Obesity interacts with cerebral hypoperfusion to exacerbate cognitive impairment in older adults with heart failure.
Obesity interacts with cerebral hypoperfusion to exacerbate cognitive impairment in older adults with heart failure.
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DOI：
10.1159/000343222
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发表时间：
2012-01
影响因子：
1.9
通讯作者：
Gunstad J
中科院分区：
文献类型：
--
作者：
Alosco ML;Spitznagel MB;Raz N;Cohen R;Sweet LH;Colbert LH;Josephson R;van Dulmen M;Hughes J;Rosneck J;Gunstad J
脑灌注不足伴随心力衰竭（HF），并与认知能力下降有关。肥胖在HF患者中普遍存在，并且也是认知功能的可能贡献者，因为它与健康个体的认知障碍独立相关。目前的研究探讨了肥胖与老年HF患者认知能力之间的关系，以及肥胖是否与脑灌注不足相互作用而加重认知障碍。HF患者（n = 99，67.46 ± 11.36岁）完成了神经心理学测试和阻抗心动图。经颅多普勒超声测量脑血流速度（CBF-V）定量脑灌注和体重指数（BMI）可操作性肥胖。分层回归分析表明，较低的CBF-V与注意力/执行功能和记忆测试的表现降低相关。BMI升高与注意力/执行功能和语言测试表现降低独立相关。值得注意的是，CBF-V和BMI之间的显著相互作用表明，低灌注和高BMI的组合对HF患者的注意力/执行功能具有特别不利的影响。目前的研究结果表明，脑灌注不足和肥胖相互作用，损害HF患者的认知能力。这些结果可能具有重要的临床意义，因为脑灌注不足的高风险HF患者可能从体重减轻中获益。
Cerebral hypoperfusion accompanies heart failure (HF) and is associated with reduced cognitive performance. Obesity is prevalent in persons with HF and is also a likely contributor to cognitive function, as it has been independently linked to cognitive impairment in healthy individuals. The current study examined the association between obesity and cognitive performance among older adults with HF and whether obesity interacts with cerebral hypoperfusion to exacerbate cognitive impairment. Patients with HF (n = 99, 67.46 ± 11.36 years of age) completed neuropsychological testing and impedance cardiography. Cerebral blood flow velocity (CBF-V) measured by transcranial Doppler sonography quantified cerebral perfusion and body mass index (BMI) operationalized obesity. A hierarchical regression analysis showed that lower CBF-V was associated with reduced performance on tests of attention/executive function and memory. Elevated BMI was independently associated with reduced attention/executive function and language test performance. Notably, a significant interaction between CBF-V and BMI indicated that a combination of hypoperfusion and high BMI has an especially adverse influence on attention/executive function in HF patients. The current findings suggest that cerebral hypoperfusion and obesity interact to impair cognitive performance in persons with HF. These results may have important clinical implications, as HF patients who are at high risk for cerebral hypoperfusion may benefit from weight reduction.