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Cognitive impairments in atrial fibrillation associated with cardiovascular diseases
Authors: Derevnina E.S., Akimova N.S., Martynovich T.V., Makarov N.S., Kon’shina L.E., Shvarts Yu.G.
Number of views: 575
Objective. The aim was to study relationships between atrial fibrillation, its form and cognitive disorders in patients with cardiovascular diseases with regard to main clinical features. Material and methods. 64 patients with cardiovascular diseases and atrial fibrillation, as well as 17 patients without heart rhythm disturbances were included into the study. Exclusion criteria were cerebrovascular accidents in the past medical history or these according to MRI, disorders of carbohydrate metabolism, hemodynamically significant stenosis and atherosclerotic plaques of brachiocephalic vessels, dementia, age over 65.0 years. General clinical examination, electrocardiography, transthoracic echocardiography, duplex ultrasound of the vessels of head and neck and extensive neuropsychological assessment with a qualitative and quantitative estimation of the results were performed in each patient. MMSE for the exclusion of dementia, verbal and non-verbal subtests Wexler 5 and 7, correction test Bourdon, visual-analogue scale for the assessment of memory, attention and state of health of the patients were used. For the diagnosis of strokes in the past medical history MRI of the brain was carried out. To assess the emotional state hospital anxiety and depression scale (HADS) was used. Results. Deterioration of the neurodynamic and attention characteristics were identified in patients with atrial fibrillation, predominantly in males, regardless of characteristics of the left heart and the presence of myocardial infarction in the past medical history. Analyzing emotional state there were no statistically significant relationships between the level of anxiety, depression and the results of the cognitive tests in patients with sinus rhythm and various forms of atrial fibrillation. Conclusion. In patients with atrial fibrillation the decrease in cognitive functions, mainly the speed of sensomotor processes and weakening of attention, compared to the patients with cardiovascular pathology free of heart rhythm disturbances are revealed. The presence of atrial fibrillation is associated with the development of cognitive dysfunction mainly in males. Atrial fibrillation is the independent predictor of cognitive disorders in patients with cardiovascular diseases regardless of the characteristics of the left heart and myocardial infarction. Patients with atrial fibrillation to a much lesser extent note a reduction of memory and attention compared to patients without heart rhythm disturbances, that may indicate differences in the perception of the disease in patients with arrhythmias and without heart rhythm disturbances.