Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 210032, China.
Department of Cardiology, Xijing Hospital, the Air Force Military Medical University, Xi'an 710032, China.
Acta Biochim Biophys Sin (Shanghai). 2020 Jan 2;52(1):1-8. doi: 10.1093/abbs/gmz115.
Dementia, a devastating neurological disorder commonly found in the elderly, is characterized by severe cognitive and memory impairment. Ample clinical and epidemiological evidence has depicted a close association between dementia and heart failure. While cerebral blood under perfusion and neurohormonal activation due to the dampened cardiac pump function contribute to the loss of nutrient supply and neuronal injury, Alzheimer's disease (AD), the most common type of dementia, also provokes cardiovascular function impairment, in particular impairment of diastolic function. Aggregation of amyloid-β proteins and mutations of Presenilin (PSEN) genes are believed to participate in the pathological changes in the heart although it is still debatable with regards to the pathological cue of cardiac anomalies in AD process. In consequence, reduced cerebral blood flow triggered by cardiac dysfunction further deteriorates vascular dementia and AD pathology. Patients with atrial fibrillation, heart failure, and other cardiac anomalies are at a higher risk for cognitive decline and dementia. Conclusion: Due to the increased incidence of dementia and cardiovascular diseases, the coexistence of the two will cause more threat to public health, warranting much more attention. Here, we will update recent reports on dementia, AD, and cardiovascular diseases and discuss the causal relationship between dementia and heart dysfunction.
痴呆症是一种常见于老年人的严重神经退行性疾病，其特征是严重的认知和记忆障碍。大量的临床和流行病学证据表明，痴呆症与心力衰竭之间存在密切关联。由于心脏泵功能减弱导致脑灌注不足和神经激素激活，从而导致营养供应丧失和神经元损伤，而阿尔茨海默病（AD）是最常见的痴呆症类型，也会引起心血管功能障碍，特别是舒张功能障碍。尽管淀粉样蛋白-β蛋白的聚集和早老素（PSEN）基因突变被认为参与了心脏的病理变化，但在 AD 过程中心脏异常的病理线索仍存在争议。因此，心脏功能障碍引发的脑血流量减少进一步加重血管性痴呆和 AD 病理。患有心房颤动、心力衰竭和其他心脏异常的患者认知能力下降和痴呆的风险更高。结论：由于痴呆症和心血管疾病的发病率增加，两者并存将对公众健康造成更大的威胁，需要引起更多的关注。在这里，我们将更新关于痴呆症、AD 和心血管疾病的最新报告，并讨论痴呆症与心脏功能障碍之间的因果关系。
