心臓移植患者に対する認知機能評価の経験
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概要
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Heart failure has been proposed as a possible cause of neurocognitive dysfunction. In this case report, we present a patient with end stage heart disease who underwent neurocognitive assessment before and after heart transplantation. The patient was a 40-years-old, right-handed, male restaurant worker with a senior high-school education. Before heart transplantation, he had a Nipro left ventricular assist system (LVAS) placed. On the Wechsler Adult Intelligence Scale (WAIS-III), he achieved a Full Scale IQ of 67, which is in the Intellectually Deficient range of intellectual functioning. The Wechsler Memory Scale-Revised (WMS-R) showed defects in general memory (81), and he displayed poor verbal learning and memory performances in an Auditory Verbal Learning Test (AVLT). e Cerebral blood flow measured by single-photon emission computed tomography (SPECT) was moderately reduced. After heart transplantation, although his intellectual ability measured with WAIS-III was not significantly improved (a Full Scale IQ of 70), general memory (104) assessed using WMS-R was improved to normal range. Chronic cerebral hypoperfusion caused by hypotension and low cardiac output and stress may lead to impairment in neurocognitive performance in a patient requiring long-term cardiac support with a VAS. We hypothesized that improvement in neurocognitive performance after heart transplantation would be a result of improved cerebral perfusion and a decrease in stress.
- 一般社団法人 日本移植学会の論文
一般社団法人 日本移植学会 | 論文
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