Neurocognition and Greater Maintenance of Sinus Rhythm in AF (NOGGIN AF)

AF 中的神经认知和窦性心律的更好维持 (NOGGIN AF)

基本信息

  • 批准号:
    10632044
  • 负责人:
  • 金额:
    $ 76.57万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2021
  • 资助国家:
    美国
  • 起止时间:
    2021-09-01 至 2026-05-31
  • 项目状态:
    未结题

项目摘要

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, affecting 1%-3% of the general population, with greater prevalence in older persons (8%-10%). AF is associated with an increased risk for cognitive decline, dementia, stroke, myocardial infarction, heart failure, chronic kidney disease, and mortality, resulting in an incremental yearly cost of AF in the US of $26 billion. AF and cognitive decline share several risk factors including advancing age and comorbidities such as hypertension, diabetes mellitus, and heart failure. Microbleeds from anticoagulation, a proinflammatory and prothrombotic state, and cerebral hypoperfusion can cumulatively result in silent cerebral infarction, white matter hyperintensities, brain atrophy, and disruption of functional network connectivity, and also lead to AF-related cognitive decline. While the link between AF and the development of cognitive impairment has been established, the driving mechanisms and the effect of sinus rhythm restoration are not completely understood. Our long-term goals are to understand the interaction between heart rhythm and neurologic health, and to investigate methods to prevent cognitive dysfunction due to AF. Thus, in the proposed study, we will test our hypothesis that among AF patients receiving oral anticoagulation, restoration of sinus rhythm with catheter ablation vs drug therapy leads to less long-term neurologic damage and dysfunction due to improved cerebral blood flow and lower risk for additional ischemic injury. The primary aims of our prospective, observational clinical trial are to 1) compare structural cortical characteristics in Alzheimer’s disease-risk regions in AF patients treated with catheter ablation vs drug therapy; 2) compare cerebral blood flow in AF patients treated with catheter ablation vs drug therapy; 3) compare cognitive function in AF patients treated with catheter ablation vs drug therapy; and 4) assess the relationship between neurologic outcomes and plasma and imaging biomarkers of coagulation and inflammation. This will be the first study to incorporate a comprehensive neurocognitive test battery, structural and functional neuroimaging, cerebral blood flow assessment, and plasma and imaging biomarkers to a) better delineate the contribution of each of the known risk factors to the development of cognitive decline in patients with AF, and b) assess how restoration of sinus rhythm using catheter ablation vs drug therapy may alter the trajectory of cognitive decline and development of dementia. Our preliminary data showed that catheter ablation did not worsen cognitive function or white matter hyperintensity burden 6 weeks or 1 year later, while drug therapy patients showed greater cortical thinning at 1 year in brain regions associated with Alzheimer’s, and this thinning correlated with worse cognitive performance. Thus, this study is significant, and will vertically advance the field of AF management by revolutionizing our understanding of the mechanisms by which AF induces cognitive decline, and by providing an important and necessary step toward justifying rhythm control by catheter ablation as a strategy to arrest the processes that lead to cognitive impairment and dementia.
心房颤动(AF)是最常见的持续性心律失常,约占总人口的1%-3%

项目成果

期刊论文数量(12)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Neuromodulation therapy for atrial fibrillation.
  • DOI:
    10.1016/j.hrthm.2022.08.011
  • 发表时间:
    2023-01
  • 期刊:
  • 影响因子:
    5.5
  • 作者:
    Karatela, Maham F.;Fudim, Marat;Mathew, Joseph P.;Piccini, Jonathan P.
  • 通讯作者:
    Piccini, Jonathan P.
Alert-driven vs scheduled remote monitoring of implantable cardiac defibrillators: A cost-consequence analysis from the TRUST trial.
植入式心脏除颤器的警报驱动与预定远程监测:TRUST 试验的成本后果分析。
  • DOI:
    10.1016/j.hrthm.2022.12.003
  • 发表时间:
    2023
  • 期刊:
  • 影响因子:
    5.5
  • 作者:
    Chew,DerekS;Piccini,JonathanP;Au,Flora;Frazier-Mills,CamilleG;Michalski,Justin;Varma,Niraj;TRUSTInvestigators
  • 通讯作者:
    TRUSTInvestigators
Omnipolar Versus Bipolar Electrode Mapping in Patients With Atrial Fibrillation Undergoing Catheter Ablation.
接受导管消融的心房颤动患者的全极与双极电极标测。
  • DOI:
    10.1016/j.jacep.2022.08.026
  • 发表时间:
    2022
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Karatela,MahamF;Dowell,RobertS;Friedman,Daniel;Jackson,KevinP;Piccini,JonathanP
  • 通讯作者:
    Piccini,JonathanP
Rates and predictors of hospital and emergency department care after catheter ablation of atrial fibrillation.
心房颤动导管消融术后医院和急诊科护理的发生率和预测因素。
  • DOI:
    10.1111/jce.15841
  • 发表时间:
    2023
  • 期刊:
  • 影响因子:
    2.7
  • 作者:
    Friedman,DanielJ;Freeman,JamesV;Wong,Charlene;Febre,Janice;Iglesias,Maximiliano;Khanna,Rahul;Piccini,JonathanP
  • 通讯作者:
    Piccini,JonathanP
Device-Related Thrombus After Left Atrial Appendage Occlusion: The Villain of the Piece.
左心耳闭塞后与设备相关的血栓:其中的罪魁祸首。
  • DOI:
    10.1016/j.jacep.2022.11.029
  • 发表时间:
    2023
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Friedman,DanielJ;Piccini,JonathanP
  • 通讯作者:
    Piccini,JonathanP
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Joseph P Mathew其他文献

