Increased Left Ventricular Mass Index Is Associated With Compromised White Matter Microstructure Among Older Adults

Abstract

BackgroundLeft ventricular (LV) hypertrophy is associated with cerebrovascular disease and cognitive decline. Increased LV mass index is a subclinical imaging marker that precedes overt LV hypertrophy. This study relates LV mass index to white matter microstructure and cognition among older adults with normal cognition and mild cognitive impairment.Methods and ResultsVanderbilt Memory & Aging Project participants free of clinical stroke, dementia, and heart failure (n=318, 73±7 years, 58% male, 39% mild cognitive impairment) underwent brain magnetic resonance imaging, cardiac magnetic resonance, and neuropsychological assessment. Voxelwise analyses related LV mass index (g/m2) to diffusion tensor imaging metrics. Models adjusted for age, sex, education, race/ethnicity, Framingham Stroke Risk Profile, cognitive diagnosis, and apolipoprotein E–ε4 status. Secondary analyses included a LV mass index×diagnosis interaction term with follow‐up models stratified by diagnosis. With identical covariates, linear regression models related LV mass index to neuropsychological performances. Increased LV mass index related to altered white matter microstructure (P<0.05). In models stratified by diagnosis, associations between LV mass index and diffusion tensor imaging were present among mild cognitive impairment participants only (P<0.05). LV mass index was related only to worse visuospatial memory performance (β=−0.003, P=0.036), an observation that would not withstand correction for multiple testing.ConclusionsIn the absence of prevalent heart failure and clinical stroke, increased LV mass index corresponds to altered white matter microstructure, particularly among older adults with clinical symptoms of prodromal dementia. Findings highlight the potential link between subclinical LV remodeling and cerebral white matter microstructure vulnerability.

Left Ventricular Hypertrophy and Cerebral Small Vessel Disease: A Systematic Review and Meta-Analysis

“…Twenty-two studies [ 20 - 22 , 53 - 55 , 58 , 59 , 61 - 64 , 66 , 68 - 72 , 75 , 77 , 78 , 80 ] investigated WMHs (n=15,636). In 14 of these studies (n=8,540) the outcome was presence of extensive WMHs, whereas six studies (n=6,319) examined WMHs severity or volume as continuous outcomes.…”

“…Regarding continuous WMH data, either semi-quantitative scales were used to assess WMH severity, or semi-automated and automated computer-based algorithms calculated WMH volume. Two recent studies [ 20 , 54 ] examined the association between LVMI and diffusion tensor imaging parameters of WM integrity.…”

“…19 These associations could be explained by effects of LVH on the microvasculature. Although several studies explore the associations between LVH or increased LVM and subclinical neuroimaging markers of CSVD, [20][21][22] the results vary widely, probably because of heterogeneity in the populations examined, small sample sizes, variable methodologies for LVH assessment or LVM indexing, and differences in CSVD neuroimaging definitions. Furthermore, the studies differ regarding their methods for adjustment for hypertension and other vascular risk factors.…”

Echocardiographic index E/e’ in association with cerebral white matter hyperintensity progression

“…Reduced cardiac output, increased LVMI, and raised right atrial pressure have been shown to be associated with the development of dementia, compromised white-matter microstructure, and WMH volume, respectively. [ 27 , 29 , 30 ] However, E/e’ might have some advantages as it is a widely used echocardiographic marker with easy measurability that correlates with the long-term progression of cerebral WMH. [ 15 , 17 , 21 , 22 ]…”

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

“…Зокрема, збільшення ММЛШ на кожні 25 г асоціюється з меншим об'ємом гіпокампа (відношення шансів (OR) 0,01 %; 95% довірчий інтервал (ДІ) 0,02, 0,00; p = 0,001) і більш вираженою гіперінтенсивністю білої речовини мозку (OR 0,10; 95% ДI 0,02, 0,18; p = 0,014) [13]. З кожним наступним потовщенням стінок ЛШ на 1 мм гіперінтенсивність білої речовини посилювалась на 0,66 см 3 (95% ДІ 0,08-1,25); із збільшенням ІММЛШ на кожні 10 г/м 2 -на 0,64 см 3 (95 % ДІ 0,19-1,08) [14]. Імовірність інфаркту мозку також підвищується із потовщенням стінок ЛШ (OR 1,11, 95% ДІ 1,01-1,23 на 1 мм) та зі збільшенням ММЛШ (OR 1,08, 95% ДІ 1,00-1,17 на 10 г/м 2 ) [15].…”