摘要
目的探讨缺血性心脏病患者左心室功能受损与认知功能障碍的相关性及其发生认知功能障碍的潜在机制。方法回顾性纳入2020年9月至2022年12月首都医科大学宣武医院接受心脏一体化正电子发射断层显像(positron emission tomography,PET)/MR检查的缺血性心脏病患者50例,根据蒙特利尔认知评估量表(Montreal cognitiveassessment,MoCA)评分分为认知正常组21例(MoCA评分≥26分)和认知下降组29例(MoCA评分<26分)。所有患者进行^(13)N-NH_(3)·H_(2)O心肌灌注显像和18F-脱氧葡萄糖心脏PET/MR检查,获得心功能及心脏影像参数。应用Spearman相关系数分析心脏影像参数与MoCA评分的相关性,一般线性模型分析校正协变量后MoCA评分与心脏影像参数的相关性。结果与认知正常组比较,认知下降组每搏量[56.95(47.51,77.64)mlvs 82.66(73.88,92.92)ml,P=0.001]、每搏量指数[34.07(28.93,43.20)ml/m^(2)vs44.28(38.06,49.49)ml/m^(2),P=0.008]、心排血量[3.92(3.18,5.34)L/minvs 5.13(4.58,5.67)L/min,P=0.007]和心脏指数[(2.42±0.68)L/(min·m^(2))vs(2.78±0.39)L/(min·m^(2)),P=0.021]明显降低。Spearman相关性分析显示,MoCA评分与每搏量(r=0.497,P=0.001)、每搏量指数(r=0.365,P=0.009)及心排血量(r=0.361,P=0.010)呈正相关。采用一般线性回归模型校正性别、年龄、教育年限及血管危险因素后,MoCA评分仍与每搏量呈正相关(r=0.497,P=0.003)。结论缺血性心脏病患者全身低灌注状态可能是导致认知功能障碍的潜在机制之一。
Objective To investigate the correlation between lett ventricular dysfunction and cogni-tive impairment in patients with ischemic heart disease(IHD),and explore the potential patho-genesis of cognitive impairment in IHD patients.Methods Fifty IHD patients who underwent hybrid cardiac PET/MR in our hospital from September 2020 to December 2022 were retrospec-tively enrolled in this study.According to their Montreal cognitive assessment(MoCA)scores,they were categorized into a cognitively normal group(21 cases,MoCA score fa26)and a cogni-tively declining group(29 cases,MoCA score<26).A11 patients received ^(13)N-NH_(3)·H_(2)O myocar-dial perfusion imaging and ^(18)F-FDG cardiac PET/MR to evaluate cardiac function and obtain car-diac imaging parameters.Spearman correlation analysis was applied to analyze the correlation between cardiac PET/MR parameters and MoCA scores.General linear model analysis was applied to analyze the correlation between MoCA scores and cardiac PET/MR parameters after adjusting for covariates.Results Compared with the cognitively normal group,the patients in the cognitively declining group had significantly lower stroke volume[56.95(47.51,77.64)ml vs 82.66(73.88,92.92)ml,P=0.001],stroke volume index[34.07(28.93,43.20)ml/m^(2) vs 44.28(38.06,49.49)ml/m^(2),P=0.008],cardiac output[3.92(3.18,5.34)L/min vs 5.13(4.58,5.67)L/min,P=0.007],and cardiac index[(2.42±0.68)L/(min·m^(2))vs(2.78±0.39)L/(min·m^(2)),P=0.021].Spearman correlation analysis revealed that MoCA score was positively correlated with stroke volume(r=0.497,P=0.001),stroke volume index(r=0.365,P=0.009)and cardiac output(r=0.361,P=0.010).After adjusting for sex,age,education level and vascular risk factors,MoCA score re-mained positively correlated with stroke volume(r=0.497,P=0.003).Conclusion Systemic hy-poperfusion in 1HD patients may be one of the mechanisms leading to cognitive impairment.
作者
郑冲
崔亚东
谷珊珊
崔碧霄
马杰
司瑾
肖克令
李静
卢洁
Zheng Chong;Cui Yadong;Gu Shanshan;Cui Bixiao;Ma Jie;Si Jin;Xiao Keling;Li Jing;Lu Jie(Department of Radiology and Nuclear Medicine,Xuanwu Hospital,Capital Medical University Beijing 100053,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2023年第12期1240-1244,共5页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
国家重点研发计划项目(2022YFC2406900)
首都医科大学宣武医院“汇智”人才工程学者计划项目(HZ2021ZCLJ005)。
关键词
认知功能障碍
心肌缺血
正电子发射断层显像术
回顾性研究
数据相关性
心脏病危险因素
cognitive dysfunction
myocardial ischemia
positron-emission tomography
retrospective studies
correlation of data
heart disease risk factors
