The Role of Cardiovascular and Metabolic Comorbidities in the Link between Atrial Fibrillation and Cognitive Impairment: An Appraisal of Current Scientific Evidence

被引:11
作者
AlTurki, Ahmed [1 ]
Maj, Jakub B. [1 ]
Marafi, Mariam [2 ]
Donato, Filippo [3 ]
Vescovo, Giovanni [3 ]
Russo, Vincenzo [4 ]
Proietti, Riccardo [3 ]
机构
[1] McGill Univ, Div Cardiol, Hlth Ctr, Montreal, PQ H3G 1A4, Canada
[2] Montreal Neurol Inst, Dept Neurol & Neurosurg, Montreal, PQ H3A 2B4, Canada
[3] Univ Padua, Dept Cardiac Thorac & Vasc Sci, I-35121 Padua, Italy
[4] Univ Campania Luigi Vanvitelli, Dept Med Translat Sci, Monaldi Hosp, I-80131 Naples, Italy
来源
MEDICINA-LITHUANIA | 2019年 / 55卷 / 12期
关键词
atrial fibrillation; metabolic syndrome; obesity; cognitive impairment; dementia; TEMPORAL RELATIONSHIP; ATHEROSCLEROSIS RISK; INSULIN-RESISTANCE; DEMENTIA; OBESITY; MANAGEMENT; DECLINE; POPULATION; STROKE; ASSOCIATION;
D O I
10.3390/medicina55120767
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice with implications on long-term outcomes. Metabolic disorders including diabetes mellitus and obesity are independent predictors of atrial fibrillation and present therapeutic targets to reduce both the incidence and duration burden of atrial fibrillation. The presence of pericardial fat in direct contact with cardiac structures, as well the subsequent release of proinflammatory cytokines, may play an important role in this connection. Atrial fibrillation is an independent predictor of cognitive impairment and dementia. While clinical stroke is a major contributor, other factors such as cerebral hypoperfusion and microbleeds play important roles. New evidence suggests that atrial fibrillation and cognitive impairment may be downstream events of atrial cardiomyopathy, which may be caused by several factors including metabolic syndrome, obesity, and obstructive sleep apnea. The mechanisms linking these comorbidities to cognitive impairment are not yet fully elucidated. A clearer understanding of the association of AF with dementia and cognitive impairment is imperative. Future studies should focus on the predictors of cognitive impairment among those with AF and aim to understand the potential mechanisms underlying these associations. This would inform strategies for the management of AF aiming to prevent continued cognitive impairment.
引用
收藏
页数:9
相关论文
共 53 条
[1]   Effect of Weight Reduction and Cardiometabolic Risk Factor Management on Symptom Burden and Severity in Patients With Atrial Fibrillation A Randomized Clinical Trial [J].
Abed, Hany S. ;
Wittert, Gary A. ;
Leong, Darryl P. ;
Shirazi, Masoumeh G. ;
Bahrami, Bobak ;
Middeldorp, Melissa E. ;
Lorimer, Michelle F. ;
Lau, Dennis H. ;
Antic, Nicholas A. ;
Brooks, Anthony G. ;
Abhayaratna, Walter P. ;
Kalman, Jonathan M. ;
Sanders, Prashanthan .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2013, 310 (19) :2050-2060
[2]   Pericardial fat and atrial fibrillation: Epidemiology, mechanisms and interventions [J].
Al-Rawahi, Mohamed ;
Proietti, Riccardo ;
Thanassoulis, George .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2015, 195 :98-103
[3]  
Alonso Alvaro, 2016, Eur Cardiol, V11, P49
[4]   Subclinical Atrial Fibrillation and Risk of Stroke: Past, Present and Future [J].
AlTurki, Ahmed ;
Marafi, Mariam ;
Russo, Vincenzo ;
Proietti, Riccardo ;
Essebag, Vidal .
MEDICINA-LITHUANIA, 2019, 55 (10)
[5]   Transient cerebral hypoperfusion and hypertensive events during atrial fibrillation: a plausible mechanism for cognitive impairment [J].
Anselmino, Matteo ;
Scarsoglio, Stefania ;
Saglietto, Andrea ;
Gaita, Fiorenzo ;
Ridolfi, Luca .
SCIENTIFIC REPORTS, 2016, 6
[6]   Obesity is associated with incident atrial fibrillation independent of gender: A meta-analysis [J].
Asad, Zain ;
Abbas, Mubasher ;
Javed, Isma ;
Korantzopoulos, Panagiotis ;
Stavrakis, Stavros .
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2018, 29 (05) :725-732
[7]   Atrial fibrillation and type 2 diabetes: Prevalence, etiology, pathophysiology and effect of anti-diabetic therapies [J].
Bell, David S. H. ;
Goncalves, Edison .
DIABETES OBESITY & METABOLISM, 2019, 21 (02) :210-217
[8]   Adipose tissue, inflammation, and cardiovascular disease [J].
Berg, AH ;
Scherer, PE .
CIRCULATION RESEARCH, 2005, 96 (09) :939-949
[9]   Temporal Relationship Between Subclinical Atrial Fibrillation and Embolic Events [J].
Brambatti, Michela ;
Connolly, Stuart J. ;
Gold, Michael R. ;
Morillo, Carlos A. ;
Capucci, Alessandro ;
Muto, Carmine ;
Lau, Chu P. ;
Van Gelder, Isabelle C. ;
Hohnloser, Stefan H. ;
Carlson, Mark ;
Fain, Eric ;
Nakamya, Juliet ;
Mairesse, Georges H. ;
Halytska, Marta ;
Deng, Wei Q. ;
Israel, Carsten W. ;
Healey, Jeff S. .
CIRCULATION, 2014, 129 (21) :2094-2099
[10]   Patients Treated with Catheter Ablation for Atrial Fibrillation Have Long-Term Rates of Death, Stroke, and Dementia Similar to Patients Without Atrial Fibrillation [J].
Bunch, T. Jared ;
Crandall, Brian G. ;
Weiss, J. Peter ;
May, Heidi T. ;
Bair, Tami L. ;
Osborn, Jeffrey S. ;
Anderson, Jeffrey L. ;
Muhlestein, Joseph B. ;
Horne, Benjamin D. ;
Lappe, Donald L. ;
Day, John D. .
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2011, 22 (08) :839-845