脑血管损害和认知能力下降是由慢性心力衰竭驱动的
Chenjia Zhao1, Fengjun Du2, Xiaoxia Hou3
1Department of Electrocardiogram, Gusu College of Nanjing Medical University, Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital), Suzhou, China.
Frontiers in neurology
|November 13, 2025
概括
慢性心力衰竭与左心室喷射率 (LVEF) 减少与大脑小血管疾病 (CSVD) 和认知能力下降有关. 较低的LVEF与更严重的CSVD和更差的认知功能相关.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 医疗成像医学成像
背景情况:
- 慢性心力衰竭 (CHF) 影响多个器官系统,包括大脑.
- 大脑小血管疾病 (CSVD) 是心脏病患者的常见发现.
- 在CHF和认知障碍中减少的左心室射出分数 (LVEF) 之间的关系需要进一步阐明.
研究的目的:
- 调查慢性心力衰竭 (CHF) 与左心室喷射分数 (LVEF) 水平变化和大脑小血管疾病 (CSVD) 之间的关联.
- 评估LVEF对心脏衰竭患者认知功能的影响.
- 探索白质完整性,CSVD和CHF患者的认知表现之间的关系.
主要方法:
- 一组73名患有CHF的患者被分为LVEF≥50%和LVEF<50%的组.
- 进行了脑部MRI,包括以通道为基础的空间统计 (TBSS) 分析的扩散张力成像 (DTI).
- 用蒙特利尔认知评估 (MoCA) 和其子域来评估神经认知功能.
主要成果:
- 患有LVEF<50%的患者的MoCA得分明显较低 (p<0.001),白质超强度 (WMH) 的患病率更高 (OR=0.228,p=0.042).
- 降低的LVEF与整体的MoCA分数和特定的认知领域 (视觉空间/执行功能,注意力,延迟回忆) 有积极的相关性.
- 在LVEF<50%组中,TBSS揭示了分数异构 (FA) 的降低和平均扩散率 (MD),轴向扩散率 (AD) 和辐射扩散率 (RD) 的增加,与认知缺陷相关.
结论:
- 慢性心力衰竭,特别是减少LVEF,与CSVD和认知障碍有关.
- 降低LVEF是白质变化和CHF患者认知结果较差的重要预测因素.
- 这些发现强调了评估CHF患者的大脑健康的重要性,特别是那些LVEF降低患者.
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