eprintid: 26130
rev_number: 16
eprint_status: archive
userid: 1589
dir: disk0/00/02/61/30
datestamp: 2019-04-29 07:53:19
lastmod: 2024-05-26 01:05:48
status_changed: 2019-04-29 07:53:19
type: article
metadata_visibility: show
creators_name: Terhoeven, Valentin
creators_name: Nikendei, Christoph
creators_name: Cranz, Anna
creators_name: Weisbrod, Matthias
creators_name: Geis, Nicolas
creators_name: Raake, Philip W.
creators_name: Katus, Hugo A.
creators_name: Herzog, Wolfgang
creators_name: Friederich, Hans-Christoph
creators_name: Schultz, Jobst-Hendrik
creators_name: Pleger, Sven T.
title: Effects of MitraClip on cognitive and psychological function in heart failure patients: the sicker the better
subjects: ddc-150
subjects: ddc-610
divisions: i-910100
divisions: i-910600
divisions: i-910700
keywords: Chronic heart failure, MitraClip intervention, Cognitive performance, Memory, Executive function, Depression, Quality of life
abstract: Purpose: Cognitive impairment and reduced quality of life is a common condition in patients with heart failure (HF). Percutaneous mitral valve repair using (PMVR) MitraClip (MC) has emerged as a promising interventional tool, reducing all-cause mortality and hospitalization as well as increasing cognitive functioning and quality of life. However, the benefit of HF patients with severely depressed cognitive functioning remains unknown.

Methods: We assessed cognitive functioning (figural memory—FGT, executive function—TOL, TMT B), psychosocial functioning (depression—PHQ-9, quality of life—SF36), and clinical parameters (echocardiography, 6-min walk test distance, and cardiac biomarkers) 1 day before (t0) and 6 weeks after (t1) MC intervention in HF patients (n = 40). First, paired sample t tests were conducted to uncover improvements in cognitive functioning post-MC intervention. Second, the COGBAT Norm-sample, a representative age-matched healthy sample, was used to compare participants’ individual scores. Third, bivariate linear regressions were calculated for all key predictors of the detected improvements in cognitive functioning post-MC intervention (t1–t0).

Results: Following the MC intervention, we found significant improvements in figural memory, executive functioning, and psychosocial functioning. Most of the patients with depressed executive functioning before the MC intervention showed post-intervention test scores within the normal range (> 50th percentile; t0 22.5% vs. t1 60%) as compared to the normative COGBAT sample. Regression analyses revealed that lower baseline scores in planning ability before the MC intervention (t0) were associated with greater planning ability (TOL; B = − 0.78, 95% CI − 1.04 to − 0.53), figural memory (FGT; B = − 0.26, 95% CI − 0.44 to − 0.07), and cognitive flexibility (TMT B; B = − 0.36, 95% CI − 0.50 to − 0.23) improvement post-MC intervention (t1–t0). Psychosocial functioning and age were not associated with these improvements.

Conclusions: Patients with depressed executive functioning showed the greatest benefit from the MC intervention regarding cognitive functioning. Age and psychological functioning seem less important for cognitive performance improvements post-MC intervention. Hence, severely depressed cognitive functioning in patients is not a contraindication for PMVR using MitraClip.
date: 2019
publisher: BioMed Central
id_scheme: DOI
ppn_swb: 1666325171
own_urn: urn:nbn:de:bsz:16-heidok-261307
language: eng
bibsort: TERHOEVENVEFFECTSOFM2019
full_text_status: public
publication: European Journal of Medical Research
volume: 24
number: 14
place_of_pub: London
pagerange: 1-8
issn: 2047-783X
citation:   Terhoeven, Valentin ; Nikendei, Christoph ; Cranz, Anna ; Weisbrod, Matthias ; Geis, Nicolas ; Raake, Philip W. ; Katus, Hugo A. ; Herzog, Wolfgang ; Friederich, Hans-Christoph ; Schultz, Jobst-Hendrik ; Pleger, Sven T.  (2019) Effects of MitraClip on cognitive and psychological function in heart failure patients: the sicker the better.  European Journal of Medical Research, 24 (14).  pp. 1-8.  ISSN 2047-783X     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/26130/1/40001_2019_Article_371.pdf