COGNITIVE SYMPTOMS OF CHRONIC DISORDERS OF CEREBRAL CIRCULATION IN PATIENTS WITH ATRIAL FIBRILLATION

Atrial fibrillation is a heart rhythm disorder, accompanied by numerous systemic disorders. One of them accounting for changes in the central nervous system is of great importance. Reduction of cardiac output and contractile function of the heart cause a deterioration of cerebral blood flow, thus contributing to the formation and progression of cognitive disorders that subsequently can lead to dementia. The objective of this study was to investigate clinical manifestations of chronic cerebrovascular pathology in patients with different clinical forms of atrial fibrillation based on neuropsychological studies. Eighty two patients with atrial fibrillation nonvalvular etiology, developed due to coronary heart disease, were examined. The comparison group consisted of 30 patients with ischemic heart disease without any cardiac rhythm and conduction. Patients in both groups underwent a computed tomography examination of the brain. The study established that cognitive disorders in patients with atrial fibrillation were manifested in attention deficit, reduced rate of speech and mental activity, impaired visual-spatial functions and secondary memory disorders. The permanent form of atrial fibrillation showed accelerated decrease in the speed of psychomotor reactions, visual-spatial disorders and memory loss, whereas deterioration of cognitive functions occurs regardless of age, duration of hypertension, and predictors of dyslipidemic disorders. The presence of atrial fibrillation is associated with a higher incidence of diffuse lesions of the white matter of the brain. The most pronounced changes in patients with atrial fibrillation are detected in the periventricular matter and perivascular spaces. The progression of diffuse changes of the white matter of the brain associated with the increase of memory disorders, attention and mental speed. Thus, early manifestations of chronic disorders of cerebral circulation in patients with atrial fibrillation in the absence of severe focal neurological symptoms may be mild cognitive disorders, whose identification is necessary due to the increased risk of progression to the stage of severe cognitive deficits.