211 - Decreased Baroreflex Sensitivity After Surgery is Associated with Elevated Postoperative Pain: A Secondary Analysis
211 - 手术后压力反射敏感性降低与术后疼痛升高相关:一项二次分析
  • DOI:
    10.1016/j.jpain.2025.105009
  • 发表时间:
    2025-04-01
  • 期刊:
  • 影响因子:
    4.000
  • 作者:
    Heberto Suarez-Roca;Negmeldeen Mamoun;Andrey V Bortsov;Joseph P Mathew
  • 通讯作者:
    Joseph P Mathew

Joseph P Mathew的其他文献

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{{ truncateString('Joseph P Mathew', 18)}}的其他基金

Neurocognition and Greater Maintenance of Sinus Rhythm in AF (NOGGIN AF)
AF 中的神经认知和窦性心律的更好维持 (NOGGIN AF)
  • 批准号:
    10475214
  • 财政年份:
    2021
  • 资助金额:
    $ 76.57万
  • 项目类别:
Neurocognition and Greater Maintenance of Sinus Rhythm in AF (NOGGIN AF)
AF 中的神经认知和窦性心律的更好维持 (NOGGIN AF)
  • 批准号:
    10299458
  • 财政年份:
    2021
  • 资助金额:
    $ 76.57万
  • 项目类别:
Identification and Validation of a Novel Central Analgesia Circuit
新型中枢镇痛回路的识别和验证
  • 批准号:
    10362236
  • 财政年份:
    2021
  • 资助金额:
    $ 76.57万
  • 项目类别:
Resolution of Neuroinflammation and Persistent Pain by Complementary Approaches
通过补充方法解决神经炎症和持续性疼痛
  • 批准号:
    9703529
  • 财政年份:
    2020
  • 资助金额:
    $ 76.57万
  • 项目类别:
Cortical Beta-amyloid Levels and Neurocognitive Performance After Cardiac Surgery
心脏手术后皮质 β-淀粉样蛋白水平和神经认知功能
  • 批准号:
    8095975
  • 财政年份:
    2011
  • 资助金额:
    $ 76.57万
  • 项目类别:
Cortical Beta-amyloid Levels and Neurocognitive Performance After Cardiac Surgery
心脏手术后皮质 β-淀粉样蛋白水平和神经认知功能
  • 批准号:
    8306387
  • 财政年份:
    2011
  • 资助金额:
    $ 76.57万
  • 项目类别:
Lidocaine for Neuroprotection During Cardiac Surgery
利多卡因在心脏手术期间的神经保护作用
  • 批准号:
    8475499
  • 财政年份:
    2009
  • 资助金额:
    $ 76.57万
  • 项目类别:
Lidocaine for Neuroprotection During Cardiac Surgery
利多卡因在心脏手术期间的神经保护作用
  • 批准号:
    7698221
  • 财政年份:
    2009
  • 资助金额:
    $ 76.57万
  • 项目类别:
Lidocaine for Neuroprotection During Cardiac Surgery
利多卡因在心脏手术期间的神经保护作用
  • 批准号:
    8075116
  • 财政年份:
    2009
  • 资助金额:
    $ 76.57万
  • 项目类别:
Lidocaine for Neuroprotection During Cardiac Surgery
利多卡因在心脏手术期间的神经保护作用
  • 批准号:
    7915376
  • 财政年份:
    2009
  • 资助金额:
    $ 76.57万
  • 项目类别:

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激素治疗、绝经年龄、既往产次和 APOE 基因型会影响老年人的认知。
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