慢性心力衰竭的认知功能障碍。治疗慢性心力衰竭的新疗法如何影响认知功能?

Y. Aksenova, Y. Osmolovskaya, A. A. Petrukhina, I. V. Zhirov, A. Beniashvili, S. N. Tereshchenko, M. A. Morozova
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引用次数: 0

摘要

心力衰竭是一种严重的慢性疾病,也是一个全球性的医疗保健问题。在世界各地,心力衰竭患者的再入院率和死亡率都在上升。心力衰竭通常与合并症并存,其中认知障碍尤为重要。约 30% 至 80% 的心力衰竭患者存在认知障碍,这会降低患者的生活质量,增加反复住院的频率,增加死亡率,恶化预后。尽管已有相关研究,但人们对心力衰竭与认知功能障碍之间关系的潜在病理生理学仍知之甚少。本文讨论了有关心力衰竭患者认知障碍背后不同病理生理机制的现有最佳证据。心力衰竭和认知障碍有许多共同的病理生理学途径,包括脑血流量减少、炎症、神经体液激活、氧化应激和血清生物标志物或蛋白质的变化。了解疾病的病理生理学有助于有效评估健康状况和开发合适的治疗方法。及时发现认知障碍将为心力衰竭患者带来更好的临床疗效。本综述提出了心力衰竭与认知功能障碍之间关系的问题,提供了治疗心力衰竭的新疗法对认知功能影响的证据,并提出了潜在的未来研究方向。例如,植入人工左心室可能会改善认知功能;但有研究表明,植入人工左心室后,认知功能会立即得到改善,但随着时间的推移,认知功能会逐渐恶化,这需要长期研究。此外,有证据表明,使用虚拟现实技术中的放松情景可以有效减轻躯体住院患者的焦虑和情感抱怨,但能否改善慢性心衰患者的认知功能仍有待探索。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cognitive impairment in chronic heart failure. How new therapeutic options for the treatment of chronic heart failure affect cognitive function?
Heart failure is a serious chronic illness and a global healthcare problem. Patients with heart failure have increased hospital readmission rates and mortality around the world. Heart failure often coexists with comorbidities of which cognitive impairment is particularly important. Сognitive impairment is present in around 30% to 80% in heart failure decreases quality of life and increases the frequency of repeated hospitalizations, increases mortality and worsens the prognosis in such patients. Despite existing research, the underlying pathophysiology of the relationship between heart failure and cognitive impairment remains poorly understood. The article discusses the best available evidence concerning different pathophysiological mechanisms behind cognitive impairment in individuals with heart failure. Heart failure and cognitive impairment have a number of common pathophysiological pathways including reduced cerebral blood flow, inflammation, neurohumoral activations, oxidative stress and changes in serum biomarkers or proteins. Understanding the pathophysiology of diseases will allow the effective evaluation of health status and development of suitable treatments. Prompt detection of cognitive impairment will bring about better clinical outcomes in heart failure patients. This review raises questions about the relationship between heart failure and cognitive dysfunction, provides evidence on the impact of new therapeutic options for treating heart failure on cognitive function, and suggests potential future research directions. For example, implantation of an artificial left ventricle may improve cognitive function; however, there are studies on immediate improvement in cognitive function followed by gradual deterioration over time after implantation of an artificial left ventricle, which requires long-term study In addition, evidence is provided for the effectiveness of using a relaxation scenario in virtual reality technology to reduce anxiety and affective complaints in somatic hospitalized patients, but the ability to improve cognitive function in patients with chronic heart failure remains to be explored.
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