Left Ventricular Hypertrophy and Remodeling and Risk of Cognitive Impairment and Dementia

Moazzami, Kasra; Ostovaneh, Mohammad Reza; Ambale-Venkatesh, Bharath; Habibi, Mehdi; Yoneyama, Kihei; Wu, Colin O.; Liu, Kiang; Pimenta, Isabel; Fitzpatrick, Annette L.; Shea, Steven; McClelland, Robyn L.; Heckbert, Susan R.; Gottesman, Rebecca F.; Bluemke, David A.; Hughes, Timothy M.; Lima, João A.C.

doi:10.1161/hypertensionaha.117.10289

Cited by 35 publications

(36 citation statements)

References 39 publications

(55 reference statements)

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“…Although this observation is consistent with some prior work,9, 10 the remaining null cognitive results contrast with literature reporting cognitive associations with LVH8 or increased LV mass index3, 28 in aging cohorts that include dementia cases. Although increased LV mass index is an early marker of pathologic LV remodeling, it may not strongly correspond with subtle cognitive changes in cognitively normal individuals or elders with only mild prodromal symptoms of dementia, such as those participants studied here.…”

Section: Discussionsupporting

confidence: 90%

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

Moore

Liu

Pechman

et al. 2018

JAHA

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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.

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Section: Discussionsupporting

confidence: 90%

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

Moore

Liu

Pechman

et al. 2018

JAHA

View full text Add to dashboard Cite

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“…Our study finding for an association between LVH and CSVD could explain previous observations regarding the effects of LVH on other endpoints [ 18 , 19 ]. Specifically, in a previous meta-analysis, we found LVH to be strongly associated with cognitive impairment and decline [ 19 ], whereas more recent longitudinal studies have shown LVH to be associated with the risk of incident dementia independently of known vascular risk factors [ 89 , 90 ]. Furthermore, multiple studies have shown that LVH is an independent risk factor for stroke [ 16 - 18 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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Background and Purpose Left ventricular hypertrophy (LVH) is associated with the risk of stroke and dementia independently of other vascular risk factors, but its association with cerebral small vessel disease (CSVD) remains unknown. Here, we employed a systematic review and meta-analysis to address this gap.<br/>Methods Following the MOOSE guidelines (PROSPERO protocol: CRD42018110305), we systematically searched the literature for studies exploring the association between LVH or left ventricular (LV) mass, with neuroimaging markers of CSVD (lacunes, white matter hyperintensities [WMHs], cerebral microbleeds [CMBs]). We evaluated risk of bias and pooled association estimates with random-effects meta-analyses.<br/>Results We identified 31 studies (n=25,562) meeting our eligibility criteria. In meta-analysis, LVH was associated with lacunes and extensive WMHs in studies of the general population (odds ratio [OR]lacunes, 1.49; 95% confidence interval [CI], 1.12 to 2.00) (ORWMH, 1.73; 95% CI, 1.38 to 2.17) and studies in highrisk populations (ORlacunes: 2.39; 95% CI, 1.32 to 4.32) (ORWMH, 2.01; 95% CI, 1.45 to 2.80). The results remained stable in general population studies adjusting for hypertension and other vascular risk factors, as well as in sub-analyses by LVH assessment method (echocardiography/electrocardiogram), study design (cross-sectional/cohort), and study quality. Across LV morphology patterns, we found gradually increasing ORs for concentric remodelling, eccentric hypertrophy, and concentric hypertrophy, as compared to normal LV geometry. LVH was further associated with CMBs in high-risk population studies.<br/>Conclusions LVH is associated with neuroimaging markers of CSVD independently of hypertension and other vascular risk factors. Our findings suggest LVH as a novel risk factor for CSVD and highlight the link between subclinical heart and brain damage.

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“…Therefore, it is critical to find serum indexes to reflect the changes in the epicardial fat volume of patients. Adiponectin is a protein secreted by adipocyte, which can regulate glucose metabolism, improve insulin resistance and fight atherosclerosis, and is expressed obviously lower in the serum of CAD patients (10). Chemerin belongs to the adipocyte-factor family, which has the function of leukocyte chemotaxis and can promote the development of inflammatory response in injured tissues by recruiting inflammatory cells of chemerin receptors (11).…”

Section: Introductionmentioning

confidence: 99%

Correlation between adiponectin, chemerin, vascular endothelial growth factor and epicardial fat volume in patients with coronary artery disease

Chen

et al. 2019

Exp Ther Med

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Epicardial fat, a local visceral fat depot surrounded by visceral pericardial sac, surrounds the coronary arteries for most of their course and may contribute to the development of coronary atherosclerosis by local production of inflammatory cytokines. Some studies on non-invasive measurement of epicardial fat mass have shown that epicardial fat mass is associated with the increased incidence of coronary artery disease (CAD), onset and progression of coronary plaque, mainly including major adverse cardiovascular events, myocardial ischemia, and atrial fibrillation. In the present study the correlation of adiponectin, chemerin, and vascular endothelial growth factor (VEGF) with the epicardial fat volume in patients with coronary artery disease was explored, and the risk factors for vascular remodeling of CAD patients were analyzed.

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Left Ventricular Hypertrophy and Remodeling and Risk of Cognitive Impairment and Dementia

Cited by 35 publications

References 39 publications

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

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

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

Correlation between adiponectin, chemerin, vascular endothelial growth factor and epicardial fat volume in patients with coronary artery disease

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