Когнитивные нарушения у больных с фибрилляцией предсердий

Abstract

Atrial fibrillation (AF) is an important medical and social problem due to its wide prevalence in the population and high risk of embolic complications leading to severe consequences. The article describes an association established between AF and an increased risk of cognitive impairment (CI). Cardioembolic stroke due to AF is a common cause of CI, however, there are other mechanisms for CI development. The article also examines the role of small vessel disease and asymptomatic cerebral infarction in the formation of CI in patients with AF. Adding that, it provides data on the AF role in the development of neurodegenerative process with the accumulation of amyloid and tau protein in the brain tissue. There is an increased risk of Alzheimer’s disease in patients with AF, although the causal relationship of these conditions requires clarification. Modern data concerning the role of neuroinflammation and genetic predisposition in the development of CI in AF were analyzed. The conclusion is made about the pathogenetic heterogeneity of higher cerebral functions disorders on the basis of the presented data on the CI pathogenetic mechanism in patients with AF and comorbid conditions. It was suggested that the optimal pathogenetic therapy can be chosen taking into account the known CI pathogenetic mechanisms. KEYWORDS: atrial fibrillation, cognitive impairment, dementia, Alzheimer’s disease, cardioembolic stroke, small vessel disease, neurodegeneration, amyloid, tau protein, pathogenesis. FOR CITATION: Mityaeva E.V., Kamchatnov P.R. Cognitive impairment in patients with atrial fibrillation. Russian Medical Inquiry. 2020;4(9):578–583. DOI: 10.32364/2587-6821-2020-4-9-578-583.