Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Centro de Investigacion Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Madrid, Spain.
Servicio de Geriatría, Complejo Hospitalario Universitario de Albacete, CIBER de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain.
Am J Cardiol. 2020 Dec 1;136:94-99. doi: 10.1016/j.amjcard.2020.09.008. Epub 2020 Sep 16.
The association between atrial fibrillation, stroke, and interatrial block (IAB) (P-wave duration ≥120 ms) is well recognized, particularly in the case of advanced IAB. We aimed to assess the association of IAB with mild cognitive impairment. Advanced Characterization of Cognitive Impairment in Elderly with Interatrial Block was a case-control multicenter study, conducted in subjects aged ≥70 years in sinus rhythm without significant structural heart disease. Diagnosis of mild cognitive impairment was performed by an expert geriatrician, internist, or neurologist in the presence of changes in cognitive function (Mini Mental State Examination score 20 to 25) without established dementia. A total of 265 subjects were included. Mean age was 79.6 ± 6.3 years and 174 (65.7%) were women; there were 143 cases with mild cognitive impairment and 122 controls with normal cognitive function. Compared with controls, cases had longer P-wave duration (116.2 ± 13.8 ms vs 112.5 ± 13.3 ms, p = 0.028), higher prevalence of IAB (73 [51.0%] vs 38 [31.1%], p = 0.001), higher prevalence of advanced IAB (28 [19.6%] vs 10 [8.2%], p = 0.002), and higher MVP ECG risk score (2.7 ± 1.4 vs 2.2 ± 1.3, p = 0.004). IAB was independently associated with mild cognitive impairment, both for partial (odds ratio 2.0, 95% CI: 1.1 to 3.9) and advanced IAB (odds ratio 2.8, 95% CI: 1.1 to 6.7). In conclusion, in subjects aged ≥70 years without significant structural heart disease, IAB is independently associated with mild cognitive impairment. This association is stronger in the case of advanced IAB.
心房颤动、中风和房间隔阻滞（IAB）（P 波持续时间≥120ms）之间的关联是众所周知的，尤其是在晚期 IAB 的情况下。我们旨在评估 IAB 与轻度认知障碍的关联。老年伴有房间隔阻滞的轻度认知障碍的高级特征是一项病例对照多中心研究，在窦性节律且无明显结构性心脏病的≥70 岁受试者中进行。轻度认知障碍的诊断由老年病学家、内科医生或神经病学家在认知功能改变（简易精神状态检查评分 20-25）但无明确痴呆的情况下进行。共纳入 265 例受试者。平均年龄为 79.6±6.3 岁，174 例（65.7%）为女性；143 例为轻度认知障碍病例，122 例为认知功能正常的对照。与对照组相比，病例组的 P 波持续时间更长（116.2±13.8ms 比 112.5±13.3ms，p=0.028），IAB 发生率更高（73[51.0%]比 38[31.1%]，p=0.001），晚期 IAB 发生率更高（28[19.6%]比 10[8.2%]，p=0.002），MVP ECG 风险评分更高（2.7±1.4 比 2.2±1.3，p=0.004）。IAB 与轻度认知障碍独立相关，部分 IAB（比值比 2.0，95%可信区间：1.1-3.9）和晚期 IAB（比值比 2.8，95%可信区间：1.1-6.7）均如此。总之，在无明显结构性心脏病的≥70 岁受试者中，IAB 与轻度认知障碍独立相关，晚期 IAB 相关性更强。
