Subclinical Compromise in Cardiac Strain Relates to Lower Cognitive Performances in Older Adults
BackgroundGlobal longitudinal strain (GLS), reflecting total shortening of the myocardium during the cardiac cycle, has emerged as a more precise myocardial function measure than left ventricular ejection fraction (LVEF). Longitudinal strain may be selectively affected in subclinical heart disease,...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2018-02-01
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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.117.007562 |
| _version_ | 1811333630012686336 |
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| author | Hailey A. Kresge Omair A. Khan Madison A. Wagener Dandan Liu James G. Terry Sangeeta Nair Francis E. Cambronero Katherine A. Gifford Katie E. Osborn Timothy J. Hohman Kimberly R. Pechman Susan P. Bell Thomas J. Wang John Jeffrey Carr Angela L. Jefferson |
| author_facet | Hailey A. Kresge Omair A. Khan Madison A. Wagener Dandan Liu James G. Terry Sangeeta Nair Francis E. Cambronero Katherine A. Gifford Katie E. Osborn Timothy J. Hohman Kimberly R. Pechman Susan P. Bell Thomas J. Wang John Jeffrey Carr Angela L. Jefferson |
| author_sort | Hailey A. Kresge |
| collection | DOAJ |
| description | BackgroundGlobal longitudinal strain (GLS), reflecting total shortening of the myocardium during the cardiac cycle, has emerged as a more precise myocardial function measure than left ventricular ejection fraction (LVEF). Longitudinal strain may be selectively affected in subclinical heart disease, even in the presence of normal LVEF. This study examines subclinical cardiac dysfunction, assessed by GLS and LVEF, and cognition among older adults. Methods and ResultsVanderbilt Memory and Aging Project participants who were free of clinical dementia, stroke, and heart failure (n=318, 73±7 years, 58% male) completed neuropsychological assessment and cardiac magnetic resonance to quantify GLS and LVEF. Linear regression models related GLS and LVEF to neuropsychological performances, adjusting for age, sex, race/ethnicity, education, Framingham Stroke Risk Profile, cognitive diagnosis, and APOE*ε4 status. Models were repeated with a cardiac×cognitive diagnosis interaction term. Compromised GLS (reflected by higher values) related to worse naming (β=−0.07, P=0.04), visuospatial immediate recall (β=−0.83, P=0.03), visuospatial delayed recall (β=−0.22, P=0.03), and verbal delayed recall (β=−0.11, P=0.007). LVEF did not relate to worse performance on any measure (P>0.18). No diagnostic interactions were observed. ConclusionsOur study results are among the first to suggest that compromised GLS relates to worse episodic memory and language performance among older adults who are free of clinical dementia, stroke, and heart failure. Subclinical cardiac dysfunction may correlate with cognitive health in late life, even when LVEF remains normal. The results add to growing evidence that GLS may be a more sensitive and preferred method for quantifying subclinical changes in cardiac function. |
| first_indexed | 2024-04-13T16:55:50Z |
| format | Article |
| id | doaj.art-7425f981f88a428882bad1fb0a2d500d |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T16:55:50Z |
| publishDate | 2018-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-7425f981f88a428882bad1fb0a2d500d2022-12-22T02:38:49ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802018-02-017410.1161/JAHA.117.007562Subclinical Compromise in Cardiac Strain Relates to Lower Cognitive Performances in Older AdultsHailey A. Kresge0Omair A. Khan1Madison A. Wagener2Dandan Liu3James G. Terry4Sangeeta Nair5Francis E. Cambronero6Katherine A. Gifford7Katie E. Osborn8Timothy J. Hohman9Kimberly R. Pechman10Susan P. Bell11Thomas J. Wang12John Jeffrey Carr13Angela L. Jefferson14Department of Neurology, Vanderbilt Memory & Alzheimer's Center Vanderbilt University Medical Center, Nashville, TNDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TNDepartment of Neurology, Vanderbilt Memory & Alzheimer's Center Vanderbilt University Medical Center, Nashville, TNDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TNRadiology& Radiological Sciences, Vanderbilt University Medical Center, Nashville, TNRadiology& Radiological Sciences, Vanderbilt University Medical Center, Nashville, TNDepartment