Electrocardiographic Predictors of Cognitive Decline and Dementia: A Systematic Review

Background: Markers of altered cardiac function might predict cognitive decline and dementia. Objective: This systematic review aims to review the literature that examines the associations of various electrocardiogram (ECG) markers with cognitive decline and dementia in middle-aged and elderly populations. Methods: We searched PubMed, Embase, and Web of Science through 1 July 2020 for literature and conducted a systematic literature review. We included studies examining the associations of ECG markers (e.g., left ventricular hypertrophy [LVH], spatial QRS-T angle, and QT prolongation) with cognitive function and dementia in adult populations regardless of study setting and design, but excluded studies examining atrial fibrillation and heart rate variability. Results: Fourteen community-based cross-sectional and longitudinal studies were identified. ECG markers were investigated in association with dementia in four prospective studies, and with cognitive decline in ten prospective studies. ECG-assessed LVH was associated with dementia in one study while five heterogeneous prospective studies yielded inconsistent associations with cognitive decline. Regarding ventricular repolarization markers, spatial QRS-T angle was associated with cognitive decline in one study while another study found no association between QT prolongation and cognitive decline. High resting heart rate was associated with both dementia and cognitive decline in one study but not associated with dementia in another study. P-wave abnormality was significantly associated with incident dementia and cognitive decline in one prospective study. Conclusion: Some ECG markers were associated with incident dementia and cognitive decline. However, limited number of heterogeneous studies did not allow us to make firm conclusions. Further studies are needed.

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The cardiac profile and electrocardiographic standard of at-height workers

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.64.05.448 ◽

2018 ◽

Vol 64 (5) ◽

pp. 448-453

Author(s):

Tatiana Soares ◽

Maria Claudia Irigoyen ◽

Sílvia Goldmeier

Keyword(s):

Control Program ◽

Cross Sectional Study ◽

Left Ventricular ◽

Demographic Variables ◽

Medical Assessment ◽

Cross Sectional ◽

Medical Control ◽

Medicine Service ◽

Electrocardiographic Changes ◽

Electrocardiogram Ecg

SUMMARY BACKGROUND The Medical Control Program for Occupational Health establishes the required supplementary exams, according to the activity exercised by the worker and its inherent risks. The Regulatory Norm No. 35, recently deployed, stipulates that at-height workers must undergo electrocardiogram exams as an additional routine examination. OBJECTIVE To evaluate the electrocardiographic standard in at-height. METHODOLOGY A cross-sectional study, developed from May 2014 to January 2015 with male at-height workers. Anthropometric and clinical data were collected after the electrocardiogram (ECG). The workers included in the program were evaluated by an occupational medicine service of Serra Gaúcha, responsible for medical assessment and occupational tests. All workers were assessed by the researcher. RESULTS A total of 561 at-height workers participated in the study. The average age was 35.9 ± 12.2 years. A total of 176 (31%) presented electrocardiographic changes in the analysis of the resting ECG. Regarding the amendments in the resting ECG, 15.7% were attributed to changes in ventricular repolarization, 8% as blocks conductions, and 5.8% as left ventricular overload. Demographic variables were not associated with changes in the electrocardiographic tracing CONCLUSION This study demonstrated the electrocardiographic alterations and the profile of at-height workers. These findings can help determine prevention strategies and provide warnings of possible future harms to the health of these workers.

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Associations of Sedentary Time with Heart Rate and Heart Rate Variability in Adults: A Systematic Review and Meta-Analysis of Observational Studies

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168508 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8508

Author(s):

Abdullah Bandar Alansare ◽

Lauren C. Bates ◽

Lee Stoner ◽

Christopher E. Kline ◽

Elizabeth Nagle ◽

...

Keyword(s):

