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J Am Heart Assoc ; 9(19): e015379, 2020 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-32981450

RESUMO

Background Neurocognitive impairment is a common complication of congenital heart disease (CHD) as well as acquired cardiovascular disease. Data are limited on neurocognitive function in adults with CHD (ACHD). Methods and Results A total of 1020 individuals with mild-to-moderate ACHD and 497 987 individuals without ACHD from the volunteer-based UK Biobank study underwent neurocognitive tests for fluid intelligence, reaction time, numeric memory, symbol-digit substitution, and trail making at enrollment and follow-up. Performance scores were compared before and after exclusion of preexisting stroke or coronary artery disease as measures of cerebro- and cardiovascular disease. Individuals with ACHD had significantly poorer performance on alpha-numeric trail making, a measure of visual attention and cognitive flexibility, spending 6.4 seconds longer on alpha-numeric trail making (95% CI, 3.0-9.9 seconds, P=0.002) and 2.5 seconds longer on numeric trail making (95% CI, 0.5-4.6 seconds, P=0.034), a measure of visual attention and processing speed. The ACHD cohort had modestly lower performance on symbol-digit substitution, a measure of processing speed, with 0.9 fewer correct substitutions (95% CI, - 1.5 to - 0.2 substitutions, P=0.021). After excluding preexisting stroke or coronary artery disease, individuals with ACHD continued to show poorer performance in all 6 domains (P=NS). Conclusions Individuals with mild-to-moderate ACHD had poorer neurocognitive performance, most significantly in tests of cognitive flexibility, analogous to deficits in children with CHD. These differences appear to be driven by increased burden of cerebro- and cardiovascular disease among individuals with ACHD.


Assuntos
Cardiopatias Congênitas , Testes de Estado Mental e Demência/estatística & dados numéricos , Transtornos Neurocognitivos , Adulto , Cognição , Correlação de Dados , Efeitos Psicossociais da Doença , Feminino , Cardiopatias Congênitas/diagnóstico , Cardiopatias Congênitas/epidemiologia , Cardiopatias Congênitas/psicologia , Humanos , Masculino , Testes de Memória e Aprendizagem , Transtornos Neurocognitivos/diagnóstico , Transtornos Neurocognitivos/fisiopatologia , Tempo de Reação , Índice de Gravidade de Doença , Análise e Desempenho de Tarefas , Teste de Sequência Alfanumérica , Reino Unido/epidemiologia
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