Cognitive function and left ventricular assist device implantation

Bhat, Geetha; Yost, Gardner; Mahoney, Edward

doi:10.1016/j.healun.2015.05.015

Cited by 54 publications

(33 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Limited data are available on the effects of long‐term support with LVAD on cognitive function. A recent study in patients with end‐stage HF demonstrated that haemodynamics and cognitive function improved significantly at 8 months after LVAD implantation, suggesting that improvement in cardiac output and cerebral perfusion may have a beneficial impact on cognitive function . Studies have shown that improvement of cognitive function with LVAD is independent of the mode of flow support (pulsatile vs. continuous) .…”

Section: Interactions Related To Heart Failure Treatmentmentioning

confidence: 99%

Heart and brain interaction in patients with heart failure: overview and proposal for a taxonomy. A position paper from the Study Group on Heart and Brain Interaction of the Heart Failure Association

Doehner

Ural

Hæusler

et al. 2017

European J of Heart Fail

152

125

View full text Add to dashboard Cite

Heart failure (HF) is a complex clinical syndrome with multiple interactions between the failing myocardium and cerebral (dys-)functions. Bi-directional feedback interactions between the heart and the brain are inherent in the pathophysiology of HF: (i) the impaired cardiac function affects cerebral structure and functional capacity, and (ii) neuronal signals impact on the cardiovascular continuum. These interactions contribute to the symptomatic presentation of HF patients and affect many co-morbidities of HF. Moreover, neuro-cardiac feedback signals significantly promote aggravation and further progression of HF and are causal in the poor prognosis of HF. The diversity and complexity of heart and brain interactions make it difficult to develop a comprehensive overview. In this paper a systematic approach is proposed to develop a comprehensive atlas of related conditions, signals and disease mechanisms of the interactions between the heart and the brain in HF. The proposed taxonomy is based on pathophysiological principles. Impaired perfusion of the brain may represent one major category, with acute (cardio-embolic) or chronic (haemodynamic failure) low perfusion being sub-categories with mostly different consequences (i.e. ischaemic stroke or cognitive impairment, respectively). Further categories include impairment of higher cortical function (mood, cognition), of brain stem function (sympathetic over-activation, neuro-cardiac reflexes). Treatment-related interactions could be categorized as medical, interventional and device-related interactions. Also interactions due to specific diseases are categorized. A methodical approach to categorize the interdependency of heart and brain may help to integrate individual research areas into an overall picture.

show abstract

Section: Interactions Related To Heart Failure Treatmentmentioning

confidence: 99%

Heart and brain interaction in patients with heart failure: overview and proposal for a taxonomy. A position paper from the Study Group on Heart and Brain Interaction of the Heart Failure Association

Doehner

Ural

Hæusler

et al. 2017

European J of Heart Fail

152

125

View full text Add to dashboard Cite

show abstract

“…The cumulative incidence of cognitive impairment in the first year after LVAD implantation was 29.2% . However, most studies found that cognition improved in the first 1 to 2 years after LVAD implantation . Risk factors for cognitive decline in this population include older age, higher CHADS2 risk score, statin use, history of stroke and hypertension, and destination therapy (as opposed to a bridge to transplantation) .…”

Section: Discussionmentioning

confidence: 94%

“…Although long‐term cognitive deficits are rare after cardiovascular procedures , encephalopathy and delirium can occur postoperatively, any time during acute care hospitalization, and sometimes during inpatient or subacute rehabilitation . The incidence of cognitive impairment in patients with advanced heart failure before LVAD implantation was 67% in 1 study . The cumulative incidence of cognitive impairment in the first year after LVAD implantation was 29.2% .…”

Section: Discussionmentioning

confidence: 95%

“…However, most studies found that cognition improved in the first 1 to 2 years after LVAD implantation . Risk factors for cognitive decline in this population include older age, higher CHADS2 risk score, statin use, history of stroke and hypertension, and destination therapy (as opposed to a bridge to transplantation) . However, cognitive deficits after LVAD implantation appear to be independent of the pulsatile‐ vs continuous‐flow device.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Rehabilitation of Patients With Advanced Heart Failure After Left Ventricular Assist Device Placement: A Narrative Review

Eickmeyer

Barker

Sayyad

et al. 2019

PM&R

View full text Add to dashboard Cite

Because more patients with advanced heart failure are receiving a left ventricular assist device (LVAD) as destination therapy or a bridge to transplantation, there is increasing attention on functional outcomes and quality of life after LVAD implantation. Rehabilitation providers in the acute inpatient rehabilitation setting increasingly will treat patients with an LVAD and should understand the exercise physiology, medical management, rehabilitation considerations, and outcomes after rehabilitation for patients with an LVAD. The purpose of this article is to provide the physiatrist with a comprehensive understanding of the rehabilitation of patients with advanced heart failure and LVAD implantation. Changes in relevant organ system physiology and exercise physiology after LVAD are summarized. Safety of rehabilitation and program considerations for acute inpatient rehabilitation are reviewed. Recommendations for medical management and prevention of secondary complications seen in patients with an LVAD are outlined. A discussion of outcomes after acute inpatient rehabilitation, the dual diagnosis of stroke and LVAD placement, and long-term cognitive, functional, and quality-of-life outcomes after LVAD placement is presented.

show abstract

“…They found that cognitive impairment is common up to 1-year post LVAD implant, and that such impairment is profound in older adults, aged 70 years and older (32,33). Cognitive dysfunction is common in heart failure, and its negative effect on the patient's QOL is widely known.…”

Section: Discussionmentioning

confidence: 99%

Advancing the Science of Self‐Management in Adults With Long‐Term Left Ventricular Assist Devices

Casida

Aikens

Pagani³

et al. 2018

Artificial Organs

View full text Add to dashboard Cite

This study tested the applicability of the individual and family self-management theory (IFSMT) to self-management (SM) in patients with left ventricular assist devices (LVADs). From an existing data set, we extracted the following variables that correspond to IFSMT's conceptual dimensions: anxiety, depression, and cognition (context dimension); self-efficacy (SM process dimension); adherence and quality of life (QOL; outcome dimensions). Descriptive statistics and partial least squares path modeling procedures were used for data analyses. A total of 100 patients (mean age 52 ± 13.4 years) with continuous flow LVAD designs comprised the present study. Most patients were White (78%), married (69%), college-educated (72%), and on disability (53%). Their mean anxiety and depression scores were slightly above normal, while their cognitive function scores were slightly lower than normal. LVAD care self-efficacy, adherence, and QOL were within normal ranges. Factor loadings ranged from 0.50 to 1.0, and there were significant forward path relationships among the context, process, and outcome dimensions (β ranges from 0.02 to 0.60, all P values < 0.05). In conclusion, the IFSMT provides a good fit for SM in LVAD. Further research is needed to clarify how best to improve LVAD SM practice and treatment outcomes.

show abstract

Cognitive function and left ventricular assist device implantation

Cited by 54 publications

References 35 publications

Heart and brain interaction in patients with heart failure: overview and proposal for a taxonomy. A position paper from the Study Group on Heart and Brain Interaction of the Heart Failure Association

Heart and brain interaction in patients with heart failure: overview and proposal for a taxonomy. A position paper from the Study Group on Heart and Brain Interaction of the Heart Failure Association

The Rehabilitation of Patients With Advanced Heart Failure After Left Ventricular Assist Device Placement: A Narrative Review

Advancing the Science of Self‐Management in Adults With Long‐Term Left Ventricular Assist Devices

Contact Info

Product

Resources

About