Cohen Michael B, Mather Paul J
Jefferson Medical College of Thomas Jefferson Heart University, Philadelphia, PA 19107, USA.
Am J Geriatr Cardiol. 2007 May-Jun;16(3):171-4. doi: 10.1111/j.1076-7460.2007.06563.x.
Heart failure is a growing epidemic with an estimated 5 million Americans suffering from this condition. Several clinical trials have demonstrated a high correlation between congestive heart failure (CHF) and cognitive impairment. The severity of cognitive impairment correlates positively with the degree of CHF. The underlying mechanism for cognitive impairment remains unclear but appears to be related to cerebral hypoperfusion and impaired cerebral reactivity with selective impairment of verbal memory and attention domains. Furthermore, cognitive dysfunction represents one aspect of frailty, a novel concept that encompasses a range of clinical conditions that results in functional impairment in patients with heart failure. In addition, frailty independently predicts mortality in CHF patients. Cognitive impairment is a common and predictable effect of CHF that contributes with social and behavioral problems to decreased compliance to prescribed therapy and increased hospital readmissions. A multidisciplinary approach is necessary to deal with the complexity of this clinical syndrome.
心力衰竭是一种日益普遍的疾病，估计有500万美国人患有这种疾病。多项临床试验表明，充血性心力衰竭（CHF）与认知障碍之间存在高度相关性。认知障碍的严重程度与CHF的程度呈正相关。认知障碍的潜在机制尚不清楚，但似乎与脑灌注不足和脑反应性受损有关，伴有言语记忆和注意力领域的选择性损害。此外，认知功能障碍是虚弱的一个方面，虚弱是一个新概念，涵盖了一系列导致心力衰竭患者功能受损的临床情况。此外，虚弱独立预测CHF患者的死亡率。认知障碍是CHF常见且可预测的后果，它与社会和行为问题共同导致对规定治疗的依从性降低和住院再入院率增加。需要采取多学科方法来应对这种临床综合征的复杂性。
