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The aim: To investigate relations between selected neurocognitive parameters and echocardiographic variables in patients with systemic lupus erythematosus. Material and methods: The study included 24 female patients with systemic lupus erythematosus. In the neuropsychological assessment, the Cambridge Neuropsychological Test Automated Battery (CANTAB) was performed, using the following tests: Motor Screening Task, Big/Little Circle, Paired Associates Learning, Stockings of Cambridge and Graded Naming Test. A decrease in the cognitive function was defined as the value of results below two standard deviations. The function of the heart was examined with transthoracic echocardiography. The diastolic function of the left ventricle was estimated with the ratio of early to late ventricular filling velocities. Results: In 8.3% of patients, Mean Latency (Motor Screening Task) was lower than standard zero, whereas Mean Errors (Motor Screening Task) remained above the cut-off level. Paired Associates Learning, Subsequent Thinking Mean Time (Stockings of Cambridge), Problems Solved in Minimum Moves (Stockings of Cambridge) and Graded Naming Test were found to be lower than standard zero in 79.16%, 26.08%, 70.83%, and 87.5% of patients, respectively. Mean Initial Thinking Time (Stockings of Cambridge) was above the cut-off level. When the cut-off level was defined as results below two standard deviations from standard zero, a reduction in cognitive functions was found in 4% of patients in Paired Associates Learning and Graded Naming Test, and in 1% of patients in Mean Subsequent Thinking Time (Stockings of Cambridge) and Problems Solved in Minimum Moves (Stockings of Cambridge). Mean Latency (Motor Screening Task), Mean Errors (Motor Screening Task), Big/Little Circle, and Mean Initial Thinking Time (Stockings of Cambridge) remained above the cut-off level. Based on the evaluation of ejection fraction, no patient showed signs of systolic dysfunction of the left ventricle, defined as ejection fraction <55%. There was no correlation between the ejection fraction and the results obtained in those CANTAB tests which were lower than two standard deviations. The ratio of early and late ventricular filling velocities showed no correlation with the results of Paired Associates Learning, Stockings of Cambridge, and Graded Naming Test. Conclusions: A decrease in selected cognitive functions in patients with systemic lupus erythematosus, examined with CANTAB and demonstrated by the results of Paired Associates Learning, Graded Naming Test, Mean Subsequent Thinking Time and Problems Solved in Minimum Moves in Stockings of Cambridge, may be present without any features of the heart failure.
PL
Cel: Zbadanie zależności pomiędzy poziomem wybranych funkcji poznawczych a zmiennymi echokardiograficznymi u pacjentów z toczniem rumieniowatym układowym. Materiał i metody: Badaniem objęto 24 pacjentki z toczniem rumieniowatym układowym. Do oceny neuropsychologicznej wykorzystano testy metody Cambridge Neuropsychological Test Automated Battery (CANTAB): Motor Screening Task, Big/Little Circle, Paired Associates Learning, Stockings of Cambridge i Graded Naming Test. Za próg spadku poziomu funkcji poznawczych przyjęto dwa odchylenia standardowe. Funkcje serca badano przy użyciu transtorakalnej echokardiografii. Czynność rozkurczową lewej komory oceniano, wykorzystując iloraz prędkości wczesnego i późnego napływu mitralnego. Wyniki: U 8,3% pacjentów wynik uzyskany w Mean Latency (Motor Screening Task) był niższy niż standardowe zero, podczas gdy wynik Mean Errors (Motor Screening Task) pozostał powyżej standardowego zera. Wyniki uzyskane w testach: Paired Associates Learning, Subsequent Thinking Mean Time (Stockings of Cambridge), Problems Solved in Minimum Moves (Stockings of Cambridge) i Graded Naming Test okazały się niższe od standardowego zera odpowiednio w 79,16%, 26,08%, 70,83% i 87,5% pacjentów. Wartość Mean Initial Thinking Time (Stockings of Cambridge) była powyżej standardowego zera. Obniżenie funkcji poznawczych (dwa odchylenia poniżej standardowego zera) stwierdzono u 4% pacjentów w Paired Associates Learning oraz Graded Naming Test, a u 1% pacjentów w Subsequent Thinking Mean Time (Stockings of Cambridge) i Problems Solved in Minimum Moves (Stockings of Cambridge). Z kolei wyniki uzyskane w Mean Latency (Motor Screening Task), Mean Errors (Motor Screening Task), Big/Little Circle oraz Mean Initial Thinking Time (Stockings of Cambridge) pozostały powyżej standardowego zera. Żaden pacjent nie wykazał objawów dysfunkcji skurczowej lewej komory serca, definiowanej jako frakcja wyrzutowa <55%. Nie stwierdzono korelacji pomiędzy frakcją wyrzutową i wynikami uzyskanymi w tych badaniach CANTAB, które były niższe niż dwa odchylenia standardowe. Nie wykazano korelacji pomiędzy wczesną i późną komorową prędkością napełnień a wynikami Paired Associates Learning, Stockings of Cambridge oraz Graded Naming Test. Wnioski: Spadek wybranych funkcji poznawczych u pacjentów z toczniem rumieniowatym układowym badanych metodą CANTAB oraz przedstawianych w postaci wyników w testach Paired Associates Learning, Graded Naming Test, Mean Subsequent Thinking Time i Problems Solved in Minimum Moves (Stockings of Cambridge) może wystąpić bez cech niewydolności serca.
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