心房颤动与认知功能障碍相关性的研究进展
陈毅刚,梁辉,罗本燕
摘要(Abstract):
<正>心房颤动(房颤)是最常见的持续性心律失常,临床主要分为3类:阵发性房颤、持续性房颤和永久性房颤[1]。房颤是引发心原性卒中的主要原因,据统计,房颤患者的卒中发生率是正常人群的5倍[2]。临床研究发现,房颤与认知功能障碍具有独立相关性[3]。目前,国内对两者的相关性报道较少,本文主要就房颤与认知功能损害的相关性、可能机制及药物选择3方面进行阐述,以提高对房颤导致神经系统并发症的认知。
关键词(KeyWords): 心房颤动;认知障碍;痴呆
基金项目(Foundation):
作者(Author): 陈毅刚,梁辉,罗本燕
参考文献(References):
- [1]January CT,Wann LS,Alpert JS,et al.2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society.J Am Coll Cardiol,2014,64:e1-e76.
- [2]李峥,刘旭.抗凝药物在心房颤动治疗中的新进展.中国介入心脏病学杂志,2011,19:50-52.
- [3]Abete P,Della-Morte D,Gargiulo G,et al.Cognitive impairment and cardiovascular diseases in the elderly.A heart-brain continuum hypothesis.Ageing Res Rev,2014,18:41-52.
- [4]Ott A,Breteler MM,de Bruyne MC,et al.Atrial fibrillation and dementia in a population-based study.The Rotterdam study,1997,Stroke,2:316-321.
- [5]Kilander L,Andrén B,Nyman H,et al.Atrial fibrillation is an independent determinant of low cognitive function:a crosssectional study in elderly men.Stroke,1998,29:1816-1820.
- [6]Jozwiak A,Guzik P,Mathew A,et al.Association of atrial fibrillation and focal neurologic deficits with impaired cognitive function in hospitalized patients>or=65 years of age.Am J Cardiol,2006,98:1238-1241.
- [7]Tilvis RS,Khnen-Vre MH,Jolkkonen J,et al.Predictors of cognitive decline and mortality of aged people over a 10-year period.J Gerontol A Biol Sci Med Sci,2004,59:268-274.
- [8]Cacciatore F,Abete P,Ferrara N,et al.Congestive heart failure and cognitive impairment in an older population.Osservatorio Geriatrico Campano Study Group.J Am Geriatr Soc,1998,46:1343-1348.
- [9]Cacciator F,Testa G,Langellotto A,et al.Role of ventricular rate response on dementia in cognitively impaired elderly subjects with atrial fibrillation:a 10-year study.Dement Geriatr Cogn Disord,2012,34:143-148.
- [10]Yusuf S,Teo K,Anderson C,et al.Effects of the angiotensin receptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors:a randomised controlled trial.Lancet,2008,372:1174-1183.
- [11]Yusuf S,Teo KK,Pogue J,et al.Telmisartan,ramipril,or both in patients at high risk for vascular events.N Engl J Med,2008,358:1547-1559.
- [12]Marzona I,O'Donnell M,Teo K,et al.Increased risk of cognitive and functional decline in patients with atrial fibrillation:results of the ONTARGET and TRANSCEND studies.CMAJ,2012,184:E329-E336.
- [13]Bunch TJ,Weiss JP,Crandall BG,et al.Atrial fibrillation is independently associated with senile,vascular,and Alzheimer's dementia.Heart Rhythm,2010,7:433-437.
- [14]Thacker EL,Mc Knight B,Psaty BM,et al.Atrial fibrillation and cognitive decline:a longitudinal cohort study.Neurology,2013,81:119-125.
- [15]Horstmann S,Rizos T,Rauch G,et al.Atrial fibrillation and prestroke cognitive impairment in stroke.J Neurol,2014,261:546-553.
- [16]Forti P.Atrial fibrillation is associated with an increased risk of cognitive impairment and dementia with or without a history of clinical stroke.Evid Based Med,2014,19:e3.
- [17]Rastas S,Verkkoniemi A,Polvikoski T,et al.Atrial fibrillation,stroke,and cognition:a longitudinal population-based study of people aged 85 and older.Stroke,2007,38:1454-1460.
