Disease-Targeted Treatment Improves Cognitive Function in Patients with Precapillary Pulmonary Hypertension
Disease-Targeted Treatment Improves Cognitive Function in Patients with Precapillary Pulmonary Hypertension
复制标题
DOI：
10.1159/000439227
复制
发表时间：
2015-01-01
期刊：
影响因子：
3.7
通讯作者：
Ulrich, Silvia
中科院分区：
文献类型：
--
作者：
Somaini, Gina;Stamm, Adriana;Ulrich, Silvia
背景资料：肺动脉高压（PH）患者可能患有认知缺陷，这可能与氧输送和脑组织氧合（CTO）减少有关。目的：评估认知功能随着治疗而改善以及CTO改善的假设。沿着CTO的改善。研究方法：20例动脉或慢性血栓栓塞性PH患者在诊断性右心导管插入术期间通过近红外光谱进行CTO监测。评估认知测试[连线测试（TMT）、维多利亚Stroop测试和五点测试（5 PT）]、6分钟步行距离（6 MWD）测试、纽约心脏协会（NYHA）分级和健康相关生活质量（HRQoL），并在疾病靶向药物治疗3个月后重复。结果：在基线时，45%的PH患者有认知缺陷。在3个月时，患者的TMT A和Stroop 2测试有所改善[37 s（27; 55）vs 30 s（24; 42），p < 0.05，18 s（16; 22）vs 16 s（15; 20），p < 0.01]，而CTO保持不变。动脉血氧饱和度、NYHA分级、6 MWD和HRQoL也有所改善。基线CTO是认知功能的最强预测因子，即使在包括年龄、6 MWD和HRQoL的多变量分析中也是如此。认知功能的改善与CTO的变化无关。结论：在PH患者中，3个月的疾病靶向药物治疗可改善认知功能。尽管CTO是基线时认知功能的最强预测因子，但在靶向治疗期间并未发生变化。该初步研究的结果应在充分把握度的对照试验中得到证实。(C)2015 S. Karger AG，巴塞尔
Background: Patients with pulmonary hypertension (PH) may suffer from cognitive deficits that potentially relate to reduced oxygen delivery and cerebral tissue oxygenation (CTO). Objective: To evaluate the hypothesis that cognitive function improves with therapy, along with improved CTO. Methods: Twenty incident patients with arterial or chronic thromboembolic PH had CTO monitoring by near-infrared spectroscopy during diagnostic right heart catheterization. Cognitive tests [Trail Making Tests (TMTs), Victoria Stroop tests and the Five-Point Test (5PT)], the 6-min walk distance (6MWD) test, New York Heart Association (NYHA) class and health-related quality of life (HRQoL) were assessed and repeated after 3 months of disease-targeted medication. Results: At baseline, 45% of PH patients had cognitive deficits. At 3 months, the patients had improved on the TMT A and the Stroop 2 test [37 s (27; 55) versus 30 s (24; 42), p < 0.05, and 18 s (16; 22) versus 16 s (15; 20), p < 0.01], whereas CTO remained unchanged. Arterial oxygen saturation, NYHA class, 6MWD and HRQoL had also improved. Baseline CTO was the strongest predictor of cognitive function, even in multivariate analysis including age, 6MWD and HRQoL. Improvements in cognitive function were not associated with changes in CTO. Conclusions: In patients with PH, 3 months of disease-targeted medication resulted in better cognitive function. Although CTO was the strongest predictor of cognitive function at baseline, it did not change during target therapy. The results of this pilot study should be confirmed in an adequately powered controlled trial. (C) 2015 S. Karger AG, Basel