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Executive cognitive dysfunction without stroke after long-term mechanical circulatory support.

Takeshi Komoda·Thorsten Drews·Shigeru Sakuraba·Masako Kubo·Roland Hetzer
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Abstract

Among patients who receive heart transplantation (HTx) after long-term mechanical circulatory support (MCS), some show executive cognitive dysfunction without a history of stroke. Fifty HTx patients (19 patients on MCS for longer than 3 months before HTx and 31 patients without MCS as control group) were enrolled in the study. All subjects were men aged between 20 and 59 years without a history of stroke. Patients with MCS were divided into two groups: the AH-Thr group (n = 11), in which thrombus was detected in the left ventricular assist device (LVAD) and quickly removed (mean 3.3 times); and the AH group (n = 8), in which there was no detectable thrombus in the LVAD. The Trail Making Test (TMT) and the Wisconsin Card Sorting Test (WCST) were administered. The AH-Thr group showed poorer cognitive performance both in the TMT part B, with longer completion time (p < 0.05 versus the other two groups), and in the WCST, with more perseverative errors (p < 0.001 versus the other two groups). These data indicate that patients in the AH-Thr group showed executive cognitive dysfunction in set-shifting ability, suggesting frontal lobe damage. The conditions that facilitate thrombus formation in the LVAD may induce executive cognitive dysfunction without stroke.

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AdultCase-Control StudiesCognition DisordersHeart TransplantationHeart-Assist DevicesHumansMaleMiddle AgedNeuropsychological TestsStrokeTime FactorsJournal Article

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Takeshi Komoda, Thorsten Drews, Shigeru Sakuraba, Masako Kubo, Roland Hetzer. Executive cognitive dysfunction without stroke after long-term mechanical circulatory support.. https://doi.org/10.1097/01.mat.0000183685.81983.5d

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