- [18]Lu J,Li D,Li F,et al.Montreal cognitive assessment in detecting cognitive impairment in Chinese elderly indiciduals:A population-based study.J Geriatr Psychiatry Neurol,2011,24:184-190.
- [19]Ball J,Carrington MJ,Stewart S,et al.Mild cognitive impairment in high-risk patients with chronic atrial fibrillation:a forgotten component of clinical management?Heart,2013,98:542-547.
- [20]Dublin S,Anderson ML,Haneuse SJ,et al.Atrial fibrillation and risk of dementia:a prospective cohort study.J Am Geriatr Soc,2011,59:1369-1375.
- [21]Knecht S,Oelschlager C,Duning T,et al.Atrial fibrillation in stroke-free patientsis associated with memory impairment and hippocampal atrophy.Eur Heart J,2008,29:2125-2132
- [22]Stefansdottir H,Arnar DO,Aspelund T,et al.Atrial fibrillation is associated with reduced brain volume and cognitive function independent of cerebral infarcts.Stroke,2013,44:1020-1025.
- [23]Kobayashi A,Iguchi M,Shimizu S,et al.Silent cerebral infarcts and cerebral white matter lesions in patients with nonvalvular atrial fibrillation.J Stroke Cerebrovasc Dis,2012,21:310-317.
- [24]Son SJ,Lee KS,Na DL,et al.The effect of anemia and white matter hyperintensities(WMH)on cognitive impairment in patients with amnestic mild cognitive impairment(MCI).Arch Gerontol Geriatr,2012,55:251-256.
- [25]Ezekowitz MD,James KE,Nazarian SM,et al.Silent cerebral infarction in patients with nonrheumatic atrial fibrillation.The Veterans Affairs Stroke Prevention in Nonrheumatic Atrial Fibrillation investigators.Circulation,1995,92:2178-2182.
- [26]Zito M,Muscari A,Marini E,et al.Silent lacunar infarcts in elderly patients with chronic non valvular atrial fibrillation.Aging(Milano),1996,8:341-346.
- [27]Richards M,Meade TW,Peart S,et al.Is there any evidence for a protective effect of antithrombotic medication on cognitive function in men at risk of cardiovascular disease?Some preliminary findings.J Neurol Neurosurg Psychiatry,1997,62:269-272.
- [28]Guo Y,Lip GY,Apostolakis S.Inflammation in atrial fibrillation.J Am Coll Cardiol,2012,60:2263-2270.
- [29]Gao SP,Deng XT,Ge LJ,et al.Is inflammation linked to thrombogenesis in atrial fibrillation?Int J Cardiol,2011,149:260-261.
- [30]任川,祖凌云,郭丽君,等.微粒在动脉粥样硬化发生发展中的作用.中国介入心脏病学杂志,2014,22:188-190.
- [31]Lappegrd KT,Pop-Purceleanu M,van Heerde W,et al.Improved neurocognitive functions correlate with reduced inflammatory burden in atrial fibrillation patients treated with intensive cholesterol lowering therapy.J Neuroinflammation,2013,10:78.
- [32]Tendolkar I,Enajat M,Zwiers MP,et al.One-year cholesterol lowering treatment reduces medial temporal lobe atrophy and memory decline in stroke-free elderly with atrial fibrillation:evidence from a parallel group randomized trial.Int J Geriatr Psychiatry,2012,27:49-58.
- [33]Park H,Hildreth A,Thomson R,et al.Non-valvular atrial fibrillation and cognitive decline:a longitudinal cohort study.Age Ageing,2007,36:157-163.
- [34]Mavaddat N,Roalfe A,Fletcher K,et al.Warfarin versus aspirin for prevention of cognitive decline in atrial fibrillation:randomized controlled trial(Birmingham Atrial Fibrillation Treatment of the Aged Study).Stroke,2014,45:1381-1386.
- [35]Efimova I,Efimova N,Chernov V,et al.Ablation and Pacing:Improving Brain Perfusion and Cognitive Function in Patients with Atrial Fibrillation and Uncontrolled Ventricular Rates.Pacing Clin Electrophysiol,2012,35:320-326.
- [36]Kwok CS,Loke YK,Hale R,et al.Atrial fibrillation and incidence of dementia:a systematic review and meta-analysis.Neurology,2011,76:914-922.