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Cognitive dysfunction in adult CHD with different structural complexity

Published online by Cambridge University Press:  18 October 2016

Manavi Tyagi ,
Theodora Fteropoulli ,
Catherine S. Hurt ,
Shashivadan P. Hirani ,
Lorna Rixon ,
Anna Davies ,
Nathalie Picaut ,
Fiona Kennedy ,
John Deanfield  and
Shay Cullen
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Manavi Tyagi
Affiliation:
Centre for Health Services Research, School of Health Sciences, City University London, London, United Kingdom GUCH Unit, The Heart Hospital, University College of London Hospitals NHS Foundation Trust, London, United Kingdom
Theodora Fteropoulli
Affiliation:
Centre for Health Services Research, School of Health Sciences, City University London, London, United Kingdom GUCH Unit, The Heart Hospital, University College of London Hospitals NHS Foundation Trust, London, United Kingdom
Catherine S. Hurt
Affiliation:
Centre for Health Services Research, School of Health Sciences, City University London, London, United Kingdom
Shashivadan P. Hirani
Affiliation:
Centre for Health Services Research, School of Health Sciences, City University London, London, United Kingdom
Lorna Rixon
Affiliation:
Centre for Health Services Research, School of Health Sciences, City University London, London, United Kingdom
Anna Davies
Affiliation:
Centre for Health Services Research, School of Health Sciences, City University London, London, United Kingdom
Nathalie Picaut
Affiliation:
GUCH Unit, The Heart Hospital, University College of London Hospitals NHS Foundation Trust, London, United Kingdom
Fiona Kennedy
Affiliation:
GUCH Unit, The Heart Hospital, University College of London Hospitals NHS Foundation Trust, London, United Kingdom
John Deanfield
Affiliation:
GUCH Unit, The Heart Hospital, University College of London Hospitals NHS Foundation Trust, London, United Kingdom
Shay Cullen
Affiliation:
GUCH Unit, The Heart Hospital, University College of London Hospitals NHS Foundation Trust, London, United Kingdom
Stanton P. Newman*
Affiliation:
Centre for Health Services Research, School of Health Sciences, City University London, London, United Kingdom Division of Cardiovascular Sciences, University College London (UCL), London, United Kingdom
*
Correspondence to: Professor S. P. Newman, Center for Health Services Research, School of Health Sciences, City University London, Northampton Square, London ECIV 0HB, United Kingdom. Tel: +44 207 040 5767; Fax: +44 207 040 8750; E-mail: Stanton.newman.1@city.ac.uk
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Abstract

Objective

We carried out a cross-sectional study to assess cognitive function in a sample of adult CHD patients, within the Functioning in Adult Congenital Heart Disease study London. The association between cognitive functioning and disease complexity was examined.

Methods

A total of 310 patients participated in this study. Patients were classified into four structural complexity groups – tetralogy of Fallot, transposition of the great arteries, single ventricle, and simple conditions. Each patient underwent neuropsychological assessment to evaluate cognitive function, including memory and executive function, and completed questionnaires to assess depression and anxiety.

Results

Among all, 41% of the sample showed impaired performance (>1.5 SD below the normative mean) on at least three tests of cognitive function compared with established normative data. This was higher than the 8% that was expected in a normal population. The sample exhibited significant deficits in divided attention, motor function, and executive functioning. There was a significant group difference in divided attention (F=5.01, p=0.002) and the mean total composite score (F=5.19, p=0.002) between different structural complexity groups, with the simple group displaying better cognitive function.

Conclusion

The results indicate that many adult CHD patients display impaired cognitive function relative to a healthy population, which differs in relation to disease complexity. These findings may have implications for clinical decision making in this group of patients during childhood. Possible mechanisms underlying these deficits and how they may be reduced or prevented are discussed; however, further work is needed to draw conclusive judgements.

Keywords

Adult CHDcognitionneuropsychological assessmentmood
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 5 , July 2017 , pp. 851 - 859
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Copyright
© Cambridge University Press 2016 

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