Cognitive and affective impairments in patients with dilated cardiomyopathy

• Applicants: Professor Dr. Marcus Dörr; Professorin Dr. Agnes Flöel
• Subject Area: Human Cognitive and Systems Neuroscience ; Cardiology, Angiology
• Term: since 2020
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 450145994

Heart failure (HF) is one of the leading causes of mortality world-wide. One important but mostly neglected aspect of HF are impairments of cognition and symptoms of depression and anxiety. Although it is known that these impairments occur frequently in patients with HF and may contribute to overall health outcome, neuropsychological assessment is not implemented in routine clinical care. Previous studies on the interactions of heart and brain have yielded heterogeneous results, due to methodological variability, but also because of massive confounding by vascular pathologies in elderly patients with ischemic chronic HF. It is of high clinical and scientific interest to better understand and predict the scope, underlying pathogenic mechanisms, and course of cognitive and affective impairments in patients with HF, with the ultimate goal to improve prevention and therapy. Non-ischemic dilated cardiomyopathy (DCM) represents a unique opportunity to better understand the etiology and underlying mechanisms of cognitive and affective disorders in HF, given that these patients lack vascular pathologies. Cognitive and affective impairments in HF patients most likely have an impact on quality of life and global outcome. Earlier detection and treatment of these impairments can improve therapy adherence and therefore lead to a better overall outcome. Given the high prevalence of cardiovascular diseases, this project is of high relevance not only for the quality of life of individual patients but also to reduce direct and indirect costs for the health system. Specifically, the goal of this project is to characterize cognitive and affective impairments and their associations to cardiac parameters in a monocentric, prospective observational study over the course of three years. Patients with DCM visiting the In- and Outpatient Department for Internal Medicine of the University Hospital Greifswald will be asked to perform a neuropsychological assessment including questionnaires on affective disorders and quality of life and an electroencephalography (EEG), and will be compared to a healthy control group. The assessment will be performed early in the course of the disease and repeated after 12 and 36 months to evaluate the long-term course of these parameters. In parallel, cardiac parameters will be correlated to neuropsychological and EEG data, to identify predictors for the course of the disease, and to identify patients at high-risk for severe cognitive deficits. As a long-term goal, cardiological and neurological expertise needs to be joined in order to implement neuropsychological assessments with diagnostic and predictive value in the routine cardiologic work-up. Ultimately, this approach shall improve prevention, counseling and treatment of neuropsychological deficits in these patients and may allow conclusions with regard to the general health outcome of these patients.

• DFG Programme: Research Grants
• Co-Investigators: Dr. Daniel Beug; Dr. Robert Fleischmann; Dr. Viola von Podewils