心力衰竭患者认知障碍的病理生理学:系统性审查
Reine Sam Shi Ni1, Hanis Qarissa Mohamed Raffi1, Yanhong Dong1
1Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Frontiers in cardiovascular medicine
|June 8, 2023
概括
心力衰竭和认知障碍通过各种大脑和系统变化联系在一起. 了解这些病理生理机制是改善患者管理和探索新干预措施的关键.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 病理生理学 病理生理学
背景情况:
- 心力衰竭和认知障碍是越来越普遍和相互关联的条件.
- 现有评论强调了这种关系,但缺乏探索潜在的病理生理机制的深度.
- 当前的研究往往侧重于患病率和心脏康复等干预措施,在了解"为什么"方面留下了差距.
研究的目的:
- 系统地审查和总结有关心力衰竭和认知障碍之间的病理生理机制的现有证据.
- 巩固关于心脏功能障碍如何影响大脑健康和相反的发现.
- 在这些条件下识别研究缺口并指导未来对脑心轴的研究.
主要方法:
- 通过使用八个电子数据库和灰色文献进行了系统审查,并进行了参考手工搜索.
- 针对人口,暴露和结果,应用了特定的纳入标准.
- 来自32项研究的数据使用叙事合成进行了合成,使用JBI批判性评估工具进行质量评估.
主要成果:
- 心力衰竭中的认知障碍源于大脑变化 (缩,白色/灰质变化,神经炎症) 和系统/心脏因素 (炎症,氧化应激,生物标志物,心律).
- 七项研究报告了负面发现,表明复杂性或潜在的双向影响.
- 确定的局限性包括包括非人体研究和大量的横截面设计.
结论:
- 未来的研究应该调查大脑和心脏之间的双向关系,超越目前关注心脏对大脑的影响.
- 更深入地了解病理生理机制可以改善心力衰竭患者的管理和预后.
- 开发缓慢或逆转认知障碍的干预措施对于降低整体疾病负担至关重要.
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