Systemic Inflammation and Cognitive Decrements in Patients With Stage B Heart Failure.
Systemic Inflammation and Cognitive Decrements in Patients With Stage B Heart Failure.
复制标题
B 期心力衰竭患者的全身炎症和认知能力下降。
DOI：
10.1097/psy.0000000000001033
复制
发表时间：
2022
影响因子：
3.3
通讯作者：
Mills,PaulJ
中科院分区：
文献类型：
--
作者：
Redwine,LauraS;Hong,Suzi;Kohn,Jordan;Martinez,Claudia;Hurwitz,BarryE;Pung,MeredithA;Wilson,Kathleen;Pruitt,Christopher;Greenberg,BarryH;Mills,PaulJ
目的本研究旨在探讨全身炎症在早期心力衰竭（HF）患者认知功能下降中的作用，同时确定与其他心血管危险因素的关联。方法对 B 期 HF 患者（n=270；平均[标准差]年龄=66.1[10.1]岁）进行横断面检查，以了解心血管疾病（CVD）与心理危险因素、C反应蛋白（CRP）和蒙特利尔认知评估（MoCA）评分之间的关系。对 C 期 HF 高风险（B 型利钠肽水平≥ 65 pg/ml）的子样本（n = 83）进行为期 12 个月的随访，以了解 CRP 水平与认知功能之间的关系。 结果基线吸烟（χ 2 = 6.33）、未婚（χ 2 = 12.0）、高血压（χ 2 = 5.72）、较大体重指数（d = 0.45）和身体疲劳(d=0.25)与较高的CRP水平相关(p值<.05)。横断面来看，除了 CVD（ΔR 2= 0.022，β=− 0.170，p<. 010）和心理危险因素（ΔR 2= 0.016，β= 0.145，p<. 027）之外，CRP 水平与 MoCA 评分呈负相关，并且与轻度认知障碍标准相关（比值比= 1.35，95% 置信区间 [CI]= 1.00–1.81，p=046）。在 12 个月内，CRP 水平≥ 3 mg/L 的 B 型利钠肽高危患者的 MoCA 评分 (23.6; 95% CI= 22.4–24.8) 低于 CRP 水平 < 3 mg/L 的患者 (25.4; 95% CI= 24.4–26.5; p=. 024)。结论 B 期 HF 和加重的患者CRP 水平在基线和随访时具有更大的认知障碍，与 CVD 和潜在的心理危险因素无关。低度全身炎症可能是心力衰竭早期认知功能障碍的机制之一。
ObjectiveThis study aimed to investigate the role of systemic inflammation in reduced cognitive functioning in patients with early-stage heart failure (HF) while determining associations with other cardiovascular risk factors.MethodsPatients with stage B HF (n= 270; mean [standard deviation] age= 66.1 [10.1] years) were examined cross-sectionally for relationships among cardiovascular disease (CVD) and psychological risk factors, C-reactive protein (CRP), and Montreal Cognitive Assessment (MoCA) scores. A subsample (n= 83) at high risk for stage C HF (B-type natriuretic peptide levels≥ 65 pg/ml) were followed up for 12 months for relationships between CRP levels and cognitive function.ResultsBaseline smoking (χ 2= 6.33), unmarried (χ 2= 12.0), hypertension (χ 2= 5.72), greater body mass index (d= 0.45), and physical fatigue (d= 0.25) were related to higher CRP levels (p values<. 05). Cross-sectionally, CRP levels were negatively related to MoCA scores, beyond CVD (ΔR 2= 0.022, β=− 0.170, p<. 010) and psychological risk factors (ΔR 2= 0.016, β= 0.145, p<. 027), and related to mild cognitive impairment criteria (odds ratio= 1.35, 95% confidence interval [CI]= 1.00–1.81, p=. 046). Across 12 months, B-type natriuretic peptide high-risk patients with CRP levels≥ 3 mg/L had lower MoCA scores (23.6; 95% CI= 22.4–24.8) than did patients with CRP levels< 3 mg/L (25.4; 95% CI= 24.4–26.5; p=. 024).ConclusionsPatients with stage B HF and heightened CRP levels had greater cognitive impairment at baseline and follow-up, independent of CVD and potentially psychological risk factors. Low-grade systemic inflammation may be one mechanism involved in cognitive dysfunction at early stages of HF.