Echocardiographic parameters linked to dementia diagnosis

A correlation has been demonstrated between relative wall thickness in the ECG and screening diagnosis of dementia (SDD) in a study that evaluated ECG parameters of older patients with and without an SDD who were hospitalised for heart failure decompensation.

“The term ‘cardiogenic dementia’ was coined based mainly on studies that documented lower left ventricular ejection fraction (LVEF) in patients suffering from cardiovascular diseases and dementia. However, some studies provide data that LVEF is not a marker of dementia in some groups of patients,” said Dr Karol Nowak (Jagiellonian University Medical College, Poland) [1]. Thus, Dr Nowak and colleagues performed detailed ECG assessments in patients following decompensated heart failure with and without SDD.

Included were 139 patients aged ≥65 years who were hospitalised for decompensated heart failure, and enrolled between 2008 and 2017. During their in-patient stay, clinical and laboratory, as well as detailed ECG measures were obtained. After their release, the patients were followed up with extensive questionnaires including the Adult Lifestyles and Function Interview-Mini-Mental State Examination (ALFI-MMSE) to evaluate for an SDD. Based on the presence of an ALFI-MMSE score <17 points that stood for SDD, 2 subgroups were investigated.

“The baseline characteristics of our study revealed older age, higher prevalence of renal failure, higher level of creatinine, lower glomerular filtration rate, lower haemoglobin, and lower haematocrit in patients with SDD,” said Dr Nowak. Within the ECG measures, there were significant inter-group differences for interventricular septal diastolic diameter (P=0.021), aortic valve peak gradient (P=0.013), posterior wall diastolic diameter (P=0.005), and relative wall thickness (P=0.004), all with higher values in the SDD group.

Using a multivariate model, the study also assessed independent predictors of patients’ ALFI-MMSE scores. The results revealed an independent correlation between older age as well as relative wall thickness and SDD. “The predictive value of relative wall thickness was the highest among all ECG parameters,” underlined Dr Nowak. The authors concluded that this is the first research providing ECG data in this unique SDD group of patients following heart failure decompensation.

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   1. Nowak K, et al. Acute exacerbation of chronic congestive heart failure and cognitive impairment coexistency in elderly patients-the first echocardiographic measurements. P60749, Heart Failure and World Congress on Acute Heart Failure 2021, 29 June–1 July.

 

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Posted on 19 August 202120 August 2021