Koide H, Kobayashi S, Kitani M, Tsunematsu T, Nakazawa Y
Third Division of Internal Medicine, Shimane Medical University, Japan.
Gerontology. 1994;40(5):279-85. doi: 10.1159/000213597.
We investigated the effects of pacemaker implantation on cerebral blood flow and cognitive function in 14 severely bradycardic patients (mean age 75.2 years). Cerebral blood flow and verbal intelligence improved after the pacemaker implantation. Systolic and mean arterial blood pressure was significantly reduced after the implantation. Changes in cerebral blood flow significantly correlated with changes in heart rate in polynomial regression analysis, but not with changes in cardiac output. Before the implantation, verbal cognitive function was lower in bradycardic patients than in age-matched control subjects, and brain CT showed significant advanced atrophy in these patients. However, verbal cognitive function was also improved after the implantation. Pacemaker implantation in the severe bradycardic elderly should be beneficial not only for cardiac function but also for brain function. We concluded that these results suggest that heart rate is one of the important factors in the regulation of cerebral circulation in patients with severe bradycardia. Pacemaker implantation in the elderly improved quality of life and may prevent mental deterioration.
我们研究了起搏器植入对14例严重心动过缓患者（平均年龄75.2岁）脑血流和认知功能的影响。起搏器植入后，脑血流和语言智力得到改善。植入后收缩压和平均动脉压显著降低。在多项式回归分析中，脑血流变化与心率变化显著相关，但与心输出量变化无关。植入前，心动过缓患者的语言认知功能低于年龄匹配的对照组，脑部CT显示这些患者有明显的晚期萎缩。然而，植入后语言认知功能也得到了改善。在严重心动过缓的老年人中植入起搏器不仅对心脏功能有益，而且对脑功能也有益。我们得出结论，这些结果表明心率是严重心动过缓患者脑循环调节的重要因素之一。老年人植入起搏器可改善生活质量，并可能预防智力衰退。
