Associations Between Left Ventricular Dysfunction and Brain Structure and Function: Findings From the SABRE (Southall and Brent Revisited) Study
BackgroundSubclinical left ventricular (LV) dysfunction has been inconsistently associated with early cognitive impairment, and mechanistic pathways have been poorly considered. We investigated the cross‐sectional relationship between LV dysfunction and structural/functional measures of the brain an...
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| Format: | Article |
| Language: | English |
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Wiley
2017-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.004898 |
| _version_ | 1811275125550481408 |
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| author | Chloe M. Park Emily D. Williams Nish Chaturvedi Therese Tillin Robert J. Stewart Marcus Richards Dean Shibata Jamil Mayet Alun D. Hughes |
| author_facet | Chloe M. Park Emily D. Williams Nish Chaturvedi Therese Tillin Robert J. Stewart Marcus Richards Dean Shibata Jamil Mayet Alun D. Hughes |
| author_sort | Chloe M. Park |
| collection | DOAJ |
| description | BackgroundSubclinical left ventricular (LV) dysfunction has been inconsistently associated with early cognitive impairment, and mechanistic pathways have been poorly considered. We investigated the cross‐sectional relationship between LV dysfunction and structural/functional measures of the brain and explored the role of potential mechanisms. Method and ResultsA total of 1338 individuals (69±6 years) from the Southall and Brent Revisited study underwent echocardiography for systolic (tissue Doppler imaging peak systolic wave) and diastolic (left atrial diameter) assessment. Cognitive function was assessed and total and hippocampal brain volumes were measured by magnetic resonance imaging. Global LV function was assessed by circulating N‐terminal pro–brain natriuretic peptide. The role of potential mechanistic pathways of arterial stiffness, atherosclerosis, microvascular disease, and inflammation were explored. After adjusting for age, sex, and ethnicity, lower systolic function was associated with lower total brain (beta±standard error, 14.9±3.2 cm3; P<0.0001) and hippocampal volumes (0.05±0.02 cm3, P=0.01). Reduced diastolic function was associated with poorer working memory (−0.21±0.07, P=0.004) and fluency scores (−0.18±0.08, P=0.02). Reduced global LV function was associated with smaller hippocampal volume (−0.10±0.03 cm3, P=0.004) and adverse visual memory (−0.076±0.03, P=0.02) and processing speed (0.063±0.02, P=0.006) scores. Separate adjustment for concomitant cardiovascular risk factors attenuated associations with hippocampal volume and fluency only. Further adjustment for the alternative pathways of microvascular disease or arterial stiffness attenuated the relationship between global LV function and visual memory. ConclusionsIn a community‐based sample of older people, measures of LV function were associated with structural/functional measures of the brain. These associations were not wholly explained by concomitant risk factors or potential mechanistic pathways. |
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| format | Article |
| id | doaj.art-49207fdf98f8455facf2aac6e0b1483d |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-12T23:32:32Z |
| publishDate | 2017-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-49207fdf98f8455facf2aac6e0b1483d2022-12-22T03:12:14ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-04-016410.1161/JAHA.116.004898Associations Between Left Ventricular Dysfunction and Brain Structure and Function: Findings From the SABRE (Southall and Brent Revisited) StudyChloe M. Park0Emily D. Williams1Nish Chaturvedi2Therese Tillin3Robert J. Stewart4Marcus Richards5Dean Shibata6Jamil Mayet7Alun D. Hughes8UCL Institute of Cardiovascular Science, University College London, London, United KingdomUCL Institute of Cardiovascular Science, University College London, London, United KingdomUCL Institute of Cardiovascular Science, University College London, London, United KingdomUCL Institute of Cardiovascular Science, University College London, London, United KingdomInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, United KingdomMRC Unit for Lifelong Health and Ageing at UCL, London, United KingdomDepartment of Radiology, University of Washington, Seattle, WAICCH, Imperial College London, London, United KingdomUCL Institute of Cardiovascular Science, University College London, London, United KingdomBackgroundSubclinical left ventricular (LV) dysfunction has been inconsistently associated with early cognitive impairment, and mechanistic pathways have been poorly considered. We investigated the cross‐sectional relationship between LV dysfunction and structural/functional measures of the brain and explored the role of potential mechanisms. Method and ResultsA total of 1338 individuals (69±6 years) from the Southall and Brent Revisited study underwent echocardiography for systolic (tissue Doppler imaging peak systolic wave) and diastolic (left atrial diameter) assessment. Cognitive function was assessed and total and hippocampal brain volumes were measured by magnetic resonance imaging. Global LV function was assessed by circulating N‐terminal pro–brain natriuretic peptide. The role of potential mechanistic pathways of arterial stiffness, atherosclerosis, microvascular disease, and inflammation were explored. After adjusting for age, sex, and ethnicity, lower systolic function was associated with lower total brain (beta±standard error, 14.9±3.2 cm3; P<0.0001) and hippocampal volumes (0.05±0.02 cm3, P=0.01). Reduced diastolic function was associated with poorer working memory (−0.21±0.07, P=0.004) and fluency scores (−0.18±0.08, P=0.02). Reduced global LV function was associated with smaller hippocampal volume (−0.10±0.03 cm3, P=0.004) and adverse visual memory (−0.076±0.03, P=0.02) and processing speed (0.063±0.02, P=0.006) scores. Separate adjustment for concomitant cardiovascular risk factors attenuated associations with hippocampal volume and fluency only. Further adjustment for the alternative pathways of microvascular disease or arterial stiffness attenuated the relationship between global LV function and visual memory. ConclusionsIn a community‐based sample of older people, measures of LV function were associated with structural/functional measures of the brain. These associations were not wholly explained by concomitant risk factors or potential mechanistic pathways.https://www.ahajournals.org/doi/10.1161/JAHA.116.004898arterial stiffnessbrain imagingbrain volumescognitive functioncognitive impairmentleft ventricular dysfunction |
| spellingShingle | Chloe M. Park Emily D. Williams Nish Chaturvedi Therese Tillin Robert J. Stewart Marcus Richards Dean Shibata Jamil Mayet Alun D. Hughes Associations Between Left Ventricular Dysfunction and Brain Structure and Function: Findings From the SABRE (Southall and Brent Revisited) Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease arterial stiffness brain imaging brain volumes cognitive function cognitive impairment left ventricular dysfunction |
| title | Associations Between Left Ventricular Dysfunction and Brain Structure and Function: Findings From the SABRE (Southall and Brent Revisited) Study |
| title_full | Associations Between Left Ventricular Dysfunction and Brain Structure and Function: Findings From the SABRE (Southall and Brent Revisited) Study |
| title_fullStr | Associations Between Left Ventricular Dysfunction and Brain Structure and Function: Findings From the SABRE (Southall and Brent Revisited) Study |
| title_full_unstemmed | Associations Between Left Ventricular Dysfunction and Brain Structure and Function: Findings From the SABRE (Southall and Brent Revisited) Study |
| title_short | Associations Between Left Ventricular Dysfunction and Brain Structure and Function: Findings From the SABRE (Southall and Brent Revisited) Study |
| title_sort | associations between left ventricular dysfunction and brain structure and function findings from the sabre southall and brent revisited study |
| topic | arterial stiffness brain imaging brain volumes cognitive function cognitive impairment left ventricular dysfunction |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.004898 |
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