Festa Joanne R, Jia Xiaoyu, Cheung Ken, Marchidann Adrian, Schmidt Michael, Shapiro Peter A, Mancini Donna M, Naka Yoshifumi, Deng Mario, Lantz Emily R, Marshall Randolph S, Lazar Ronald M
Department of Neurology, St Luke's-Roosevelt Hospital Center, New York, NY 10019, USA.
Arch Neurol. 2011 Aug;68(8):1021-6. doi: 10.1001/archneurol.2011.163.
Cognitive dysfunction has a major role in health outcomes for cardiac patients. The association of cognitive dysfunction with heart failure is well established, but the cardiac variables that contribute to cognition are not well understood.
To investigate the relationships among age, memory, and left ventricular ejection fraction (EF) in patients with heart failure.
Retrospective study.
Academic medical center.
A total of 207 patients with heart failure underwent neuropsychological assessment of memory on standardized tests.
Patients were grouped by age quartiles, and memory function was compared in those with an EF below 30% vs those with an EF of 30% or higher.
Demographic, cognitive, and medical variables having a significant association with a memory composite score were identified in a univariate linear regression analysis. In a multivariate linear model that adjusted for significant covariates, there was a significant interaction between age and EF for memory function. Patients younger than 63 years maintained stable memory function across EF levels, but patients 63 years or older showed a significant decline in memory performance when EF dropped below 30% (P < .02). Post hoc multivariate analysis showed that verbal delayed recall and recognition were the components of memory most affected by low EF.
The effect of EF on memory differs by age such that older patients with lower EFs have significantly reduced verbal memory function.
认知功能障碍在心脏病患者的健康结局中起主要作用。认知功能障碍与心力衰竭之间的关联已得到充分证实，但导致认知功能障碍的心脏变量尚不清楚。
研究心力衰竭患者年龄、记忆力和左心室射血分数（EF）之间的关系。
回顾性研究。
学术医疗中心。
共有207例心力衰竭患者接受了标准化测试的记忆力神经心理学评估。
根据年龄四分位数对患者进行分组，比较射血分数低于30%的患者与射血分数为30%或更高的患者的记忆功能。
在单变量线性回归分析中确定了与记忆综合评分有显著关联的人口统计学、认知和医学变量。在调整了显著协变量的多变量线性模型中，年龄和射血分数之间存在显著的记忆功能交互作用。63岁以下的患者在不同射血分数水平下记忆功能保持稳定，但63岁及以上的患者当射血分数降至30%以下时记忆表现显著下降（P < 0.02）。事后多变量分析表明，言语延迟回忆和识别是受低射血分数影响最大的记忆成分。
射血分数对记忆的影响因年龄而异，射血分数较低的老年患者言语记忆功能显著降低。
