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脑血管病与心脏病患者的认知结局。

Cerebrovascular Disease and Cognitive Outcome in Patients with Cardiac Disease.

机构信息

Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

出版信息

Semin Neurol. 2021 Aug;41(4):463-472. doi: 10.1055/s-0041-1726330. Epub 2021 Apr 13.

Abstract

The pace of understanding cognitive decline and dementia has rapidly accelerated over the past decade, with constantly evolving insights into the vascular contributions to cognitive impairment and dementia (VCID). Notably, more overlap has been discovered in the pathophysiology between what was previously understood to be Alzheimer's disease and VCID, leading to a heightened emphasis on disease prevention through early and aggressive control of vascular risk factors. One particularly vulnerable population may be those with cardiac disease, as they are at risk for cerebrovascular disease, which itself can lead to dementia, and increasing evidence supports cognitive impairment in disease processes such as heart failure and atrial fibrillation, independent of ischemic stroke, suggesting other potential mechanisms. In this article, we review the evidence supporting the relationship between cardiac disease, cerebrovascular disease, and cognitive decline and discuss the ongoing and future research efforts aimed at defining the important relationship between these entities.

摘要

过去十年中,人们对认知能力下降和痴呆症的理解速度迅速加快,对血管因素导致认知障碍和痴呆症(VCID)的认识也在不断发展。值得注意的是,以前被认为是阿尔茨海默病和 VCID 的病理生理学之间发现了更多的重叠,这导致人们更加重视通过早期和积极控制血管危险因素来预防疾病。一个特别脆弱的人群可能是患有心脏病的人,因为他们有患脑血管疾病的风险,而脑血管疾病本身就会导致痴呆症,越来越多的证据支持心力衰竭和心房颤动等疾病过程中的认知障碍,而与缺血性中风无关,这表明存在其他潜在机制。在本文中,我们回顾了支持心脏病、脑血管疾病与认知能力下降之间关系的证据,并讨论了目前和未来旨在确定这些实体之间重要关系的研究工作。

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