Objectives. To identify the risk factors for the development of cognitive impairments and the low treatment compliance seen in patients with chronic heart failure (CHF). Materials and methods. A total of 157 patients with CHF and 32 control subjects took part in the study. Neuropsychological investigations were carried out using a 30-min set of tests recommended by the NINDS-Canadian Stroke Standards – echocardioscopy, brain MRI scans, and cognitive event-related potentials (ERP) – along with assessment of treatment compliance. Results and conclusions. Treatment regime violations were seen in 62% of cases. Decreases in compliance were associated with increases in the severity of subcortical (frontal lobes) and periventricular leukoaraiosis, slowing of decision-taking processes (increases in the latency of the ERP P300 peak), and degradation of test performance for assessment of speech activity, optical-spatial, frontal-dysregulatory functions, and memory. Among patients with low treatment compliance, 58% showed frontal-dysregulatory cognitive disorders, 21% combined disorders, and 40% amnestic disorders. Risk factors for progression of cognitive disorders and low treatment compliance were a reduced fractional output and the restrictive type of diastolic cardiac dysfunction.