Interatrial block and cognitive impairment in the BAYES prospective registry.


Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
15 Dec 2020
Historique:
received: 04 06 2020
revised: 21 07 2020
accepted: 07 08 2020
pubmed: 19 8 2020
medline: 15 5 2021
entrez: 19 8 2020
Statut: ppublish

Résumé

An association between interatrial block (IAB) (P wave duration ≥120 ms) and dementia has been suggested. Our objective was to assess the association of IAB with cognitive impairment (CI). The prospective BAYES registry included 552 patients ≥70 years with structural heart disease without documented atrial fibrillation. Cognitive ability was assessed at baseline and every 6 months with the Pfeiffer test. The median follow-up was 22 months. Thirty patients (5.4%) had baseline CI, 20 patients with mild CI and 10 with moderate CI. Compared to patients without CI, patients with CI had higher mean age (80.4 ± 6.5 vs. 76.8 ± 5.4 years) and higher prevalence of advanced IAB (with biphasic P-wave ± in inferior leads) (14 [46.7%] vs. 122 [23.4%], p < .01). The prevalence of baseline CI was 2.7% in normal P-wave, 5.1% in partial IAB, and 10.3% in advanced IAB, p < .001. Advanced IAB was independently associated with baseline CI (odds ratio 4.9, 95% confidence interval 1.4-16.5), this was not the case with partial IAB (odds ratio 2.1, 95% confidence interval 0.5-7.4). The independent association with CI at follow-up existed both for partial IAB (hazard ratio 1.98, 95% confidence interval 1.18-3.33) and advanced IAB (hazard ratio 2.04, 95% confidence interval 1.19-3.51). In patients aged 70 years or more with structural heart disease who are in sinus rhythm advanced IAB is associated with baseline CI. There is also an association of partial and advanced IAB with CI during follow-up.

Sections du résumé

BACKGROUND BACKGROUND
An association between interatrial block (IAB) (P wave duration ≥120 ms) and dementia has been suggested. Our objective was to assess the association of IAB with cognitive impairment (CI).
METHODS METHODS
The prospective BAYES registry included 552 patients ≥70 years with structural heart disease without documented atrial fibrillation. Cognitive ability was assessed at baseline and every 6 months with the Pfeiffer test. The median follow-up was 22 months.
RESULTS RESULTS
Thirty patients (5.4%) had baseline CI, 20 patients with mild CI and 10 with moderate CI. Compared to patients without CI, patients with CI had higher mean age (80.4 ± 6.5 vs. 76.8 ± 5.4 years) and higher prevalence of advanced IAB (with biphasic P-wave ± in inferior leads) (14 [46.7%] vs. 122 [23.4%], p < .01). The prevalence of baseline CI was 2.7% in normal P-wave, 5.1% in partial IAB, and 10.3% in advanced IAB, p < .001. Advanced IAB was independently associated with baseline CI (odds ratio 4.9, 95% confidence interval 1.4-16.5), this was not the case with partial IAB (odds ratio 2.1, 95% confidence interval 0.5-7.4). The independent association with CI at follow-up existed both for partial IAB (hazard ratio 1.98, 95% confidence interval 1.18-3.33) and advanced IAB (hazard ratio 2.04, 95% confidence interval 1.19-3.51).
CONCLUSION CONCLUSIONS
In patients aged 70 years or more with structural heart disease who are in sinus rhythm advanced IAB is associated with baseline CI. There is also an association of partial and advanced IAB with CI during follow-up.

Identifiants

pubmed: 32810550
pii: S0167-5273(20)33533-6
doi: 10.1016/j.ijcard.2020.08.006
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

95-98

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

Manuel Martínez-Sellés (M)

Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Universidad Europea, Universidad Complutense, Madrid, Spain; CIBERCV, Madrid, Spain. Electronic address: mmselles@secardiologia.es.

M Esther Martínez-Larrú (ME)

Departamento de Urgencias, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

Martin Ibarrola (M)

Centro Cardiovascular BV, Buenos Aires, Argentina.

Alba Santos (A)

Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, Spain.

Pablo Díez-Villanueva (P)

Servicio de Cardiología, Hospital Universitario de la Princesa, Madrid, Spain.

Antoni Bayés-Genis (A)

CIBERCV, Madrid, Spain; Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Universidad Autónoma de Barcelona, Spain.

Adrian Baranchuk (A)

Queens University, Kingston, Ontario, Canada.

Antonio Bayés-de-Luna (A)

Fundación de Investigación Cardiovascular, ICCC- Institute de Investigación, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Roberto Elosua (R)

CIBERCV, Madrid, Spain; Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Facultad de Medicina, Universidad de Vic-Universidad Central de Cataluña, Vic, Spain.

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