Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet-Stockholm University, Stockholm, Sweden.
Centro Medicina dell'Invecchiamento, Fondazione Policlinico "A- Gemelli" IRCCS and Catholic University of Rome, Rome, Italy.
J Alzheimers Dis. 2021;84(3):1303-1322. doi: 10.3233/JAD-210606.
Markers of altered cardiac function might predict cognitive decline and dementia.
This systematic review aims to review the literature that examines the associations of various electrocardiogram (ECG) markers with cognitive decline and dementia in middle-aged and elderly populations.
We searched PubMed, Embase, and Web of Science through 1 July 2020 for literature and conducted a systematic literature review. We included studies examining the associations of ECG markers (e.g., left ventricular hypertrophy [LVH], spatial QRS-T angle, and QT prolongation) with cognitive function and dementia in adult populations regardless of study setting and design, but excluded studies examining atrial fibrillation and heart rate variability.
Fourteen community-based cross-sectional and longitudinal studies were identified. ECG markers were investigated in association with dementia in four prospective studies, and with cognitive decline in ten prospective studies. ECG-assessed LVH was associated with dementia in one study while five heterogeneous prospective studies yielded inconsistent associations with cognitive decline. Regarding ventricular repolarization markers, spatial QRS-T angle was associated with cognitive decline in one study while another study found no association between QT prolongation and cognitive decline. High resting heart rate was associated with both dementia and cognitive decline in one study but not associated with dementia in another study. P-wave abnormality was significantly associated with incident dementia and cognitive decline in one prospective study.
Some ECG markers were associated with incident dementia and cognitive decline. However, limited number of heterogeneous studies did not allow us to make firm conclusions. Further studies are needed.
改变心脏功能的标志物可能预测认知能力下降和痴呆。
本系统综述旨在回顾文献，以检查各种心电图（ECG）标志物与中年和老年人群认知能力下降和痴呆的相关性。
我们通过 7 月 1 日搜索了 PubMed、Embase 和 Web of Science 中的文献，并进行了系统的文献综述。我们纳入了研究心电图标志物（如左心室肥厚[LVH]、空间 QRS-T 角和 QT 延长）与成人人群认知功能和痴呆相关性的研究，无论研究环境和设计如何，但排除了研究房颤和心率变异性的研究。
确定了 14 项基于社区的横断面和纵向研究。四项前瞻性研究调查了 ECG 标志物与痴呆的相关性，十项前瞻性研究调查了与认知能力下降的相关性。一项研究发现 ECG 评估的 LVH 与痴呆有关，而五项异质性前瞻性研究得出了不一致的认知能力下降相关性。关于心室复极标志物，一项研究表明空间 QRS-T 角与认知能力下降有关，而另一项研究发现 QT 延长与认知能力下降无关。一项研究表明静息心率高与痴呆和认知能力下降均有关，但另一项研究则发现静息心率高与痴呆无关。一项前瞻性研究表明，P 波异常与痴呆和认知能力下降的发生显著相关。
一些 ECG 标志物与痴呆和认知能力下降的发生有关。然而，数量有限的异质性研究不允许我们得出明确的结论。需要进一步的研究。
