Cognitive Impairment and Treatment Compliance in Patients with Chronic Heart Failure

Objectives. To identify the risk factors for the development of cognitive impairments and the low treatment compliance seen in patients with chronic heart failure (CHF). Materials and methods. A total of 157 patients with CHF and 32 control subjects took part in the study. Neuropsychological investigations were carried out using a 30-min set of tests recommended by the NINDS-Canadian Stroke Standards – echocardioscopy, brain MRI scans, and cognitive event-related potentials (ERP) – along with assessment of treatment compliance. Results and conclusions. Treatment regime violations were seen in 62% of cases. Decreases in compliance were associated with increases in the severity of subcortical (frontal lobes) and periventricular leukoaraiosis, slowing of decision-taking processes (increases in the latency of the ERP P300 peak), and degradation of test performance for assessment of speech activity, optical-spatial, frontal-dysregulatory functions, and memory. Among patients with low treatment compliance, 58% showed frontal-dysregulatory cognitive disorders, 21% combined disorders, and 40% amnestic disorders. Risk factors for progression of cognitive disorders and low treatment compliance were a reduced fractional output and the restrictive type of diastolic cardiac dysfunction. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.