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Cognitive frailty is a state of weakness and mild cognitive impairment in patients without dementia.It directly affects the health of patients with cardiovascular disease, increasing disability risk and reducing quality of life.This article reviews the concept, assessment, epidemiology, prognosis, mechanisms and intervention of cognitive frailty in elderly patients with cardiovascular disease.
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Objective:To investigate the relationship between N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels and frailty in elderly hospitalized patients.Methods:A total of 604 patients aged 65 years or older(with a mean age of 74.9±6.5)admitted to Beijing Hospital from September 2018 to February 2019 were consecutively enrolled in this cross-sectional study.Patients with clinical diagnosis of heart failure or left ventricular ejection fraction(LVEF)>50% were excluded.Participants were divided into the non-frail(n=130, 21.5%), pre-frail(n=327, 54.1%)and frail(n=147, 24.3%)groups based on the Fried phenotype.Clinical data, laboratory test results and echocardiographic data were collected.Blood levels NT-proBNP were measured.The ability of daily living activities was evaluated.The relationship of NT-proBNP levels with frailty and the diagnostic value of NT-proBNP levels for frailty screening were analyzed.Results:As the severity of frailty increased, elevated NT-proBNP levels were observed( P<0.01). NT-proBNP levels were higher in the frail group than in the pre-frail group [235.7(104.1, 650.3)ng/L vs. 123.2(67.7, 281.7)ng/L, P<0.01] and higher in the pre-frail group than in the non-frail group [123.2(67.7, 281.7)ng/L vs.88.2(49.9, 203.1)ng/L, P<0.01]. With increased severity of frailty, the anterior and posterior diameter of the left atrium increased( P<0.05), while LVEF decreased( P<0.05). Logistic regression analysis showed that NT-proBNP levels were independently associated with frailty( P<0.01). The level of NT-proBNP had a certain diagnostic value for frailty, and the area under the receiver-operating characteristics(ROC)curve was 0.688( P<0.01). Conclusions:The level of NT-proBNP is elevated in elderly frail inpatients, it is an independent factor for frailty.Measuring NT-proBNP levels in frail groups can help clinicians pay attention to patients' cardiac function and give appropriate interventions as early as possible.
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Objective To understand the virology test characteristics of hepatitis B virus (HBV) for discuss the relation of HBV genotype and HBeAg, anti-HBc-IgM, HBV DNA and disease progression. Methods Two hundred cases of hepatitis B were detected by the ELJSA assay with two pairs of semi-markers (HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc) and anti-HBc-IgM, using fluorescence quantitative polymerase chain reaction (FQ-PCR) for detecting HBV DNA, using monoclonal antibody ELISA method (mAbs ELISA) for HBV genotyping and analysis of test results. Results In 200 patients with hepatitis B, the HBV genotype detected in 179 cases (89.5%), B-type 121 cases(60.5%), C-type 58 cases (29.0% ). There had no relationship with HBeAg, anti-HBc-IgM, HBV DNA and genotype. B-type HBV prevalent in asymptomatic carriers (ASC) and chronic hepatitis B (mild);C-type common in patients with liver cirrhosis (LC) and chronic hepatitis B (severe). Conclusions HBV genotype in Shenzhen mainly is B-type, C-type second;mAbs ELISA assay with HBV genotype is specific, sensitive, simple and practical features, HBV replication strength has nothing to do with the virus genotype. HBV genotype and HBeAg, anti-HBc-IgM, HBV DNA testing may complement each other, with the clinical application value.