Paper: Cytokines May Be Associated with Cognitive Function in Heart Failure (Sigma Theta Tau International's 21st International Nursing Research Congress)

Tuesday, 13 July 2010: 10:30 AM

Ponrathi R. Athilingam, PhD, RN, ACNP
School of Nursing, University of Rochester, Rochester, NY
Leway Chen, MD, MPH, FACC
Strong Heart and Vascular Center, University of Rochester, University of Rochester, Rochester, NY
Jan A. Moynihan, PhD
Department of Psychiatry, University of Rochester, Rochester, NY

Learning Objective 1: To understand the prevalence of cognitive impairment among heart failure patients.

Learning Objective 2: To understand the relationship between cytokines and cognitive impairment in patients with heart failure

Purpose: During the past century, both the causes and treatmentof heart failure (HF) have changed considerable. Biologically active molecules known as the cytokines are used for prognostification of HF. It is unclear whether these cytokines are associated with cognitive deficits in patients with HF. A recent research indicated fourfold risk of having cognitive deficit among HF patients compared to general population. The purpose of this study was to examine the relationship between cytokines and cognitive function in HF.
Methods: A cross sectional study enrolled 38 community dwelling adults aged 50 and above with HF. Mini Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to measure cognitive function and blood samples collected for cytokines (i.e., Tumor necrosis factor (TNF- alfa), Interleukin (IL6), and C-reactive protein (CRP).

Results: Most participants were men (68%), Caucasian (79%), aged 50 to 89 (62 ± 9 years), 62% were in NYHA class II, 38% in class III, 80% were in AHA/ACC stage C, 79% with ejection fraction <40%. The MoCA identified 61% participants with mild cognitive impairment with score <26 and 16% with moderate cognitive impairment score <22 with a mean score of 24.86 (SD ± 2.81) compared to 2.2% on the MMSE with a mean score of 28.96 (SD ± 1.9). Multiple regression analysis demonstrated no statistically significant association with cognitive function measured by MMSE and MoCA. Although not statistically significant, the cognitive function measured by MoCA was inversely related to TNF-alfa, IL-6, and CRP (r=0.24, p= 0.18). CRP and IL-6 were highly related to each other (r .791, p= 0.0001).

Conclusion: An appropriately designed longitudinal study may have potential to demonstrate a significant relationship between cognitive function and cytokines. In turn, this may help in early recognition of cognitive impairment and in the design of an intervention to enhance cognitive function.

See more of: Heart Health Issues
See more of: Research Sessions – Oral Paper & Posters