Online ISSN : 1687-8329


Quick Search 

July2007 Vol.44 Issue:        2        Table of Contents
Full Text

Cognitive Impairment in Patients with Heart Failure: The Role of The Inflammatory Cytokines

Sameh M. Said1, Khaled A. Fouad2, Zakareya Alyan3

Departments of Neuropsychiatry, Alexandria University1;

Cardiology, Ain Shams University2; Clinical Pathology, Cairo University3


Introduction: Increasing age and lower indices of left ventricular function were associated with worsening cognitive performance in patients with congestive heart failure (CHF). However, patients with CHF have also evidence of inflammatory cytokine activation which recently, has also been associated with cognitive disorders and dementia. Aim of the work: The aim of this study was to investigate the relationship between inflammatory cytokine levels and cognition in patients with CHF. Patients and Methods: This was a prospective cross sectional study done on 40 consecutive patients with CHF. New York heart association (NYHA) criteria were used to evaluate the degree of heart failure. Accordingly the patients were classified into two groups, group A (20 patients) included NYHA class I&II, and group B (20 patients) included NYHA class III&IV.  Cognitive function was assessed using the Hodkinson Abbreviated Mental Test (AMT). Serum IL-6 and TNF- α were measured. Results: the serum levels of IL-6 and TNF-α were significantly higher in group B than in group A. Bivariate correlation analysis revealed the presence significant negative correlations between AMT scores and the serum levels of IL-6 and TNF-α and there were significant positive correlations between the AMT scores and the LVEF and systolic blood pressure. However, stepwise linear regression analysis showed that only the serum IL-6 level could significantly predict the AMT scores. (AMT score =11.839 −0.439× serum IL-6). Conclusion: The current study showed that patients with heart failure had cognitive impairment that worsened with the severity of heart failure. It also showed that the serum levels of IL-6 and TNF-α were significantly elevated in severe cases with heart failure (NYHA classification III & IV) more than in milder cases (NYHA classification I&II).  Both cytokine levels were negatively correlated with the cognitive impairment, however, only serum IL-6 levels could predict the degree of cognitive impairment in patients with heart failure.

(Egypt J. Neurol. Psychiat. Neurosurg., 2007, 44(2): 705-711)


2008 � Copyright The Egyptian Journal of Neurology,
Psychiatry and Neurosurgery. All rights reserved.

Powered By DOT IT