Neurocognitive, Social-Cognitive and Quality of Life Differences in Children with Advanced Heart Failure: A Single-Center Cross-Sectional Study.

BACKGROUND

Children with heart failure (HF) are at risk of cognitive and psychiatric problems, and reduced health-related quality of life (QoL), yet data remain limited. This study compared neurocognition, social cognition, health-related quality of life, and psychiatric symptoms among children awaiting transplantation with or without ventricular assist devices (VADs), those who had undergone heart transplantation, and matched controls.

METHODS

Twenty-three patients at Ege University and 17 age- and sex-matched controls were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Present and Lifetime Version (K-SADS-PL), Screen for Child Anxiety-Related Emotional Disorders (SCARED), Children's Depression Inventory (CDI), Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), Eyes Test, and Pediatric Quality of Life Inventory (PedsQL), evaluating psychiatric diagnoses, anxiety and depressive symptoms, cognition, social cognition, and health-related quality of life.

RESULTS

Diagnosis rates and CDI and SCARED child scores were comparable, but SCARED parent scores were significantly higher in the HF group. Patients scored significantly lower on most WISC-IV subtests (8 of 10) and all composite scores and the Eyes Test, indicating impaired social cognition. Child- and parent-reported PedsQL scores were significantly lower across all domains. Cognitive outcomes did not differ significantly across treatment subgroups, though these comparisons were underpowered.

CONCLUSIONS

Children with HF show marked impairments in neurocognition, social cognition, and health-related quality of life versus healthy peers. Cognitive outcomes did not differ significantly across treatment subgroups, although these subgroup analyses (5-7 children per group) were underpowered and cannot establish the absence of a treatment effect. These findings underscore the need for integrated multidisciplinary care.