Brain volume and cognitive function in patients with revascularized coronary artery disease

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• 作者：Thomas H. Ottens^a ; ¹ ; ^{t.h.ottens@umcutrecht.nl} ; Jeroen Hendrikse^b ; ¹ ; Hendrik M. Nathoe^c ; Geert Jan Biessels^d ; ¹ ; Diederik van Dijk^e ; ¹
• 关键词：CABG ; Coronary Artery Bypass Grafting ; CAD ; Coronary Artery Disease ; MRI ; Magnetic Resonance Imaging ; PCI ; Percutaneous Coronary Intervention ; UDES ; Utrecht Diabetic Encephalopathy Study
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：1 March 2017
• 年：2017
• 卷：230
• 期：Complete
• 页码：80-84
• 全文大小：222 K
• 卷排序：230

文摘

The pathogenesis of cognitive dysfunction in patients with CAD remains unclear. CAD is associated with brain atrophy and specific lesions. Detailed knowledge about the association of brain volume measured with MRI, and cognitive function in patients with CAD is lacking. We therefore investigated brain volume and cognitive function in patients with revascularized coronary artery disease (CAD), and controls without CAD.MethodsBrain MRI scans and cognitive tests from patients with CAD were compared with data from control subjects without CAD. Cognitive performance was assessed with the Rey Auditory Verbal Learning (short term memory) and Trailmaking (divided attention) tests. Multivariable regression analysis was used to study associations between CAD, brain volume and cognitive function.ResultsA total of 102 patients with CAD and 48 control subjects were included. Level of education and age were comparable between the groups. Compared with controls, patients with CAD had smaller total brain volume (expressed as fraction of intracranial volume) [%ICV, mean (SD), 0.78 (0.03) vs 0.80 (0.02), P = 0.001] and larger volume of non-ventricular cerebrospinal fluid [%ICV, median (IQR) 0.19 (0.18 to 0.21) vs 0.18 (0.17 to 0.20), P = 0.001]. Patients in the CAD group had poorer cognitive function [mean (SD) Z-score − 0.16 (0.72) vs 0.41 (0.69), P < 0.01]. Multivariable regression showed that CAD, higher age, lower level of education and greater cerebrospinal fluid volume were independent predictors of poorer cognitive function.ConclusionsCAD patients had a smaller total brain volume and poorer cognitive function than controls. Greater volume of cerebrospinal fluid was an independent predictor of poorer cognitive function.