Psychiatria Danubina · 2025
COGNITIVE FUNCTION EVALUATION IN PATIENTS WITH NEWLY DIAGNOSED PAROXYSMAL ATRIAL FIBRILLATION.
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Germanova Olga, Reshetnikova Yulia, Popova Daria, Galati Giuseppe
Аннотация
BACKGROUND: To evaluate cognitive function of patients with newly diagnosed paroxysmal atrial fibrillation.
MATERIALS AND METHODS: In a single-center case-control study, we undertook 24 hours ECG monitoring of 6630 patients, among whom 97 showed paroxysmal atrial fibrillation (AF) Fourteen of the AF patients have informed consent to participate in the study. All patients had additional 24 hours ECG monitoring, along with transthoracic echocardiography, volumetric sphygmography, and the Montreal Cognitive Assessment (MoCA) test.
RESULTS: The median MoCA score was 24 [22; 26], indicating mild cognitive impairment in nine of the 14 patients (64%, age 67.9 ± 8.6 y.o.). The least severe impairment was in visual-spatial perception (median 4 of 5 possible), and the most severe was in executive-functional skills (median 3 of 5). Despite the high mean arterial stiffness (CAVI > 8), there was no significant correlation with MoCA (rs = -0.256, p = 0.364). However, there was a significant negative Spearman correlation between MoCA and LV myocardial mass index (rs = -0.737, 95% CI [-0.914; -0.323], p = 0.003), indicating an association between declining cognitive function and myocardial structure.
CONCLUSIONS: In most of the patients with asymptomatic paroxysmal newly revealed AF, we observed mild cognitive impairment. Increased LV-indexed mass was associated with worse cognitive function in these AF patients (rs = -0.737, 95% CI [-0.914; -0.323], p = 0.003). This observation calls for investigation of the causal mechanism whereby myocardial remodeling in AF patients may impair brain function.
MATERIALS AND METHODS: In a single-center case-control study, we undertook 24 hours ECG monitoring of 6630 patients, among whom 97 showed paroxysmal atrial fibrillation (AF) Fourteen of the AF patients have informed consent to participate in the study. All patients had additional 24 hours ECG monitoring, along with transthoracic echocardiography, volumetric sphygmography, and the Montreal Cognitive Assessment (MoCA) test.
RESULTS: The median MoCA score was 24 [22; 26], indicating mild cognitive impairment in nine of the 14 patients (64%, age 67.9 ± 8.6 y.o.). The least severe impairment was in visual-spatial perception (median 4 of 5 possible), and the most severe was in executive-functional skills (median 3 of 5). Despite the high mean arterial stiffness (CAVI > 8), there was no significant correlation with MoCA (rs = -0.256, p = 0.364). However, there was a significant negative Spearman correlation between MoCA and LV myocardial mass index (rs = -0.737, 95% CI [-0.914; -0.323], p = 0.003), indicating an association between declining cognitive function and myocardial structure.
CONCLUSIONS: In most of the patients with asymptomatic paroxysmal newly revealed AF, we observed mild cognitive impairment. Increased LV-indexed mass was associated with worse cognitive function in these AF patients (rs = -0.737, 95% CI [-0.914; -0.323], p = 0.003). This observation calls for investigation of the causal mechanism whereby myocardial remodeling in AF patients may impair brain function.