Alterações neurocognitivas e fatores de riscos associados em pacientes com insuficiência cardíaca

Abstract

Heart Failure (HF) is a debilitating condition in which the heart cannot deliver enough oxygen to organs. Its high prevalence is associated with significant morbidity and mortality, and can affect patients' cognition, functionality and quality of life. The study aimed to compare cognitive performance between patients with and without HF, as well as identify factors associated with cognition, quality of life and functionality. This is a cross-sectional and exploratory study carried out with 183 patients divided into two groups: with HF (n=82) and without HF (n=101). Socioeconomic and clinical data were collected, and cognitive screening was carried out using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) tests. Quality of life was assessed using the World Health Organization Quality of Life Bref, and functional capacity was measured using the 6-minute Walk and Sit and Stand Tests. The HF group included 82 patients with a mean age of 59.4±12.92 years, of which 63.41% were men, 51.22% had an ejection fraction equal to or greater than 50% and 34.15% were in New York Heart Association class II. A higher prevalence of cognitive impairment was observed in patients with HF compared to patients without this condition, both in the MMSE (52.43% vs. 47.52%) and in the MoCA (18.29% vs. 9.90% ). In the group of patients with HF, a significant impairment in the cognitive functions of orientation, attention, visuospatial capacity and language was detected. Risk factors such as advanced age, family history of HF, low education and lack of physical activity were determinants for cognitive impairment in these patients. Furthermore, HF is associated with a worse health-related quality of life in psychological and environmental aspects, and reduced functional capacity, which is significantly correlated with advanced age and male sex. The study showed significant differences in cognitive performance between patients with HF and individuals without this condition, highlighting the importance of carrying out regular cognitive screenings. Furthermore, identifying factors related to cognition and functionality provides essential insights for the development of more effective clinical and therapeutic approaches, aiming to improve the quality of life of these patients.