Venous flow disturbance links to the cognitive function in the ultrasonographical validation study

Abstract

AbstractBackgroundAccording to the dementia progression, especially in Alzheimer’s disease (AD), venous reflex disturbance may be concerned. We previously found and reported that the validation of the spontaneous echo contrast or velocities of the internal jugular vein are convenient AD diagnosis screening methods and that the venous reflux disturbance correlates with AD development (Matsuzono K et al. J Alzheimers Dis. 2021;84(2):787‐796). In order to clear the relationship between venous reflex disturbance and dementia, we performed the additional study using the transesophageal echocardiography (TEE).MethodWe performed the TEE examination and the higher brain function test to the 80 participants. According to the TEE examination, we validated 1) the spontaneous echo contrast in heart, 2) shunt including the patent foramen ovale, 3) velocities at the left atrial appendage, and 4) the plaque length at the aortic arch. According to the higher brain function, we validated the Mini‐Mental State Examination (MMSE), Hasegawa Dementia Rating Scale‐Revised (HDS‐R), and Frontal Assessment Battery (FAB).ResultTwenty‐six (32.5%) of the 80 participants showed positive spontaneous echo contrast in the heart. All the MMSE, HDS‐R, and FAB scores of the positive group was significantly lower than that of the negative (26 vs 24, 26 vs 22.5, 14 vs 10.5, p<0.05). According to the shunt, there was no significant relationship to the cognitive function. The velocities at the left atrial appendage showed positive correlation while the plaque length at the aortic arch showed negative correlation to the cognitive function (r = 0.2).ConclusionIn both of the internal jugular vein and of the heart, the spontaneous echo contrast significantly correlates with the cognitive impairment. Our study using the ultrasonographical examination shows the venous reflex disturbance concerns with the dementia progression.