Zenger Brian, Rizzi Scott, Steinberg Benjamin A, Ranjan Ravi, Bunch T Jared
School of Medicine, University of Utah, SLC, UT, US.
Department of Internal Medicine, University of Utah Health Sciences, SLC, UT, US.
Arrhythm Electrophysiol Rev. 2023 Jan;12:e01. doi: 10.15420/aer.2022.29.
AF is an independent and strong predictor of long-term cognitive decline. However, the mechanism for this cognitive decline is difficult to define and likely multifactorial, leading to many different hypotheses. Examples include macro- or microvascular stroke events, biochemical changes to the blood-brain barrier related to anticoagulation, or hypo-hyperperfusion events. This review explores and discusses the hypothesis that AF contributes to cognitive decline and dementia through hypo-hyperperfusion events occurring during cardiac arrhythmias. We briefly explain several brain perfusion imaging techniques and further examine the novel findings associated with changes in brain perfusion in patients with AF. Finally, we discuss the implications and areas requiring more research to further understand and treat patients with cognitive decline related to AF.
房颤是长期认知功能衰退的一个独立且强有力的预测因素。然而，这种认知功能衰退的机制难以界定，可能是多因素的，从而产生了许多不同的假说。例子包括大或微血管中风事件、与抗凝相关的血脑屏障的生化变化，或灌注不足-灌注过多事件。本综述探讨并讨论了房颤通过心律失常期间发生的灌注不足-灌注过多事件导致认知功能衰退和痴呆的假说。我们简要解释几种脑灌注成像技术，并进一步研究与房颤患者脑灌注变化相关的新发现。最后，我们讨论其意义以及需要更多研究的领域，以进一步了解和治疗与房颤相关的认知功能衰退患者。
