Related Experiment Video
Updated: Sep 21, 2025
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
The Relationship Between Pre-existing Coronary Heart Disease and Cognitive Impairment Is Partly Explained by Reduced
Suhang Shang1, Ziyu Liu1, Jinying Gao2
1Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Insights
Coronary heart disease (CHD) is linked to cognitive impairment. Reduced cardiac systolic function, measured by left ventricular ejection fraction (LVEF), significantly explains this association in patients without heart failure.
Area of Science:
- Cardiology
- Neurology
- Geriatrics
Background:
- Coronary heart disease (CHD) is linked to cognitive impairment, particularly in severe heart failure.
- The role of cardiac systolic function in this relationship among individuals without clinical heart failure remains unclear.
Purpose of the Study:
- To investigate the association between pre-existing CHD and cognitive impairment.
- To determine if cardiac systolic function, specifically left ventricular ejection fraction (LVEF), mediates this relationship in subjects without heart failure.
Main Methods:
- 208 subjects were divided into CHD and non-CHD groups.
- Cognitive function was assessed using the Mini-Mental State Examination (MMSE).
- Left ventricular ejection fraction (LVEF) was measured via echocardiography; logistic regression was used for analysis.
Main Results:
- Cognitive impairment was more prevalent in the CHD group (22.0%) than the non-CHD group (8.9%).
- CHD was associated with a higher risk of cognitive impairment (OR=3.284, p=0.044) before LVEF adjustment.
- After adjusting for LVEF, the association weakened (OR=2.127, p=0.228), while LVEF showed a negative association with cognitive impairment risk (OR=0.928, p=0.004).
Conclusions:
- Pre-existing CHD is associated with an increased risk of cognitive impairment.
- Reduced LVEF significantly explains the link between CHD and cognitive impairment.
- Impaired cardiac systolic function may be a key factor in cognitive decline among patients with pre-heart failure conditions.
Background:
Coronary heart disease (CHD) is closely associated with cognitive impairment, especially in severe cases of heart failure. However, it is unclear whether cardiac systolic function plays a role in the relationship between pre-existing CHD and cognitive impairment in subjects without clinical heart failure.
Methods:
In total, 208 subjects from the First Affiliated Hospital of Xi'an Jiaotong University were recruited from June 2014 to January 2015, and were divided into CHD (n = 118) and non-CHD (n = 90) groups according to the inclusion and exclusion criteria. The global cognitive function of all subjects was assessed by the Mini-Mental State Examination (MMSE) and cognitive impairment was defined as the score lower than the cutoff value. Left ventricular ejection fraction (LVEF) was measured using transthoracic echocardiograms. The relationship among pre-existing CHD, LVEF, and cognitive impairment was analyzed by multivariate logistic regression.
Results:
In total, 34 subjects met the criteria of cognitive impairment. Univariate analysis showed that the cognitive impairment prevalence in the CHD group was significantly higher than that in the non-CHD group (22.0 vs. 8.9%, p = 0.011). Multivariate logistic analysis revealed that CHD was significantly associated with a higher risk of cognitive impairment (odds ratio [OR] = 3.284 [95% CI, 1.032-10.450], p = 0.044) after adjusting for confounds except for LVEF. However, the OR of CHD decreased (OR = 2.127 [95% CI, 0.624-7.254], p = 0.228) when LVEF was further corrected as a continuous variable, and LVEF was negatively associated with the risk of cognitive impairment (OR = 0.928 [95% CI, 0.882-0.976], p = 0.004).
Conclusion:
Pre-existing CHD is associated with a higher risk of cognitive impairment, and such an association can be considerably explained by reduced LVEF. An impaired cardiac systolic function may play a key role in the relationship between CHD and cognitive impairment among patients with pre-heart failure conditions.
More Related Videos
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease II: Pathophysiology
01:30Coronary Artery Disease III: Clinical Manifestations
01:27Heart Failure I: Introduction
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...