Fatores de risco cardiovascular, declínio cognitivo e alteraçoẽs cerebrais detectadas através de técnicas de neuroimagem

Abstract

Several research studies have shown associations between cardiovascular risk factors and the development of cognitive decline. There is also evidence of an increased rate of morbidity and mortality in subjects with cardiovascular diseases with concomitant cognitive decline. Congestive heart failure and hypertension, among all cardiovascular risk factors, have shown a strong relationship with the presence of cognitive deficits, but the brain mechanisms underlying such association have not yet been clarified. The cognitive decline associated with cardiac diseases is characterized mainly by impairments of memory (learning and fixation), attention and information processing. In this article, we review neuroimaging abnormalities that may be found in samples of subjects presenting with cardiovascular risk factors and cognitive decline, including regional brain volumetric changes, white matter hyperintensities, silent brain infarcts, lacunars infarcts, and functional deficits in global blood flow (associated to reduced cardiac output) or regional cerebral blood flow. We discuss the implications of these findings to the knowledge about the pathophysiology of cognitive deficits associated with cardiovascular risk factors, as well as their potential clinical applications. Finally, we discuss the potential use of novel imaging technologies in future studies evaluating abnormalities in brain structure and function related to cardiovascular risk factors, in large samples of elderly patients.