Characteristics of hippocampus, cognitive functions, lipid profile, and severity of chronic heart failure in patients with coronary heart disease

Abstract

Background: Currently, the relationship between the severity of chronic heart failure (CHF) and the main quantitative characteristics of the hippocampus, cognitive functions, and lipid profile components in patients with coronary heart disease (CHD) is not clearly understood. Materials and methods. Fifty patients with CHD and functional class (FC) II-IV CHF were examined. The study did not include patients who had severe medical conditions which could develop the morphological changes in the brain. In addition to the routine clinical tests, Doppler echocardiography and nuclear magnetic resonance imaging (MRI) of the brain were performed; the right and left hippocampal volumes and lengths as well as the cortical gray matter thickness were calculated; N-terminal pro-B-type natriuretic peptide (NT-proBNP) and lipid panel components were measured. The cognitive functions were assessed via Wechsler Verbal and Nonverbal Scale of Ability (V and VII subtests) and Bourdon test (Dot Cancellation Test). Results: The canonical correlation analysis revealed significant relationships between the groups of signs characterizing the severity of chronic heart failure parameters of the hippocampus, lipid profile components, and cognitive scores. The pairwise correlation analysis determined that the decrease in the Wechsler VII scores and time spent for the Bourdon test were associated with enlarged cardiac chambers, increased functional class, decreased right hippocampal volume and elevated cholesterol and low-density lipoprotein (LDL) levels. The Wechsler V scores were lower in patients with higher functional class, lower left ventricular ejection fraction (LVEF), shorten right hippocampal length, and higher LDL levels. The decline of Bourdon test parameters was associated with higher functional class, lower LVEF, and smaller right and left hippocampal volumes. Conclusion: The dyslipidemia, as well as development and progression of chronic heart failure in patients with coronary heart disease may be predictors for hippocampal atrophy which, in turn, may be one of the direct causes of cognitive dysfunction in this population.