of Neurology, Vanderbilt Memory & Alzheimer's Center Vanderbilt University Medical Center, Nashville, TNDepartment of Neurology, Vanderbilt Memory & Alzheimer's Center Vanderbilt University Medical Center, Nashville, TNDepartment of Neurology, Vanderbilt Memory & Alzheimer's Center Vanderbilt University Medical Center, Nashville, TNDepartment of Neurology, Vanderbilt Memory & Alzheimer's Center Vanderbilt University Medical Center, Nashville, TNDepartment of Neurology, Vanderbilt Memory & Alzheimer's Center Vanderbilt University Medical Center, Nashville, TNDepartment of Neurology, Vanderbilt Memory & Alzheimer's Center Vanderbilt University Medical Center, Nashville, TNDivision of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TNRadiology& Radiological Sciences, Vanderbilt University Medical Center, Nashville, TNDepartment of Neurology, Vanderbilt Memory & Alzheimer's Center Vanderbilt University Medical Center, Nashville, TNBackgroundGlobal longitudinal strain (GLS), reflecting total shortening of the myocardium during the cardiac cycle, has emerged as a more precise myocardial function measure than left ventricular ejection fraction (LVEF). Longitudinal strain may be selectively affected in subclinical heart disease, even in the presence of normal LVEF. This study examines subclinical cardiac dysfunction, assessed by GLS and LVEF, and cognition among older adults. Methods and ResultsVanderbilt Memory and Aging Project participants who were free of clinical dementia, stroke, and heart failure (n=318, 73±7 years, 58% male) completed neuropsychological assessment and cardiac magnetic resonance to quantify GLS and LVEF. Linear regression models related GLS and LVEF to neuropsychological performances, adjusting for age, sex, race/ethnicity, education, Framingham Stroke Risk Profile, cognitive diagnosis, and APOE*ε4 status. Models were repeated with a cardiac×cognitive diagnosis interaction term. Compromised GLS (reflected by higher values) related to worse naming (β=−0.07, P=0.04), visuospatial immediate recall (β=−0.83, P=0.03), visuospatial delayed recall (β=−0.22, P=0.03), and verbal delayed recall (β=−0.11, P=0.007). LVEF did not relate to worse performance on any measure (P>0.18). No diagnostic interactions were observed. ConclusionsOur study results are among the first to suggest that compromised GLS relates to worse episodic memory and language performance among older adults who are free of clinical dementia, stroke, and heart failure. Subclinical cardiac dysfunction may correlate with cognitive health in late life, even when LVEF remains normal. The results add to growing evidence that GLS may be a more sensitive and preferred method for quantifying subclinical changes in cardiac function.https://www.ahajournals.org/doi/10.1161/JAHA.117.007562braincardiac magnetic resonance imagingcognitionglobal longitudinal strainvascular risk factors |
| spellingShingle | Hailey A. Kresge Omair A. Khan Madison A. Wagener Dandan Liu James G. Terry Sangeeta Nair Francis E. Cambronero Katherine A. Gifford Katie E. Osborn Timothy J. Hohman Kimberly R. Pechman Susan P. Bell Thomas J. Wang John Jeffrey Carr Angela L. Jefferson Subclinical Compromise in Cardiac Strain Relates to Lower Cognitive Performances in Older Adults Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease brain cardiac magnetic resonance imaging cognition global longitudinal strain vascular risk factors |
| title | Subclinical Compromise in Cardiac Strain Relates to Lower Cognitive Performances in Older Adults |
| title_full | Subclinical Compromise in Cardiac Strain Relates to Lower Cognitive Performances in Older Adults |
| title_fullStr | Subclinical Compromise in Cardiac Strain Relates to Lower Cognitive Performances in Older Adults |
| title_full_unstemmed | Subclinical Compromise in Cardiac Strain Relates to Lower Cognitive Performances in Older Adults |
| title_short | Subclinical Compromise in Cardiac Strain Relates to Lower Cognitive Performances in Older Adults |
| title_sort | subclinical compromise in cardiac strain relates to lower cognitive performances in older adults |
| topic | brain cardiac magnetic resonance imaging cognition global longitudinal strain vascular risk factors |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.117.007562 |
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