School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, Perth, Australia.
Eur Heart J. 2012 Jul;33(14):1769-76. doi: 10.1093/eurheartj/ehr467. Epub 2012 Jan 31.
It is unclear whether the cognitive dysfunction associated with heart failure (HF) is due to HF or comorbid conditions such as ischaemic heart disease (IHD). This study aimed to determine whether, compared with controls with and without IHD, adults with systolic HF show evidence of cognitive impairment and cerebral grey matter (GM) loss.
Cross-sectional study of 35 participants with HF, 56 with IHD, and 64 controls without either HF or IHD. Subjects were older than 45 years and free of overt cognitive impairment. We acquired magnetic resonance images and used SPM8 to determine regional differences in cerebral GM volume. Participants with HF had lower scores than controls without IHD on immediate memory, long delay recall and digit coding, whereas those with IHD had lower long delay recall scores than controls without IHD. Compared with controls without IHD, participants with HF showed evidence of GM loss in the left cingulate, the right inferior frontal gyrus, the left middle and superior frontal gyri, the right middle temporal lobe, the right and left anterior cingulate, the right middle frontal gyrus, the inferior and pre-central frontal gyri, the right caudate, and occipital-parietal regions involving the left precuneus. The loss of GM followed a similar, less extensive, pattern when we compared participants with HF and IHD.
Adults with HF have worse immediate and long-term memory and psychomotor speed than controls without IHD. Heart failure is associated with changes in brain regions that are important for demanding cognitive and emotional processing.
心力衰竭（HF）相关的认知功能障碍是由于 HF 还是合并缺血性心脏病（IHD）等合并症尚不清楚。本研究旨在确定与无 IHD 的对照相比，收缩性 HF 成人是否存在认知障碍和大脑灰质（GM）损失的证据。
对 35 名 HF 患者、56 名 IHD 患者和 64 名无 HF 或 IHD 的对照组进行横断面研究。受试者年龄大于 45 岁，无明显认知障碍。我们采集了磁共振图像，并使用 SPM8 确定大脑 GM 体积的区域差异。HF 患者的即时记忆、长延迟回忆和数字编码得分低于无 IHD 的对照组，而 IHD 患者的长延迟回忆得分低于无 IHD 的对照组。与无 IHD 的对照组相比，HF 患者的左扣带回、右额下回、左额中回和额上回、右颞中回、右和左前扣带回、右额中回、下额回和额中回、右尾状核以及涉及左楔前叶的枕顶叶区域存在 GM 损失。当我们比较 HF 和 IHD 患者时，GM 的损失呈现出相似但程度较轻的模式。
HF 成人的即时和长期记忆以及心理运动速度比无 IHD 的对照组差。HF 与对认知和情感处理要求较高的大脑区域的变化有关。
