Department of Nephrology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, 68# Middle Gehu Road, Changzhou, 213164, Jiangsu Province, People's Republic of China.
BMC Cardiovasc Disord. 2023 Mar 9;23(1):127. doi: 10.1186/s12872-023-03130-0.
Left ventricular hypertrophy (LVH) and carotid atherosclerosis (CAS) have been identified as factors associated with cognitive impairment (CI) but have not been studied in patients undergoing peritoneal dialysis (PD). This study investigated the relationship between LVH and CAS and cognitive function in patients undergoing PD.
In this single-center cross-sectional study, the clinically stable patients who were over 18 years of age and had undergone PD for at least 3 months were enrolled. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), which included seven areas: visuospatial/executive function, naming, attention, language, abstraction, delayed recall, and orientation. LVH was defined as LVMI > 46.7 g/m in women and LVMI > 49.2 g/m in men. CAS was defined as carotid intima-media thickness ≥ 1.0 mm and/or the presence of plaque.
A total of 207 patients undergoing PD were recruited, with an average age of 52.14 ± 14.93 years and a median PD duration of 8 months (5-19 months). The CI rate was 56%, and the prevalence of CAS was 53.6%. LVH occurred in 110 patients (53.1%). Patients in the LVH group tended to be older, and had a higher body mass index, a higher pulse pressure, a higher male proportion, a lower ejection fraction, a higher prevalence of cardiovascular disease and CI, and a lower MoCA scores.Multivariate logistic regression analysis was conducted to analyze the association between LVH and CI (OR, 10.087; 95% confidence interval, 2.966-34.307). And the association between LVH and CI was still supported after propensity matching scores. CAS was not significantly associated with CI.
LVH is independently associated with CI in patients undergoing PD, while CAS is not significantly associated with CI.
左心室肥厚（LVH）和颈动脉粥样硬化（CAS）已被确定为与认知障碍（CI）相关的因素，但尚未在接受腹膜透析（PD）的患者中进行研究。本研究旨在探讨 PD 患者中 LVH 与 CAS 及认知功能之间的关系。
本单中心横断面研究纳入了年龄超过 18 岁且接受 PD 治疗至少 3 个月的临床稳定患者。认知功能采用蒙特利尔认知评估（MoCA）进行评估，包括七个方面：视空间/执行功能、命名、注意力、语言、抽象、延迟回忆和定向。LVH 定义为女性 LVMI>46.7g/m，男性 LVMI>49.2g/m。CAS 定义为颈动脉内膜中层厚度≥1.0mm 和/或存在斑块。
共纳入 207 例 PD 患者，平均年龄为 52.14±14.93 岁，中位 PD 时间为 8 个月（5-19 个月）。CI 发生率为 56%，CAS 患病率为 53.6%。110 例（53.1%）患者发生 LVH。LVH 组患者年龄较大，体质量指数较高，脉压较高，男性比例较高，射血分数较低，心血管疾病和 CI 发生率较高，MoCA 评分较低。多因素 logistic 回归分析显示，LVH 与 CI 相关（OR，10.087；95%置信区间，2.966-34.307）。经倾向评分匹配后，LVH 与 CI 的关联仍然存在。CAS 与 CI 无显著相关性。
LVH 与 PD 患者 CI 独立相关，而 CAS 与 CI 无显著相关性。
