Research Laboratory of Rehabilitation, Federal Almazov North-West Medical Research Centre, Saint Petersburg, Russia
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The dynamics of the cognitive functioning and emotional state of cardiac patients during rehabilitation after coronary revascularization
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Background. Coronary artery bypass grafting (CABG) has been one of the most performed surgical procedures for more than 30 years. Recent research has shown severe cognitive disorders accompanying cardiac surgery. However, mild cognitive dysfunction, which is more amenable to prevention and correction, has been less studied because of difficulties in diagnosing it.
Objective. For this reason, we set out to analyze the dynamics of cognitive functioning in CHD patients undergoing CABG. Our study focuses on the main indicators of cognitive functioning and on comparing cognitive functioning with normative data, as well as on the emotional state which accompanies cardiac surgery.
Methods. The present study enrolled 70 patients (of average age 59.71 ± 7.32 years) who underwent CABG with the standard cardiopulmonary bypass technique. Our examination used a pathopsychological test battery (including the WAIS, TMT, Stroop test, TAS, Benton test, etc.), and was performed in three stages: two days before, and both 12–14 days and three months after the surgery.
Results. The results obtained suggest that the majority of cognitive complaints are connected with memory decline after CABG. Patients with CHD experience significant postoperative cognitive decline mostly in verbal memory and attention. A significant cognitive improvement three months after the operation occurred in the following cognitive domains: visual memory, logical memory, and spatial thinking. An analysis of the patients’ trait anxiety leads to the conclusion that the highest intensity of anxiety was observed in relation to the following indicators: “emotional discomfort,” “asthenic component,” and “anxious assessment of the future.”
Conclusion. Our research demonstrates negative changes in both short- and longterm memory. Possible reasons for postoperative cognitive decline include the conditions and consequences of the surgery, normal aging, brain injury at the time of coronary surgery, and the emotional state of the patients. A positive trend was discovered in the visual and logical memory, active attention, and thinking activity.
DOI: 10.11621/pir.2017.0214
Keywords: cognitive functions, emotional state, coronary heart disease, rehabilitation, cardiac surgery
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