心房颤动对认知功能、心理困扰、生活质量和冲动性的影响。

Impact of Atrial Fibrillation on Cognitive Function, Psychological Distress, Quality of Life, and Impulsiveness.

机构信息

Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Lithuania.

Vilnius University Hospital Santaros Klinikos, Lithuania.

出版信息

Am J Med. 2018 Jun;131(6):703.e1-703.e5. doi: 10.1016/j.amjmed.2017.12.044. Epub 2018 Jan 31.

DOI:10.1016/j.amjmed.2017.12.044

PMID:29408019

Abstract

OBJECTIVE

Atrial fibrillation is the most common cardiac arrhythmia and a known risk factor for cerebrovascular stroke. Atrial fibrillation and longstanding hypertension may produce ischemic lesions leading to progressive cognitive impairment. The impact of atrial fibrillation alone on cognitive impairment has not been evaluated. Our objective was to compare cognitive function, quality of life, psychological distress, and impulsiveness in people with atrial fibrillation and a matched control group.

METHODS

The study included 60 patients. The first group of patients were ≥55 years of age, with ≥5 years history of atrial fibrillation, without hypertension (or with well-controlled hypertension), without previous dementia, compared with a matched group of 30 healthy control participants. Demographic and clinical characteristics were recorded. Subjects underwent the following rating scales: Mini-Mental State Examination, Hospital Anxiety and Depression, Heart Quality of Life, and Barratt Impulsiveness Scale.

RESULTS

In the atrial fibrillation group there were 63% male (n = 19) and 37% female (n = 11) patients; the control group was 33% male (n = 10) and 67% female (n = 20). Age range was from 55 to 81 years in both groups, mean = 63.9 years (±6.4) in the atrial fibrillation group and 66.1 years (±8.0) in controls. In the atrial fibrillation group, 23.3% had primary or general education, college - 23.3% and university - 53.3%; in the control group - 20%, 23.3%, and 56.7%, respectively. Mini-Mental State Examination score was 27.6 (±1.6) in the atrial fibrillation group vs 29.5 (±0.73) in the control group (P < .0001). Anxiety disorders were observed in 20 patients (66.7%) in atrial fibrillation vs 8 patients (26.67%) in the control group (P = .009). Heart Quality of Life mean score was 1.4 (±0.65) in the atrial fibrillation and 2.6 (±0.35) in the control group (P < .0001). Physical subscale mean scores were 1.4 (±0.74) in atrial fibrillation vs 2.8 (±0.18) in the control group (P < .0001).

CONCLUSION

Individuals with atrial fibrillation are more likely to develop anxiety disorder. Cognitive status is significantly lower in the atrial fibrillation group. In comparison with healthy subjects, individuals with atrial fibrillation have worse quality of life.

摘要

目的

心房颤动是最常见的心律失常，也是脑血管卒中的已知危险因素。心房颤动和长期高血压可能导致缺血性病变，从而导致进行性认知障碍。尚未评估单纯心房颤动对认知障碍的影响。我们的目的是比较心房颤动患者和匹配对照组的认知功能、生活质量、心理困扰和冲动性。

方法

该研究纳入了 60 名患者。第一组患者年龄≥55 岁，有≥5 年的心房颤动病史，无高血压（或高血压得到良好控制），无痴呆病史，与 30 名健康对照组参与者相匹配。记录人口统计学和临床特征。受试者接受以下评分量表：简易精神状态检查、医院焦虑和抑郁量表、心脏生活质量量表和巴瑞特冲动量表。

结果

在心房颤动组中，有 63%的男性（n=19）和 37%的女性（n=11）患者；对照组中男性占 33%（n=10），女性占 67%（n=20）。两组年龄范围均为 55 至 81 岁，心房颤动组的平均年龄为 63.9 岁（±6.4），对照组为 66.1 岁（±8.0）。在心房颤动组中，23.3%的人具有小学或普通教育学历，大学学历占 23.3%，大学学历占 53.3%；对照组分别为 20%、23.3%和 56.7%。心房颤动组简易精神状态检查评分 27.6（±1.6），对照组 29.5（±0.73）（P<.0001）。心房颤动组 20 例（66.7%）患者出现焦虑障碍，对照组 8 例（26.67%）患者出现焦虑障碍（P=.009）。心房颤动组心脏生活质量平均得分为 1.4（±0.65），对照组为 2.6（±0.35）（P<.0001）。身体子量表平均得分在心房颤动组为 1.4（±0.74），在对照组为 2.8（±0.18）（P<.0001）。