Systematic Review ◽

Heart Rate ◽

English Language ◽

Sedentary Time ◽

Meta Analysis ◽

Qualitative Synthesis ◽

Cross Sectional ◽

Inverse Variance ◽

Observational Design ◽

Substantial Heterogeneity

Purpose: To evaluate if sedentary time (ST) is associated with heart rate (HR) and variability (HRV) in adults. Methods: We systematically searched PubMed and Google Scholar through June 2020. Inclusion criteria were observational design, humans, adults, English language, ST as the exposure, resting HR/HRV as the outcome, and (meta-analysis only) availability of the quantitative association with variability. After qualitative synthesis, meta-analysis used inverse variance heterogeneity models to estimate pooled associations. Results: Thirteen and eight articles met the criteria for the systematic review and meta-analysis, respectively. All studies were cross-sectional and few used gold standard ST or HRV assessment methodology. The qualitative synthesis suggested no associations between ST and HR/HRV. The meta-analysis found a significant association between ST and HR (β = 0.24 bpm per hour ST; CI: 0.10, 0.37) that was stronger in males (β = 0.36 bpm per hour ST; CI: 0.19, 0.53). Pooled associations between ST and HRV indices were non-significant (p > 0.05). Substantial heterogeneity was detected. Conclusions: The limited available evidence suggests an unfavorable but not clinically meaningful association between ST and HR, but no association with HRV. Future longitudinal studies assessing ST with thigh-based monitoring and HRV with electrocardiogram are needed.

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Abstract P116: Chronic Kidney Disease And Cardiac Arrhythmias: A Systematic Review and Meta-analysis

Circulation ◽

10.1161/circ.141.suppl_1.p116 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Esther D Kim ◽

Ning Ding ◽

Junichi Ishigami ◽

Xuejuan Ning ◽

Yijing Feng ◽

...

Keyword(s):

Atrial Fibrillation ◽

Systematic Review ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Prospective Studies ◽

Cardiac Arrhythmias ◽

Meta Analysis ◽

Case Control ◽

Cross Sectional ◽

The Relationship

Background: Chronic kidney disease (CKD) strongly predicts sudden cardiac death and may elevate the risk of certain cardiac arrhythmias like atrial fibrillation; however, the relationships between CKD and various types of arrhythmia are not well-characterized. Methods: We performed a systematic review and meta-analysis by searching Embase and PubMed for prospective, cross-sectional, and case-control studies examining the associations of two key CKD measures, estimated glomerular filtration rate (eGFR) and albuminuria, with arrhythmias in adults that were published until July 2018. We performed qualitative assessment of studies using the Newcastle Ottawa Quality Assessment Scale. We pooled the results using random-effects models. Results: Among 16,245 articles, we identified 34 prospective (n=24,213,233), 21 cross-sectional (n=253,328), and 4 case-control (n=1,694) studies that included diverse study populations from 19 countries and were mostly high quality. Most prospective studies examined the relationship between eGFR and atrial fibrillation (AF), and demonstrated that lower eGFR was associated with a higher risk of AF (pooled hazard ratio [HR] 1.72 [95% CI: 1.30, 2.27] comparing reduced vs. referent eGFR groups)[ Figure ]. A few studies examined albuminuria and demonstrated its associations with AF (pooled HR 2.16 [95% CI: 1.74, 2.67] comparing high vs. low albuminuria). Results were similar for cross-sectional studies. Four prospective studies reported a higher incidence of ventricular tachycardia resulting in ICD shock according to reduced eGFR (pooled HR 2.32 [95% CI: 1.74, 3.09] comparing reduced vs. referent eGFR groups). Limited number of studies examined other types of arrhythmia. Conclusion: We identified robust data on the relationship between CKD (eGFR and albuminuria) and AF. Reduced eGFR was associated with life-threatening ventricular arrhythmias. Our review highlights the need of future studies for non-AF arrhythmias, especially in the context of albuminuria.

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Correlation between P-Wave Terminal Force V1 (PTFV1) from 12-Lead ECG and Left Ventricular Diastolic Dysfunction in Patients Diagnosed With Hypertension

ACI (Acta Cardiologia Indonesiana) ◽

10.22146/jaci.v6i2.625 ◽

2020 ◽

Vol 6 (2) ◽

pp. 97-103

Author(s):

Bambang Arie Hidayat Dalimunthe ◽

Nizam Akbar ◽

Refli Hasan ◽

Harris Hasan ◽

Andika Sitepu ◽

...

