Disease-Targeted Treatment Improves Cognitive Function in Patients with Precapillary Pulmonary Hypertension
| Autor: | Konrad E. Bloch, Stephan Keusch, Michael Furian, Silvia Ulrich, Florian F. Hildenbrand, Rudolf Speich, Gina Somaini, Elisabeth D. Hasler, Adriana Stamm, Séverine Müller-Mottet |
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| Přispěvatelé: | University of Zurich, Ulrich, Silvia |
| Rok vydání: | 2015 |
| Předmět: |
Male
Cardiac Catheterization Pulmonary Circulation Vasodilator Agents medicine.medical_treatment Pilot Projects Severity of Illness Index law.invention Cohort Studies Cognition Drug Delivery Systems Randomized controlled trial law Medicine Prospective Studies Prospective cohort study Cardiac catheterization Exercise Tolerance Spectroscopy Near-Infrared Middle Aged Cognitive test 10076 Center for Integrative Human Physiology Predictive value of tests Hypoxia-Ischemia Brain Cardiology Regression Analysis Female 10178 Clinic for Pneumology Switzerland Adult Pulmonary and Respiratory Medicine medicine.medical_specialty Hypertension Pulmonary 610 Medicine & health Predictive Value of Tests Internal medicine Severity of illness Humans Antihypertensive Agents Aged Analysis of Variance business.industry medicine.disease Pulmonary hypertension Capillaries Surgery 2740 Pulmonary and Respiratory Medicine Multivariate Analysis Quality of Life 10029 Clinic and Policlinic for Internal Medicine business Stroop effect |
| Zdroj: | Respiration. 90:376-383 |
| ISSN: | 1423-0356 0025-7931 |
| DOI: | 10.1159/000439227 |
| Popis: | Background: Patients with pulmonary hypertension (PH) may suffer from cognitive deficits that potentially relate to reduced oxygen delivery and cerebral tissue oxygenation (CTO). Objective: To evaluate the hypothesis that cognitive function improves with therapy, along with improved CTO. Methods: Twenty incident patients with arterial or chronic thromboembolic PH had CTO monitoring by near-infrared spectroscopy during diagnostic right heart catheterization. Cognitive tests [Trail Making Tests (TMTs), Victoria Stroop tests and the Five-Point Test (5PT)], the 6-min walk distance (6MWD) test, New York Heart Association (NYHA) class and health-related quality of life (HRQoL) were assessed and repeated after 3 months of disease-targeted medication. Results: At baseline, 45% of PH patients had cognitive deficits. At 3 months, the patients had improved on the TMT A and the Stroop 2 test [37 s (27; 55) versus 30 s (24; 42), p < 0.05, and 18 s (16; 22) versus 16 s (15; 20), p < 0.01], whereas CTO remained unchanged. Arterial oxygen saturation, NYHA class, 6MWD and HRQoL had also improved. Baseline CTO was the strongest predictor of cognitive function, even in multivariate analysis including age, 6MWD and HRQoL. Improvements in cognitive function were not associated with changes in CTO. Conclusions: In patients with PH, 3 months of disease-targeted medication resulted in better cognitive function. Although CTO was the strongest predictor of cognitive function at baseline, it did not change during target therapy. The results of this pilot study should be confirmed in an adequately powered controlled trial. |
| Databáze: | OpenAIRE |
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