The Role of Biomarkers Predicting Cognitive Impairment in Elderly Patients with Heart Failure

OBJECTIVE
The aim of this study is to investigate the role of sST2, GDF-15, and the clinical factors involved in cognitive dysfunction in elderly patients with heart failure with reduced ejection fraction (HFrEF).

METHODS
101 chronic stable HFrEF patients over 65 years old were enrolled in the study. The Montreal Cognitive Asssessment (MoCA) test and the Mini Mental State Examination (MMSE) were employed to evaluate the cognitive functions of the patients, and the sST2, GDF-15, and NT-proBNP levels were measured.

RESULTS
The NT-proBNP and GDF-15 levels were significantly higher in the cognitive dysfunction group, while the sST2 levels were similar between the groups. The patients in the cognitive dysfunction group were older. The ratio of influenza-vaccinated patients was higher in the normal cognitive function group. The GDF-15 levels showed a negative correlation with the MMSE score. The right ventricular diameter had a negative correlation and the hemoglobine levels showed a positive correlation with the MoCA and MMSE scores. In the logistic regression analysis, higher GDF-15 levels, older age, and higher NYHA classes were related to increased risk of cognitive dysfunction. Influenza vaccination in the past year was associated with a reduced risk of cognitive dysfunction.

CONCLUSION
Cognitive dysfunction may be related to age, right ventricular enlargement, anemia, the NYHA functional class, and the GDF-15 and NT-proBNP levels in elderly patients with heart failure.