Milder Alzheimer's disease pathology in heart failure and atrial fibrillation.
Milder Alzheimer's disease pathology in heart failure and atrial fibrillation.
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DOI：
10.1016/j.jalz.2016.12.002
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发表时间：
2017-07
期刊：
影响因子：
--
通讯作者：
Hachinski V
中科院分区：
文献类型：
--
作者：
Sposato LA;Ruíz Vargas E;Riccio PM;Toledo JB;Trojanowski JQ;Kukull WA;Cipriano LE;Nucera A;Whitehead SN;Hachinski V
心力衰竭（HF）和心房颤动（AF）与阿尔茨海默病（AD）的高风险相关。HF和AF是否通过增强AD的神经病理改变而与AD相关尚不清楚。我们应用网络分析和多元逻辑回归模型来评估HF和AF与AD神经病理学严重程度之间的相关性，这些患者来自国家阿尔茨海默病协调中心数据库，主要神经病理学诊断为AD。我们纳入了1593例患者，其中129例患有HF，250例患有AF。HF和AF患者年龄较大，AD病理学较轻。在网络分析中，HF和AF与轻度AD神经病理学相关。在回归分析中，年龄（比值比[OR] 0.94，95%置信区间[CI] 0.93-0.95，年龄每增加1岁，P <0.001）和HF × AF交互作用项（OR 0.61，95%CI 0.40-0.91，P = 0.014）与严重AD病理学呈负相关，而APOE ε4基因型与AD病理学呈直接相关。（OR 1.68，95% CI 1.31-2.16）。血管神经病变在HF和AF患者中比在那些没有的患者中更常见。HF和AF的AD神经病理较轻。轻度AD患者寿命更长，暴露于血管危险因素更多。HF和AF患者显示出更高的血管神经病理学频率，这可能有助于降低临床明显痴呆的阈值。
Heart failure (HF) and atrial fibrillation (AF) have been associated with a higher risk of Alzheimer’s disease (AD). Whether HF and AF are related to AD by enhancing AD neuropathological changes is unknown. We applied network analyses and multiple logistic regression models to assess the association between HF and AF with severity of AD neuropathology in patients from the National Alzheimer’s Coordinating Center database with primary neuropathological diagnosis of AD. We included 1593 patients, of whom 129 had HF and 250 had AF. HF and AF patients were older and had milder AD pathology. In the network analyses, HF and AF were associated with milder AD neuropathology. In the regression analyses, age (odds ratio [OR] 0.94, 95% confidence interval [CI] 0.93–0.95 per 1-year increase in age, P <.001) and the interaction term HF × AF (OR 0.61, 95% CI 0.40–0.91, P = .014) were inversely related to severe AD pathology, whereas APOE ε4 genotype showed a direct association (OR 1.68, 95% CI 1.31–2.16). Vascular neuropathology was more frequent in patient with HF and AF patients than in those without. HF and AF had milder AD neuropathology. Patients with milder AD lived longer and had more exposure to vascular risk factors. HF and AF patients showed a higher frequency of vascular neuropathology, which could have contributed to lower the threshold for clinically evident dementia.
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影响因子：
9.9
作者：
Duering, Marco;Righart, Ruthger;Dichgans, Martin
通讯作者：
Dichgans, Martin
影响因子：
8.3
作者：
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影响因子：
39.3
作者：
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Wersching, Heike
DOI：
10.1076/1380-3395(200008)22:4;1-0;ft518
发表时间：
2000-01-01
影响因子：
2.2
作者：
Arbuthnott, K;Frank, J
通讯作者：
Frank, J
影响因子：
56.9
作者：
Ravasz, E;Somera, AL;Barabási, AL
通讯作者：
Barabási, AL