Key result
AF contributes to cognitive decline and dementia via arrhythmia-induced cerebral hypo-hyperperfusion and vascular dysfunction.
Why the study?
Although AF independently predicts long-term cognitive decline, the underlying mechanisms remain difficult to define and likely multifactorial.
This review highlights the potential role of cardiac malperfusion events and vascular dysfunction in the development of cognitive impairment in patients with atrial fibrillation.
May warrant cognitive screening in AF; leaves open whether perfusion-targeted interventions prevent dementia.
AF is an independent and strong predictor of long-term cognitive decline. However, the mechanism for this cognitive decline is difficult to define and likely multifactorial, leading to many different hypotheses. Examples include macro- or microvascular stroke events, biochemical changes to the blood-brain barrier related to anticoagulation, or hypo-hyperperfusion events. This review explores and discusses the hypothesis that AF contributes to cognitive decline and dementia through hypo-hyperperfusion events occurring during cardiac arrhythmias. We briefly explain several brain perfusion imaging techniques and further examine the novel findings associated with changes in brain perfusion in patients with AF. Finally, we discuss the implications and areas requiring more research to further understand and treat patients with cognitive decline related to AF.
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Zenger et al. (2023) conducted a review in Atrial Fibrillation and Cognitive Impairment. Atrial fibrillation contributes to cognitive decline and dementia through hypo-hyperperfusion events occurring during cardiac arrhythmias that result in cerebral vascular dysfunction.
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