Associations Between Left Ventricular Dysfunction and Brain Structure and Function: Findings From the SABRE (Southall and Brent Revisited) Study

Abstract

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.

Association between cognitive function and parameters of echocardiography and coronary artery angiography

“…Athilingam et al reported that the mean Montreal Cognitive Assessment score was lower in patients with systolic heart failure than diastolic failure, especially in the visuospatial ability, psychomotor speed, and executive function domains 20 . In contrast to these reports, Park et al showed that there was no association between "peak velocities during systole" and cognitive function; however, left ventricular diastolic function had strong association with global cognition, which was assessed with "a community screening instrument for dementia" 21 . Visual memory and processing speed had also a significant association with left ventricular global function.…”

“…Visual memory and processing speed had also a significant association with left ventricular global function. They reported that left ventricular diastolic function correlated with working memory and fluency of speech 21 . Although, we could not find the same results for diastolic dysfunction in the total sample of our study, there was significant relationship between e' and immediate free recall of verbal learning (p = 0.04) in patients with a total NUCOG score of 86 or more.…”

Взаимосвязь Структурно-Функциональных Изменений Левых Отделов Сердца С Когнитивными Функциями У Пациентов С Артериальной Гипертензией

“…Згідно із результатами дослідження, наявність діастолічної дисфункції ЛШ значно збільшує ризик КП (OR 1,29; 95% ДI 1,01-1,66; р < 0,043). При цьому із посиленням діастолічної дисфункції когнітивний дефіцит також зростає [19]. Також доведено, що ймовірність легких КП є в два рази вищою за наявності діастолічної дисфункції ЛШ (р = 0,030) [20].…”

Parameters of Left Ventricular Mass and Dementia

“…It is well known that brain infarction and white matter volume play an important role in cognitive impairment and dementia and may mediate associations between hypertension and cognition. 1, 11…”