Cognitive dysfunction in adult CHD with different structural complexity

Abstract

This is the accepted version of the paper.This version of the publication may differ from the final published version. Tel No: +44 207 040 5767, Fax No: +44 207 0408750 Email: Stanton.newman.1@city.ac.uk Word Count: 3,215(excluding title page, abstract, key questions, references, figures, tables). Permanent repository linkKey Words: Adult Congenital Heart Disease, Cognition, Neuropsychological assessment, Mood 3 ABSTRACT ObjectiveA cross-sectional study assessed cognitive function in a sample of Adult Congenital Heart Disease patients, within the Functioning in Adult Congenital Heart Disease study London. The association between cognitive functioning and disease complexity was examined. MethodsThree hundred and ten patients participated. Patients were classified into four structural complexity groups (Tetralogy of Fallot, Transposition of the Great Arteries, Single Ventricle and Simple conditions). Each participant underwent neuropsychological assessment to evaluate cognitive function (memory, executive function) and completed questionnaires to assess depression and anxiety. ResultsForty one percent of the sample showed impaired performance (>1.5 SD below the normative mean) on at least 3 tests of cognitive function compared to established normative data. This was higher than the 8% that would be expected in a normal population. The sample exhibited significant deficits in divided attention, motor function and executive functioning. There was a significant group difference in divided attention (F=5.01, p=.002) and mean total composite score (F=5.19, p=.002) between different structural complexity groups with the Simple group displaying better cognitive function. ConclusionThe results indicate that many Adult Congenital Heart Disease patients display impaired cognitive function relative to a healthy population, which differs in relation to disease complexity. These findings may have implications for clinical decision making in this group of patients during childhood. Possible mechanisms underlying these deficits and how they may be 4 reduced or prevented are discussed; however further work is needed to draw conclusive judgments.

Congenital heart diseases: genetics, non-inherited risk factors, and signaling pathways

“…However, most children with CHDs present with failure to thrive, cough, repeated chest infections, difficulty in breathing, exercise intolerance, and bluish discoloration of mucous membranes (cyanosis) [18]. Congenital heart defects are associated with serious complications such as cognitive impairment [19][20][21][22][23][24][25][26][27] and often affect families and individuals both emotionally and financially [23,[28][29][30][31].…”

Cognitive dysfunction is associated with abnormal responses in cerebral blood flow in patients with single ventricular physiology: Novel insights from transcranial Doppler ultrasound

“…Patients with congenital heart disease are well documented to have cognitive deficits, with deficits more notable in complex forms of congenital heart disease, such as single ventricular physiology . In particular, cognitive limitation in areas essential for social and academic performance, referred to as executive function, are deficient in these patients with congenital heart disease .…”

Фактори, Що Визначають Якість Життя В Оперованих Та Неоперованих Дорослих Із Вродженими Вадами Серця Із Серцевою Недостатністю

“…Однак таке широке поняття містить декілька складників: фізичне здоров'я, психологічний статус, рівень незалежності, соціальні відносини, навколишнє середовище, духовність, релігійні погляди й особисті переконання [1,4,19]. Таке трактування терміна «якість життя» призвело до формування терміна «якість життя, що пов'язана зі здоров'ям (ЯЖПЗ)» (Health-related quality of life), що визначає показники, асоційовані й неасоційовані з хронічним неінфекційним захворюванням, дозволяє диференційовано визначити вплив хвороби та її лікування на психологічний, емоційний стан хворого, його соціальний статус у суспільстві [4,11,12,17].…”