Department VIII, Neuroscience, Discipline of Neurology II, University of Medicine and Pharmacy "Victor Babes" Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania.
Municipal Emergency Hospital Timisoara, Gheorghe Dima Street Nr. 5, 300254 Timisoara, Romania.
Medicina (Kaunas). 2024 Nov 13;60(11):1859. doi: 10.3390/medicina60111859.
: Considering the increasing prevalence of chronic heart failure (CHF) and cognitive decline (CD) observed in recent decades and the complex interrelation between these two pathologies often encountered in the same patient, in this study, we aimed to highlight the connection between CHF, defined as recommended by the European Society of Cardiology guidelines, and CD, evaluated by employing five neuropsychological scales. : Our study was conducted on 190 patients with very high cardiovascular risk profiles admitted between 5 September 2021 and 15 November 2023 in the Municipal Emergency Hospital Timisoara. Of these, 103 had CHF (group A) and 87 did not (group B). : Although similar concerning age, sex distribution, and risk factors (excepting lipid profile), patients from group A had lower Mini Mental State Evaluation (MMSE) and Montreal Cognitive Assessment (MoCA levels ( = 0.003, respectively, = 0.017) scores, more reduced daily activity ( = 0.021), and more severe depression ( = 0.015) compared to group B. We documented statistically significant correlations between left-ventricular ejection fraction (LVEF) and the levels of N-terminal pro-B-type natriuretic peptide (NT-pro-BNP), as well as with the results of MMSE (r = 0.226, = 0.002 and r = -0.275, = 0.005, respectively), daily activity, and depression ( ˂ 0.001). Multi-logistic regression models indicated age, blood pressure values, decreased daily activity, and depression as risk factors for CD in patients with CHF. : In patients with CHF, there is an increased propensity of CD, with a direct relationship between MMSE and LVEF levels and an indirect one between MMSE and NT-pro-BNP levels. The concomitance of depression and reduced activity levels are aggravating CD in these patients.
: 鉴于近几十年来慢性心力衰竭 (CHF) 和认知能力下降 (CD) 的发病率不断上升,以及这两种病理之间的复杂相互关系,在这项研究中,我们旨在强调 CHF(根据欧洲心脏病学会指南定义)与 CD 之间的联系,CD 通过使用五种神经心理学量表进行评估。: 我们的研究对象是 2021 年 9 月 5 日至 2023 年 11 月 15 日期间在蒂米什瓦拉市立急诊医院住院的心血管风险极高的 190 名患者。其中 103 名患有 CHF(A 组),87 名没有(B 组)。: 尽管两组患者在年龄、性别分布和危险因素(除血脂谱外)方面相似,但 A 组患者的简易精神状态评估(MMSE)和蒙特利尔认知评估(MoCA)得分较低(分别为 0.003 和 0.017),日常活动减少(0.021),抑郁程度更严重(0.015)。与 B 组相比,我们记录了左心室射血分数(LVEF)与 N 端脑利钠肽前体(NT-pro-BNP)水平之间以及与 MMSE 结果之间的统计学显著相关性(r = 0.226, = 0.002 和 r = -0.275, = 0.005),日常活动和抑郁( ˂ 0.001)。多逻辑回归模型表明,年龄、血压值、日常活动减少和抑郁是 CHF 患者 CD 的危险因素。: 在 CHF 患者中,CD 的发生率增加,MMSE 与 LVEF 水平之间存在直接关系,而 MMSE 与 NT-pro-BNP 水平之间存在间接关系。在这些患者中,抑郁和活动水平降低的并存会加重 CD。