High prevalence of cognitive decline following heart transplantation

Medium and long-term cognitive function in heart transplant recipients is the main theme of Britta Susanne Bürker‘s PhD thesis.


MAIN RESULTS:

  1. The prevalence of cognitive decline following heart transplantation is high.
  2. Posttransplant depression is related to increased risk of early death.

THESIS DEFENCE:

Thesis: Mood and Cognitive Outcome after Heart Transplantation: The MOODHEART study.
Candidate: Britta Susanne Bürker
Time: September 10, 2019 at 13:15
Place: Oslo University Hospital, Rikshospitalet: Rødt auditorium
Link to university website


SUMMARY:

(1) Cognitive assessment should be integrated into the follow-up of patients after heart transplantation. Bürker and co-workers examined the cognitive function of 37 patients three years after transplantation, of which about half received standard immunosuppressive therapy with the calcineurine inhibitor cyclosporine. The rest had been randomly assigned to experimental immunosuppression with everolimus and a much lower dose of cyclosporin, shown to retain renal function better and reduce calcification of the large blood vessels of the new heart. There was no difference in cognitive function between the two groups. Overall, 40% of patients had cognitive impairments such as attention, memory or language problems.

(2) Nearly 40%  of long-term heart transplant survivors exhibit impaired test performance on several cognitive measures. All 37 patients included had survived for more than 16 years after transplantation, and they generally scored below population norms on cognitive parameters like precessing speed, executive functions, memory and language. 30 % qualified for mild cognitive impairement. 

(3) Patients with clinical significant depression five years after heart transplantation have doubled risk of premature death. 141 heart transplant recipients were included in the study and followed for up to 20 years after transplantation.


REFERENCES:

(1) Bürker, B. S., Gullestad, L., Gude, E., Relbo Authen, A., Grov, I., Hol, P. K., Andreassen, A. K., Arora, S., Dew, M. A., Fiane, A. E., Haraldsen, I. R., Malt, U. F., & Andersson, S. (2017). Cognitive function after heart transplantation: Comparing everolimus‐based and calcineurin inhibitor‐based regimens. Clinical transplantation31(4), e12927.

(2) Bürker, B. S., Gude, E., Gullestad, L., Grov, I., Relbo Authen, A., Andreassen, A. K., Havik, O. E., Dew, M. A., Fiane, A., Haraldsen, I. R., Malt, U. F., & Andersson, S. (2017). Cognitive function among long‐term survivors of heart transplantation. Clinical transplantation31(12), e13143.

(3) Bürker, B. S., Gullestad, L., Gude, E., Havik, O. E., Authen, A. R., Grov, I., Andreassen, A. K., Fiane, A. E., Haraldsen, I. R., Dew, M. A., & Andersson, S. (2019). The predictive value of depression in the years after heart transplantation for mortality during long-term follow-up. Psychosomatic medicine81(6), 513-520.