Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy
Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy
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DOI：
10.1093/eurheartj/ehn341
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发表时间：
2008-09-01
影响因子：
39.3
通讯作者：
Wersching, Heike
中科院分区：
文献类型：
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作者：
Knecht, Stefan;Oelschlaeger, Christian;Wersching, Heike
目的确定无卒中患者的心房颤动（AF）是否与认知功能受损和大脑结构异常相关。AF导致卒中和继发性认知功能下降。在没有明显的中风，AF可以激活凝血，并导致脑微栓塞，可能会损害brain.Methods和结果，我们横断面评估了122个无中风的个人与AF招募本地内的德国能力网络AF。作为比较，我们招募了563个人，年龄在37-84岁，没有AF从同一个社区。受试者接受3 T磁共振成像以评估隐蔽性区域性脑梗死、白色病变和脑容量测量。排除有中风、痴呆或抑郁证据的受试者。认知功能通过广泛的神经心理学成套测试进行评估，包括学习和记忆、注意力和执行功能、工作记忆和视觉空间技能。通过逐步多元回归模型比较房颤患者和非房颤患者的认知评分和影像学指标。无中风的房颤患者在学习和记忆任务中表现明显较差（beta =-0.115，P < 0.01）以及注意和执行功能（beta =-0.105，P < 0.01），与无房颤者相比，（P = 0.062）与阵发性房颤相比，慢性房颤患者在学习记忆任务中的表现更差。海马体积减少AF患者。其他放射学措施并没有显着groups.Conclusion之间的差异，即使在没有明显的中风，AF是认知功能障碍和海马萎缩的危险因素。因此，在评估AF的新治疗方法时，应考虑对脑结构完整性的认知和测量。
Aims To determine whether atrial fibrillation (AF) in stroke-free patients is associated with impaired cognition and structural abnormalities of the brain. AF contributes to stroke and secondary cognitive decline. In the absence of manifest stroke, AF can activate coagulation and cause cerebral microembolism which could damage the brain.Methods and results We cross-sectionally evaluated 122 stroke-free individuals with AF recruited locally within the German Competence Network on AF. As comparator, we recruited 563 individuals aged 37-84 years without AF from the same community. Subjects underwent 3 T magnetic resonance imaging to assess covert territorial brain infarction, white matter lesions, and brain volume measures. Subjects with evidence for stroke, dementia, or depression were excluded. Cognitive function was assessed by an extensive neuropsychological test battery covering the domains learning and memory, attention and executive functions, working memory, and visuospatial skills. Cognitive scores and radiographic measures were compared across individuals with and without AF by stepwise multiple regression models. Stroke-free individuals with AF performed significantly worse in tasks of learning and memory (beta = -0.115, P < 0.01) as well as attention and executive functions (beta = -0.105, P < 0.01) compared with subjects without AF. There was also a trend (P = 0.062) towards worse performance in learning and memory tasks in patients with chronic as compared with paroxysmal AF. Corresponding to the memory impairment, hippocampal volume was reduced in patients with AF. Other radiographic measures did not differ between groups.Conclusion Even in the absence of manifest stroke, AF is a risk factor for cognitive impairment and hippocampal atrophy. Therefore, cognition and measures of structural brain integrity should be considered in the evaluation of novel treatments for AF.