., Portegies M., Leening M. et al. Subclinical cardiac dysfunction increases the risk of stroke and dementia: the Rotterdam Study // Neurology.– 2015.– Vol. 84 (8).– P. 833–840. doi: https://doi.org/10.1212/WNL.0000000000001289.

Dubois B., Slachevsky A., Litvan I. et al. The FAB: a Frontal Assessment Battery at bedside // Neurology.– 2000.– Vol. 55 (11).– P. 1621–1626. doi: https://doi.org/10.1212/wnl.55.11.1621.

Eggermont L.H., de Boer K., Muller M. et al. Cardiac disease and cognitive impairment: a systematic review // Heart.– 2012.– Vol. 98.– P. 1334–1340. doi: https://doi.org/10.1136/heartjnl-2012-301682.

Folstein M., Folstein S., McHugh P. Mini-mental state: A practical method for grading the cognitive state of patients for the clinician // J. Psychiatric. Research.– 1975.– Vol. 12 (3).– P. 189–198. doi: https://doi.org/10.1016/0022-3956(75)90026-6.

Gorelick P., Scuteri A., Black S. et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association // Stroke.– 2011.– Vol. 42 (9).– P. 2672–2713. doi: https://doi.org/10.1161/STR.0b013e3182299496.

Kerola T, Nieminen T, Hartikainen S. et al. B-type natriuretic peptide as a predictor of declining cognitive function and dementia – a cohort study of an elderly general population with a 5-year follow up // Ann. Med.– 2010.– Vol. 42.– P. 207–215. doi: https://doi.org/10.3109/07853891003652542.

Lang R., Badano L., Mor-Avi V. et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging // Eur. Heart J. Cardiovasc. Imaging.– 2015.– Vol. 16 (3).– P. 233–270. doi: https://doi.org/10.1093/ehjci/jev014.

Langa K., Levine D. The diagnosis and management of mild cognitive impairment: a clinical review // JAMA.– 2014.– Vol. 312.– P. 2551–2561. doi: https://doi.org/10.1001/jama.2014.13806.

Moser D., Hoth K., Robinson R. et al. Blood vessel function and cognition in elderly patients with atherosclerosis // Stroke.– 2004.– Vol. 35.– P. 369–372. doi: https://doi.org/10.1161/01.STR.0000145050.35039.51.

Nagueh S., Smiseth O., Appleton C. et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging // Eur. Heart J. Cardiovasc. Imaging.– 2016.– Vol. 17 (12).– P. 1321–1360. doi: https://doi.org/10.1093/ehjci/jew082.

Nasreddine Z., Phillips N., Bédirian V. et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for

mild cognitive impairment // J. Am. Geriatr. Soc.– 2005.– Vol. 53 (4).– P. 695–699.

doi: https://doi.org/10.1111/j.1532-5415.2005.53221.x.

Nudchenko A., Dolzhenko M., Lurye S. et al. Blood pressure control in very-high risk patients in Ukraine and Europe by EUROASPIRE IV results comparison // J. Hypertension.– 2015.– Vol. 33.– P. e391. doi: https://doi.org/10.1097/01.hjh.0000468597.38941.aa.

Sacre J., Ball J., Wong C. et al. Mild cognitive impairment is associated with subclinical diastolic dysfunction in patients with chronic heart disease // Eur. Heart J. Cardiovasc. Imaging.– 2018.– Vol. 19 (3).– P. 285–292. doi: https://doi.org/10.1093/ehjci/jex169.

Schneider P., Buerger K., Teipel S. et al. Antihypertensive therapy is associated with reduced rate of conversion to Alzheimer’s disease in midregional proatrial natriuretic peptide stratified subjects with mild cognitive impairment // Biol. Psychiatry.– 2011.– Vol. 70.– P. 145–151. doi: https://doi.org/10.1016/j.biopsych.2011.01.036.

Tombaugh T., Rees L., McIntyre N. et al. Normative data for the Trail Making Test. Personal communication cited in Spreen and Strauss. A compendium of neuropsychological tests: Administration, norms and commentary (2nd ed.).– New York: Oxford University Press, 1998.

Yasar S., Lin F., Fried L. et al. Diuretic use is associated with better learning and memory in older adults in the Ginkgo Evaluation of Memory Study // Alzheimer’s Dement.– 2012.– Vol. 8.– P. 188–195. doi: https://doi.org/10.1016/j.jalz.2011.03.010.10.1212/WNL.0000000000001289.

Dubois B., Slachevsky A., Litvan I. et al. The FAB: a Frontal Assessment Battery at bedside // Neurology.– 2000.– Vol. 55 (11).– P. 1621–1626. doi: 10.1212/wnl.55.11.1621.

Eggermont L.H., de Boer K., Muller M. et al. Cardiac disease and cognitive impairment: a systematic review // Heart.– 2012.– Vol. 98.– P. 1334–1340. doi: https://doi.org/10.1136/heartjnl-2012-301682.

Folstein M., Folstein S., McHugh P. Mini-mental state: A practical method for grading the cognitive state of patients for the clinician // J. Psychiatric. Research.– 1975.– Vol. 12 (3).– P. 189–198. Ехокардіографічна оцінка діастолічної функції лівого шлуночка: проект оновлених рекомендацій Асоціації кардіологів України та Всеукраїнської асоціації фахівців з ехокар­­­діо­­графії // Аритмологія.– 2017.– № 4 (23).– С. 5-43.

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Nudchenko A., Dolzhenko M., Lurye S. et al. Blood pressure control in very-high risk patients in Ukraine and Europe by EUROASPIRE IV results comparison // J. Hypertension.– 2015.– Vol. 33.– P. e391. doi: https://doi.org/10.1097/01.hjh.0000468597.38941.aa.

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Schneider P., Buerger K., Teipel S. et al. Antihypertensive therapy is associated with reduced rate of conversion to Alzheimer’s disease in midregional proatrial natriuretic peptide stratified subjects with mild cognitive impairment // Biol. Psychiatry.– 2011.– Vol. 70.– P. 145–151. doi: https://doi.org/10.1016/j.biopsych.2011.01.036.

Tombaugh T., Rees L., McIntyre N. et al. Normative data for the Trail Making Test. Personal communication cited in Spreen and Strauss. A compendium of neuropsychological tests: Administration, norms and commentary (2nd ed.).– New York: Oxford University Press, 1998.

Yasar S., Lin F., Fried L. et al. Diuretic use is associated with better learning and memory in older adults in the Ginkgo Evaluation of Memory Study // Alzheimer’s Dement.– 2012.– Vol. 8.– P. 188–195. doi: https://doi.org/10.1016/j.jalz.2011.03.010.

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