Keyword(s):

Diastolic Dysfunction ◽

Systolic Dysfunction ◽

Hypertensive Heart Disease ◽

Left Ventricular Diastolic Dysfunction ◽

Left Ventricular ◽

P Wave ◽

P Value ◽

Cross Sectional ◽

Ventricular Diastolic Dysfunction ◽

Grade Iii

Background: Patients diagnosed with hypertension will deteriorate into hypertensive heart disease which is characterized by diastolic dysfunction first followed by systolic dysfunction later in the course of the disease. Diastolic dysfunction of the left ventricle causes an increase in LVEDP as well as in the dimension of the left atrium. P-Wave Terminal Force V1 (PTFV1) which is derived from 12 lead ECG could help diagnose diastolic dysfunction in centers where echocardiography is not available. The purpose of this study was to determine the correlation of PTFV1 on the 12-lead Electrocardiography with diastolic dysfunction in patients diagnosed with hypertension in the outpatient clinic of Cardiac Center Adam Malik General Hospital in Medan. Methods: This is a cross-sectional study conducted from March 2019 until August 2019. Patients with hypertension who met the inclusion criteria were examined electrocardiographically to obtain PTFV1 value. Then echocardiography examination was then performed to assess the grades of diastolic dysfunction and other parameters. Analysis of correlation between PTFV1 values and diastolic dysfunction was then conducted. Results: From the clinical characteristics, there is no difference regarding age, sex , and risk factorsbetween the three diastolic dysfunction groups, while echocardiography characteristic shows more reduced EF in grade III diastolic dysfunction (36.5±7.7). Significant differences in PTFV1 are found among diastolic dysfunction groups. Grade I diastolic dysfunction has PTFV1 value of 23.8 mm.ms, grade II diastolic dysfunction has PTFV1 value of 34.1 mm.ms, and grade III diastolic dysfunction has PTFV1 value of 52.1 mm.ms, Significance of p value is <0.001. There is a strong correlation between PTFV1 and diastolic dysfunction grade (r = 0.63 (P <0.001)). Cut off point of PTFV1 > 29.8 mm.ms can discriminate patients who have increased LAP with a sensitivity of 84% and specificity of 71%. Conclusions: PTFV1 is a simple screening tool which is widely available and correlate well with left ventricular diastolic dysfunction in patients with hypertension, which makes it a good alternative tool especially in areas where echocardiography is not readily available.

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Vitamin B12, B6, or Folate and Cognitive Function in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis

Journal of Alzheimer s Disease ◽

10.3233/jad-200534 ◽

2020 ◽

Vol 77 (2) ◽

pp. 781-794 ◽

Cited By ~ 1

Author(s):

Chenbo Zhang ◽

Jianfeng Luo ◽

Changzheng Yuan ◽

Ding Ding

Keyword(s):

Systematic Review ◽

Older Adults ◽

Cognitive Function ◽

Cognitive Decline ◽

Vitamin B12 ◽

Prospective Studies ◽

Meta Analysis ◽

Community Dwelling ◽

Sensitivity Analyses ◽

Community Dwelling Older Adults

Background: Previous studies have indicated that B vitamin deficiencies are an essential cause of neurological pathology. There is a need to provide evidence of the benefit of B vitamins for the prevention of cognitive decline in community-dwelling older adults. Objective: To examine the association between intake and plasma levels of vitamins B12, B6, and folate and cognitive function in older populations through a systematic review and meta-analysis. Methods: Medline (PubMed), EMBASE, and Cochrane databases were used to search the literature though August 8, 2019. We included observational population-based studies evaluating the association between concentrations or intake levels of vitamins B6, B12, or folate and cognition in older adults aged ≥45 years. The quality of all studies was assessed by the modified Newcastle-Ottawa Scale. Odds ratios (ORs) and hazard ratios (HRs) were analyzed by the random-effects model. Sensitivity analyses were conducted by excluding the studies with significant heterogeneity. Results: Twenty-one observational studies with sample sizes ranging from 155–7030 were included in the meta-analysis. Higher levels of vitamin B12 (OR = 0.77, 95% CI = 0.61–0.97) and folate concentration (OR = 0.68, 95% CI = 0.51–0.90) were associated with better cognition in cross-sectional studies, but not in sensitivity analyses or prospective studies. High vitamin B6 concentrations showed no significant benefit on cognition and dementia risk. Prospective studies did not provide substantial evidence for the relationship. Conclusion: The results from our meta-analysis suggest that vitamins B12, B6, and folate may not be modifiable risk factors for slowing cognitive decline among community-dwelling older individuals.

