Role of Ventricular Rate Response on Dementia in Cognitively Impaired Elderly Subjects with Atrial Fibrillation: A 10-Year Study
Role of Ventricular Rate Response on Dementia in Cognitively Impaired Elderly Subjects with Atrial Fibrillation: A 10-Year Study
复制标题
DOI：
10.1159/000342195
复制
发表时间：
2012-01-01
影响因子：
2.4
通讯作者：
Abete, Pasquale
中科院分区：
文献类型：
--
作者：
Cacciatore, Francesco;Testa, Gianluca;Abete, Pasquale
背景资料：心室率反应（VRr）对老年认知功能障碍和房颤（AF）受试者痴呆发生率的作用尚不清楚。因此，我们研究了VRr预测有和无AF的认知受损老年受试者痴呆的能力。方法：共有358名有和无AF的认知受损老年受试者（MMSE < 24）被分层为低/高（90）和中度（> 50/< 90 bpm）VRr。进行了10年随访。结果如下：在随访结束时，认知功能受损的痴呆患者为135例（37.7%）：33例（75.0%）存在AF，102例（32.5%）不存在AF（p < 0.001）。多变量分析显示，AF是痴呆的强预测因子（风险比，HR = 4.10; 95%置信区间，CI = 1.80-9.30，p < 0.001）。更重要的是，低/高VRr（90 bpm）是预测痴呆症的存在（HR = 7.70，95% CI = 1.10-14.20，p = 0.03），但不是在没有（HR = 1.85; 95% CI = 0.78-4.47; p = 0.152）的AF。结论：这项研究表明，AF预测痴呆症的老年受试者与认知功能障碍。此外，VRr似乎在患有AF的认知受损老年受试者的痴呆发生率中起关键作用。Karger AG，巴塞尔
Background: The role of ventricular rate response (VRr) on the incidence of dementia in elderly subjects with cognitive impairment and atrial fibrillation (AF) is not known. Thus, we examined the ability of VRr to predict dementia in cognitively impaired elderly subjects with and without AF. Methods: A total of 358 cognitively impaired elderly subjects (MMSE < 24) with and without AF were stratified in low/high (< 50/> 90) and moderate (> 50/< 90 bpm) VRr. A 10-year follow-up was performed. Results: Cognitively impaired subjects with dementia at the end of the follow-up were 135 (37.7%): 33 in the presence (75.0%) and 102 (32.5%) in the absence of AF (p < 0.001). Multivariate analysis shows that AF is a strong predictor of dementia (hazard ratio, HR = 4.10; 95% confidence interval, CI = 1.80-9.30, p < 0.001). More importantly, low/high VRr (< 50/> 90 bpm) is predictive of dementia in the presence (HR = 7.70, 95% CI = 1.10-14.20, p = 0.03) but not in the absence (HR = 1.85; 95% CI = 0.78-4.47; p = 0.152) of AF. Conclusions: This study demonstrates that AF predicts dementia in elderly subjects with cognitive impairment. Moreover, VRr seems to play a key role in the incidence of dementia in cognitively impaired elderly subjects with AF. Copyright (C) 2012 S. Karger AG, Basel