Correlation Analysis And Risk Factor Assessment Of Patent Foramen Ovale With Cognitive Impairment

Objective: To investigate the incidence rate of cognitive impairment(CI)in patients with patent foramen ovale(PFO)and assess the related risk factors.Methods: A total of 169 PFO patients from the Second Hospital of Lanzhou University were enrolled and divided into CI group(n=78)and non-CI group(n=91)according to the mini Mental State Examination(MMSE)score.The general clinical data,laboratory and imaging indicators of the two groups were analyzed to explore the incidence rate and related risk factors of vascular cognitive impairment in patients with PFO.Result:(1)Of the 169 PFO patients,78(46.2%)had cognitive impairment of varying degrees.Compared with the non-CI group,the CI group were older,more female,had hypertension,and had higher levels of high-density lipoprotein,lowdensity lipoprotein,mean arterial pressure and pulse pressure,but lower levels of serum creatinine,E/A value and right-to-left shunt(RLS)grade,with statistical significance(P<0.05).While in stroke,diabetes,migraine history and BMI,fasting blood glucose,uric acid,urea,total cholesterol,triglyceride,hemoglobin,red blood cell,hematocrit,platelet,D-Dimer,PFO aperture,RLS type,atrial septal aneurysm(ASA),pulmonary artery pressure,left atrial(LA)anteroposterior diameter,left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS),left ventricular end-diastolic volume(LVESV),left ventricular end-diastolic volume(LVEDs),left ventricular stroke output(LVSV),main pulmonary artery diameter(MPA),left ventricular end-systolic diameter(LVEDs),and left ventricular enddiastolic diameter(LVEDd)there were no significant differences between the two groups(p<0.05).(2)Multivariate Logistic regression analysis showed that the incidence of CI in PFO patients was related to gender,age,education level,PFO aperture size and RLS grade level.The risk of CI in female PFO patients was higher than that in male PFO patients,and the difference was statistically significant(OR=0.194,95%CI: 0.050-0.757,p=0.018);The higher the education level,the lower the risk of CI in PFO patients,and the difference was statistically significant(OR=0.026,95%CI: 0.004-0.155,p<0.001);Increasing age was positively correlated with the risk of CI,and the difference was statistically significant(OR=1.066,95%CI: 1.012-1.123,p=0.015);Compared with small PFO,large PFO increased the risk of CI,and the difference was statistically significant(OR=5.665,95%CI: 1.259-25.482,p=0.024);The incidence rate of CI in patients with small RLS shunt was higher than those no shunt,and the difference was statistically significant(OR=53.120,95%CI: 1.581-1785.008,p=0.027).Conclusions:(1)This study found that the incidence of CI in PFO patients was46.2%.(2)The incidence of CI in PFO patients is related to gender,age,education level,PFO aperture size and RLS classification level.Female,lower education level,older age,larger PFO aperture and RLS grading may increase the risk of CI in PFO patients.