Cardiac autonomic function and cognitive performance in patients with atrial fibrillation.

Hämmerle, Peter; Aeschbacher, Stefanie; Springer, Anne; Eken, Ceylan; Coslovsky, Michael; Dutilh, Gilles; Moschovitis, Giorgio; Rodondi, Nicolas; Chocano, Patricia; Conen, David; Osswald, Stefan; Kühne, Michael; Zuern, Christine S (2021). Cardiac autonomic function and cognitive performance in patients with atrial fibrillation. (In Press). Clinical research in cardiology Springer-Verlag 10.1007/s00392-021-01900-4

[img]
Preview
Text
H_mmerle__Clin_Res_Cardiol_2021.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (956kB) | Preview

BACKGROUND

Atrial fibrillation (AF) is associated with loss of cognition and dementia. Cardiac autonomic dysfunction has been linked to cognitive decline. We aimed to investigate if reduced cardiac autonomic function (CAF) is associated with cognitive impairment in AF patients.

METHODS

Patients with paroxysmal, persistent and permanent AF were enrolled from a multicenter cohort study if they had AF ("AF group") or sinus rhythm ("SR group") on a baseline 5 min ECG recording. Parameters quantifying CAF (heart rate variability triangular index (HRVI), mean heart rate (MHR), RMSSD, SDNN, total power and power in the VLF, LF, HF ranges) were calculated. We used the Montreal Cognitive Assessment (MoCA) to assess global cognitive function.

RESULTS

1685 AF patients with a mean age of 73 ± 8 years, 29% females, were included. MoCA score was 24.5 ± 3.2 in the AF group (N = 710 patients) and 25.4 ± 3.2 in the SR group (N = 975 patients). After adjusting for multiple confounders, lower HRVI was associated with lower MoCA scores, both in the SR group [β = 0.049; 95% confidence interval (CI) 0.016-0.081; p = 0.003] and in the AF group (β = 0.068; 95% CI 0.020-0.116; p = 0.006). In the AF group, higher MHR was associated with a poorer performance in the MoCA (β =  - 0.008; 95% CI - 0.014 to - 0.002; p = 0.014). We found no convincing evidence of association for other CAF parameters with cognition.

CONCLUSION

Our data suggest that impaired CAF is associated with worse cognitive performance in patients with AF. Among standard HRV parameters, HRVI might be the most promising ECG index.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02105844.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Rodondi, Nicolas and Chocano Bedoya, Patricia Orializ

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1861-0684

Publisher:

Springer-Verlag

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Tobias Tritschler

Date Deposited:

01 Jul 2021 09:54

Last Modified:

07 Sep 2021 17:17

Publisher DOI:

10.1007/s00392-021-01900-4

PubMed ID:

34156525

Uncontrolled Keywords:

Atrial fibrillation Cardiac autonomic function Heart rate variability Montreal Cognitive Assessment Neurocognitive function

BORIS DOI:

10.48350/157210

URI:

https://boris.unibe.ch/id/eprint/157210

Actions (login required)

Edit item Edit item
Provide Feedback