心力衰竭致认知功能紊乱机制的研究进展

心力衰竭(Heart Failure, HF)的主要特征在于异常的心脏收缩和(或)舒张功能,能够导致全身多脏器、多组织功能紊乱。其中HF常见的中枢系统并发症--认知功能紊乱(Cognitive Disorders, CDs)主要表现为学习能力和记忆力减退、定向力障碍以及执行力受损等;其主要病理生理机制包括:血流动力学改变及脑血流自身调节功能受损导致的脑灌注不足、自身免疫系统激活导致的神经炎症反应和神经-内分泌轴紊乱导致的内分泌紊乱等。流行病学调查发现,HF患者罹患CDs的风险明显高于非HF患者;CDs严重影响HF患者的生活质量,并显著增加不良预后的风险。本文对目前HF导致CDs的发病机制进行了详细地阐述和总结,以期有助于疾病的治疗和后续科学研究。

Advances in the Mechanisms of Heart Failure Induced Cognitive Disorders

ABSTRACT: Aberrant systolic and diastolic functions are the main features of heart failure, which induces multi-organ dysfunction. The symptoms of cognitive disorders, a common central nervous system complications of heart failure, include learning and memory deficiency, disorientation and execution impairment. The pathophysiologic mechanisms of CDs induced by HF is consists of cerebral hypo-perfusion and cerebral blood flow auto-regulation dysfunction, as a consequence of hemodynamic changes. In addition, heart failure activates innate immune system and neuroendocrine axis leading to inflammation and endocrine disorder. Cognitive disorders affects prognosis of heart failure dramatically. This review summarizes the possible mechanisms of heart failure induced cognitive disorders, which is expected to be helpful to the prevention and treatment of heart failure induced cognitive disorders and contribute to the further research.