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通过整体纵向应变评估的亚临床左心室功能障碍与高血压患者的轻度认知障碍相关。

Subclinical left ventricular dysfunction assessed by global longitudinal strain correlates with mild cognitive impairment in hypertensive patients.

作者信息

Ferruzzi Germano Junior, Campanile Alfonso, Visco Valeria, Loria Francesco, Mone Pasquale, Masarone Daniele, Dattilo Giuseppe, Agnelli Graziella, Moncada Alice, Falco Luigi, Mancusi Costantino, Fucile Ilaria, Mazzeo Pietro, Stabile Eugenio, Citro Rodolfo, Molloy William, Ravera Amelia, Illario Maddalena, Gatto Cristina, Carrizzo Albino, Santulli Gaetano, Iaccarino Guido, Vecchione Carmine, Ciccarelli Michele

机构信息

Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy.

Cardiovascular and Thoracic Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.

出版信息

Hypertens Res. 2025 May;48(5):1768-1778. doi: 10.1038/s41440-025-02182-3. Epub 2025 Mar 17.

Abstract

Prevention of dementia represents a public health priority. Hypertension is a risk factor for mild cognitive impairment (MCI), a precursor to progressive dementia. A great effort is underway to develop accurate and sensitive tools to detect the MCI condition in hypertensive patients. To investigate the potential association of subclinical left ventricular dysfunction expressed by the global longitudinal strain (GLS) with the MCI, defined by the Italian version of the quick mild cognitive impairment (Qmci-I). This multi-centric study included 180 consecutive hypertensive patients without medical diseases and/or drugs with known significant effects on cognition but with a not negligible comorbidity burden to avoid a possible "hyper-normality bias". The study cohort was classified into two main groups concerning the median value of the GLS. A weighted logistic regression model was employed after an inverse probability of treatment weighting (IPTW) analysis to characterize a potential association between GLS and MCI. Almost 41,1% of the whole study population was female. The mean age was 65,6 ± 7,2. 39 patients (21,7%) showed MCI. After IPTW, the GLS was significantly associated with the study endpoint (OR, 1,22; 95% CI: 1,07-1,39, P = 0.003). Our results highlight that the GLS is a potential predictor of MCI and, therefore, a valuable tool for establishing preventive strategies to arrest the progression toward a cognitive decline in hypertensive patients.

摘要

预防痴呆是一项公共卫生重点工作。高血压是轻度认知障碍(MCI)的一个风险因素,MCI是进行性痴呆的前驱症状。目前正在大力开发准确且灵敏的工具,以检测高血压患者的MCI状况。本研究旨在探讨由整体纵向应变(GLS)所表示的亚临床左心室功能障碍与以意大利语版快速轻度认知障碍(Qmci-I)定义的MCI之间的潜在关联。这项多中心研究纳入了180例连续的高血压患者,这些患者无已知对认知有显著影响的内科疾病和/或药物,但合并症负担不可忽视,以避免可能的“超正常偏差”。根据GLS的中位数,将研究队列分为两个主要组。在进行倾向评分加权分析(IPTW)后,采用加权逻辑回归模型来描述GLS与MCI之间的潜在关联。整个研究人群中近41.1%为女性。平均年龄为65.6±7.2岁。39例患者(21.7%)表现为MCI。经过IPTW分析后,GLS与研究终点显著相关(比值比,1.22;95%置信区间:1.07 - 1.39,P = 0.003)。我们的研究结果表明,GLS是MCI的一个潜在预测指标,因此是制定预防策略以阻止高血压患者向认知衰退发展的一个有价值的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5473/12055581/0d48f90a7710/41440_2025_2182_Fig1_HTML.jpg

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