Banca de DEFESA: Sebastiao Martins de Araujo Costa Neto

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : Sebastiao Martins de Araujo Costa Neto
DATE: 27/09/2022
TIME: 14:00
LOCAL: Plataforma Teams
TITLE:

EVALUATION OF THE ASSOCIATION BETWEEN THE CARDIAC CALCIUM INDEX, MEASURED BY TWO-DIMENSIONAL TRANSTHORACIC ECHOCARDIOGRAM, AND THE PRESENCE OF COGNITIVE DECLINE IN OCTOGENARY PEOPLE FREE OF MANIFEST CEREBROVASCULAR DISEASE

 

KEY WORDS:

Atherosclerosis; cardiac calcifications; Vascular cognitive impairment; Very elderly.

PAGES: 30
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

Introduction: Vascular cognitive decline is one of the varieties of dementia syndromes resulting from cerebrovascular impairment and its ischemic manifestations with a high prevalence in the elderly. Calcifications of cardiac structures such as the mitral annulus, aortic valve, papillary muscles and aortic root, in addition to being prevalent in the elderly population, are an expression of systemic atherosclerosis, also associated with cardiovascular risk factors common to those for cerebrovascular atherogenesis. Thus, patients with a higher degree of cardiac calcifications are expected to have lower cognitive performance and a higher prevalence of cognitive decline.

Objective: To verify the association between cardiac calcium index and cognitive decline in octogenarians free of overt cerebrovascular disease. Methods: Cross-sectional analysis of an observational cohort study evaluating the prevalence of risk factors and the development of atherosclerotic disease in patients aged 80 years and older free of overt cerebrovascular disease at baseline. For cognitive assessment, the Mini Mental State Examination (MMSE) was performed. The cardiac calcium index was obtained through a two-dimensional transthoracic echocardiogram according to the semi-quantitative score proposed by Gaibazzi et al. with analysis of calcifications in the mitral annulus, aortic valve, papillary muscles and aortic root. The final score was the sum of all calcium deposits identified in a range from 0 (no visible calcium) to 8 (extensive cardiac and aortic root calcium deposits). Non-contrast-enhanced cranial magnetic resonance imaging was performed at T1, T2 and FLAIR views to assess neuroimaging alterations compatible with vascular dementia in a sample of the group. The collected data were analyzed using Student's T test, Mann-Whitney test, chi-square test, multivariate analysis by logistic regression and linear regression.

Results: In the study, 255 elderly people were evaluated. The median age of the enrolled individuals was 83 years, composed of 61% female and presence of cognitive decline in 52 individuals (20.4% of the participants). Mitral annulus calcification was statistically significantly correlated with cognitive decline in both the unadjusted model (p=0.024), the linear regression model adjusted for age, sex and time of study (p=0.033) and the adjusted model for age, sex, time of study, aortic valve sclerosis and total calcification score (p=0.033). The independent variables total calcium score and aortic valve sclerosis were analyzed in multivariate models, which did not correlate with the MMSE score characteristic of cognitive decline. No statistically significant differences on cranial magnetic resonance variables were found between groups. Conclusion: The presence of mitral annulus calcification was independently associated with cognitive decline in this sample of octogenarians free of overt cerebrovascular disease. Total calcium score, aortic valve sclerosis, papillary muscle calcification, and aortic root calcification did not correlate with the MMSE score characteristic of cognitive decline after adjustments.

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