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Abstract 18342: Inducible Cardiomyocyte-Specific Deletion of Stromal Interaction Molecules Results in Cardiomyopathy in Mice

Circulation ◽

10.1161/circ.130.suppl_2.18342 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Saravanakumar Murugesan ◽

Ryan D Sullivan ◽

Salvatore Mancarella

Keyword(s):

Heart Rate ◽

Dilated Cardiomyopathy ◽

Mammalian Cells ◽

Calcium Release ◽

Cardiac Contractility ◽

Calcium Transient ◽

Left Ventricular ◽

P Wave ◽

Calcium Sensors

Background: Stromal interaction molecules (STIM1 and STIM2) are sarco/endoplasmic calcium sensors ubiquitously expressed in mammalian cells. Upon Ca2+ store discharge STIM proteins oligomerize in proximity of the plasma membrane to activate the Ca2+ selective channels (Orai) and trigger Ca2+ entry. While this mechanism is widely accepted to be the main source of calcium in non-excitable cells, in cardiomyocytes the calcium-induced calcium-release is the major controller of myocardial function, and the presence of STIM in these cells appears somewhat puzzling. Here we investigated the role of STIM in cardiomyocytes and its role in regulating cardiac contractility and intracellular Ca2+ dynamics. Methods: We have generated an inducible cardiac-specific STIM1 knockout (STIM KO) mouse model to elucidate the role of STIM in the myocardium. Echocardiography was used to evaluate structure and function of the left ventricle. Heart rate was monitored continuously in conscious mice by telemetry. Cell dimensions, shortening, and relaxation were determined by videomicroscopy and calcium transients by fura 2. Results: Echocardiographic analyses revealed development of dilated cardiomyopathy with a significant reduction of left ventricular fractional shortening (39.91±4.05% vs. 22.41±7.92%, p<0.01). Histological and morphological analyses confirmed a dilated cardiomyopathy characterized by enlarged ventricular chambers. Electrocardiography showed higher heart rate in the STIM1 KO mice with no differences in P-wave duration and QRS interval while Q-T interval was reduced in the STIM1 KO mice as compared to the WT mice. Sarcomere length and cell shortening measurements in freshly isolated cardiomyocytes from STIM1 KO mice confirmed the reduced contractility associated with a reduction of time to 50% relaxation (283±13ms vs. 258±8ms, p<0.05) . Intracellular calcium transient analysis in STIM1 KO cardiomyocytes showed a higher peak amplitude and a time to 50% decay of calcium significantly accelerated. Conclusions: Our data demonstrate that STIM proteins play an important role in the maintaining normal cardiac function in the adult heart and reveal that STIM plays an important role during cardiac repolarization.

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Cholesterol as a Risk Factor for Dementia and Cognitive Decline: A Systematic Review of Prospective Studies With Meta-Analysis

American Journal of Geriatric Psychiatry ◽

10.1097/01.jgp.0000310778.20870.ae ◽

2008 ◽

Vol 16 (5) ◽

pp. 343-354 ◽

Cited By ~ 199

Author(s):

Kaarin J. Anstey ◽

Darren M. Lipnicki ◽

Lee-Fay Low

Keyword(s):

Systematic Review ◽

Risk Factor ◽

Cognitive Decline ◽

Prospective Studies ◽

Meta Analysis

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The effect of psychological distress on health outcomes: A systematic review and meta-analysis of prospective studies

Journal of Health Psychology ◽

10.1177/1359105319842931 ◽

2019 ◽

Vol 25 (2) ◽

pp. 227-239 ◽

Cited By ~ 6

Author(s):

Vaughn Barry ◽

Mary E Stout ◽

Mary Ellen Lynch ◽

Shanna Mattis ◽

Duc Q Tran ◽

...

Keyword(s):

Systematic Review ◽

Health Outcome ◽

Psychological Distress ◽

Prospective Studies ◽

Detrimental Effect ◽

Meta Analysis ◽

Future Health ◽

Cross Sectional ◽

Measurement Tools ◽

Cross Sectional Studies

Distress effects are widely examined in cross-sectional studies with less known about effects on future health. This review summarizes distress impacts on health among adults in prospective studies and describes available distress measurement tools. Four inter-disciplinary databases were searched. Effects of distress on mortality and other outcomes were reviewed and estimated in a meta-analysis. A total of 19 studies were assessed which incorporated 10 distress tools. Distress had a detrimental effect on health regardless of the population studied, distress tool used, and health outcome examined. There was an increased mortality risk among those reporting high versus low distress (pooled hazard ratio (95% confidence interval) = 1.29 (1.15–1.46)).

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