Screening diagnosis of dementia in patients following heart failure decompensation is associated with a higher relative wall thickness

Abstract

BACKGROUND: The usefulness of echocardiographic characteristics for dementia prediction in patients with heart failure decompensation (HFD) is not determined. Therefore, we sought to investigate the echocardiographic features of patients with HFD and screening diagnosis of dementia (SDD). METHODS: 139 patients aged over 65 years were hospitalized with the diagnosis of HFD. Clinical characteristics and echocardiographic characteristics were recorded during hospitalization. SDD was defi ned based on the result of ALFI-MMSE of < 17 points. RESULTS: Patients with SDD were older (p = 0.013), had thicker IVSd (p = 0.021), thicker PWd (p = 0.005) and had a higher RWT (0.40 vs 0.35, p = 0.004) than patients without SDD, without differences in LVMI (p = 0.13). There was no correlation between RWT and LVMI (r = −0.01, p = 0.88). In the multivariate analysis, an older age (β = −0.116, 95% CI −0.224 -−0.008, p = 0.035, per year) and a higher RWT (β =−0.069, 95% CI −0.137 -−0.002, p=0.045, per 0.01) infl uenced a lower ALFI-MMSE. For a prediction of SDD, the RWT reached the area under a ROC curve of 0.67 (95% CI 0.56-0.77, p = 0.004 with sensitivity of 60% and specifi city of 70% for RWT of ≥0.375). CONCLUSIONS: Apart from age, RWT refl ecting left ventricular geometry changes but not hypertrophy was independently but moderately associated with SDD in patients following HFD (Tab. 4, Fig. 1, Ref. 35).

Rare instances of concomitant acute myocardial infarction and stroke

“…The proper order of interventions is difficult to determine because there are no clear indications as to whether MI or stroke should be treated first. However, every decision can impact the patient's health, including disability or heart failure in future (11)(12)(13).…”