Cognitive impairment in heart failure with Cheyne-Stokes respiration

Abstract

Objectives-To document the degree of cognitive impairment in stable heart failure, and to determine its relation to the presence of Cheyne-Stokes respiration during sleep. Subjects-104 heart failure patients and 21 healthy normal volunteers. Methods-Overnight oximetry was used (previously validated as a screening tool for Cheyne-Stokes respiration in heart failure). Cognitive function was assessed using a battery of neuropsychological tests. Left ventricular function was assessed by echocardiography. Results-Heart failure patients performed worse than the healthy volunteers in tests that measured vigilance. Reaction times were 48% slower (0.89 (0.03) s v 0.60 (0.05) s; p < 0.005) and they hit twice as many obstacles on the Steer Clear simulator (75 (6.4) v 33 (4.6); p < 0.005). Cognitive impairment within the heart failure group was unrelated to either the presence of Cheyne-Stokes respiration, the degree of left ventricular dysfunction, or indices of nocturnal oxygenation. Conclusions-Vigilance was impaired in heart failure but this did not appear to be related to the presence of Cheyne-Stokes respiration during sleep. Impaired vigilance as measured on the Steer Clear test has been associated with an increased risk of motor vehicle accidents. The issue of fitness to drive in heart failure requires further attention. (Heart 2001;85:18-22)

Cognitive functions in severe congestive heart failure before and after an exercise training program

“…Sleeprelated breathing disorders, including obstructive sleep apnea and Cheyne-Stokes respiration with central sleep apnea commonly occur in patients with severe congestive heart failure [24,25], and may be modified by exercise training [26].…”

Sleep Disturbance in People With Heart Failure

“…80 However, others have found no associations between SDB and selfreported physical function, 31,69 fatigue, 31 or 6-minute walk. 41,81 Sleep efficiency, measured through wrist actigraphy, was associated with both self-reported and actigraph-recorded physical function, 15 and selfreported sleep quality and duration of nocturnal awakenings were associated with 6-minute walk distance in systolic HF patients; self-reported sleep difficulty was also associated with quality of life in older HF patients. 13 However, Erickson and colleagues 16 found that only napping and not feeling tired at bedtime, not nocturnal characteristics, were associated with 6-minute walk distance.…”

Cognitive and Psycholologic Considerations in Pediatric Heart Failure

“…Cognitive impairment in adult patients with CHF, especially in the domains of vigilance and memory, is well described and appears to be reversible with cardiac transplantation. 11,12 Anatomic changes in brain gray matter volume in adults with chronic heart failure have also been reported. 6 Data in children, however, are limited.…”