Relationship between Cognitive Impairment and Echocardiographic Parameters: A Review

Arangalage, Dimitri; Éderhy, Stéphane; Soulat-Dufour, Laurie; Joffre, Jérémie; Vynckt, Clélie Van Der; Lang, Sylvie; Tzourio, Christophe

doi:10.1016/j.echo.2014.11.009

Cited by 17 publications

(18 citation statements)

References 108 publications

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“…Clinical results show correlation between features of HF and functional or structural brain pathology . The majority of these findings relate to HFrEF patients with an advanced stage of HF with insufficient systolic heart function.…”

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confidence: 93%

“…[5][6][7][8] Clinical results show correlation between features of HF and functional or structural brain pathology. 5,9,10 The majority of these findings relate to HFrEF patients with an advanced stage of HF with insufficient systolic heart function. Based on indirect evidence from clinical trials in which cognitive function was improved after pharmacological compensation of HF, 11 improved adherence to treatment, 12 and successful cardiac resynchronization therapy 13 or left ventricular assist device implantation, 14 2 major pathomechanisms of cognitive impairment associated with HF were identified.…”

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confidence: 99%

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Vascular Cognitive Impairment Linked to Brain Endothelium Inflammation in Early Stages of Heart Failure in Mice

Adamski

Sternak

Mohaissen

et al. 2018

JAHA

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BackgroundAlthough advanced heart failure (HF) is a clinically documented risk factor for vascular cognitive impairment, the occurrence and pathomechanisms of vascular cognitive impairment in early stages of HF are equivocal. Here, we characterize vascular cognitive impairment in the early stages of HF development and assess whether cerebral hypoperfusion or prothrombotic conditions are involved.Methods and ResultsTgαq*44 mice with slowly developing isolated HF triggered by cardiomyocyte‐specific overexpression of G‐αq*44 protein were studied before the end‐stage HF, at the ages of 3, 6, and 10 months: before left ventricle dysfunction; at the stage of early left ventricle diastolic dysfunction (with preserved ejection fraction); and left ventricle diastolic/systolic dysfunction, respectively. In 6‐ to 10‐month‐old but not in 3‐month‐old Tgαq*44 mice, behavioral and cognitive impairment was identified with compromised blood‐brain barrier permeability, most significantly in brain cortex, that was associated with myelin sheet loss and changes in astrocytes and microglia. Brain endothelial cells displayed increased E‐selectin immunoreactivity, which was accompanied by increased amyloid‐β1‐42 accumulation in piriform cortex and increased cortical oxidative stress (8‐OHdG immunoreactivity). Resting cerebral blood flow measured by magnetic resonance imaging in vivo was preserved, but ex vivo NO‐dependent cortical arteriole flow regulation was impaired. Platelet hyperreactivity was present in 3‐ to 10‐month‐old Tgαq*44 mice, but it was not associated with increased platelet‐dependent thrombogenicity.ConclusionsWe report for the first time that vascular cognitive impairment is already present in the early stage of HF development, even before left ventricle systolic dysfunction. The underlying pathomechanism, independent of brain hypoperfusion, involves preceding platelet hyperreactivity and brain endothelium inflammatory activation.

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confidence: 93%

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confidence: 99%

Vascular Cognitive Impairment Linked to Brain Endothelium Inflammation in Early Stages of Heart Failure in Mice

Adamski

Sternak

Mohaissen

et al. 2018

JAHA

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“…10 Its indicators, such as decreased left ventricular ejection fraction (LVEF), increased left atrial volume (LAV) and higher left ventricular (LV) mass may serve as reversible risk markers for compromised brain health. 11 Recent studies suggest that cardiac dysfunction can already be detected in young adults, especially among black persons. 12 There is a lack of data on whether cardiac function as early as in young adulthood affects brain health.…”

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confidence: 99%

Subclinical Cardiac Dysfunction and Brain Health in Midlife: CARDIA (Coronary Artery Risk Development in Young Adults) Brain Magnetic Resonance Imaging Substudy

Čermáková

Muller

Armstrong

et al. 2017

JAHA

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BackgroundWe investigated whether cardiac parameters in young adulthood are associated with indicators of brain health in midlife.Methods and ResultsThis study includes 648 participants from the CARDIA (Coronary Artery Risk Development in Young Adults) study (52% women, 38% black). We studied associations of cardiac parameters assessed by echocardiography (left ventricular ejection fraction, left atrial volume, and left ventricular mass) in young adulthood (mean age: 30 years) with brain measures obtained by magnetic resonance imaging (total brain, gray and white matter volume, white matter integrity, abnormal white matter) in midlife (mean age: 50 years). In 406 individuals with complete measurements, higher left atrial volume was associated with lower white matter fractional anisotropy, independent of traditional cardiovascular risk factors (β=−0.002; P <0.02). The association was strongest in black participants and in men.ConclusionsHigher left atrial volume in early adulthood is associated with impairment of white matter integrity in midlife. Interventions to improve cardiac function in young adults may benefit brain health and should be targeted in particular at black men.

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“…MRI‐derived aortic stiffness and pulse wave velocity have shown to relate with early brain abnormalities . Moreover, dilation of the aorta associates with atherosclerosis along the vessel, which is related to brain abnormalities . Although our study is limited in its assessment of vascular elasticity, the findings suggest that vascular properties, as measured by aortic root dimensions, may relate to brain white matter abnormalities independent of traditional risk factors.…”

Section: Discussionmentioning

confidence: 99%

Association of early left ventricular dysfunction with advanced magnetic resonance white matter and gray matter brain measures: The CARDIA study

Armstrong

Muller²,

Ambale-Ventakesh

et al. 2017

Echocardiography

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Introduction Relations between heart failure and clinically manifested stroke are well known, but the associations between heart and brain early abnormalities are not totally clear. Aims We explore relations of subclinical brain abnormalities with early cardiac dysfunction in a large healthy middle-aged biracial cohort. Methods The CARDIA study enrolled 5,115 young adults aged 18–30 years at baseline (1985–1986). We assessed 719 Caucasian and African-American participants of the CARDIA study, with echocardiograms and brain MRI at follow-up year-25 (2010–2011). Echocardiography assessed aortic root diameter; LVEF; circumferential, longitudinal, and radial deformation. Cerebral MRI DTI, and, on a subset, ASL perfusion sequences were used to assess white matter fractional anisotropy and grey matter cerebral blood flow (CBF). Linear regression explored relations between cardiac parameters and cerebral measures, adjusting for anthropometrics, risk factors, and brain constitutional variation. Results Mean age 50±4 years, SBP 118±15mmHg; 60% white, and 48% men. Mean CBF was 46±9mL/100g/min and white matter fractional anisotropy was 0.31±0.02. Worse circumferential deformation and larger aortic root related to worse white matter fractional anisotropy. Worse radial systolic deformation was related to worse CBF in multivariable models. LVEF did not relate to early brain abnormalities. Conclusions In spite of no apparent effect of LV ejection fraction, early subclinical cardiac dysfunction and brain abnormalities are present and associated in middle-aged generally healthy individuals.

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Relationship between Cognitive Impairment and Echocardiographic Parameters: A Review

Cited by 17 publications

References 108 publications

Vascular Cognitive Impairment Linked to Brain Endothelium Inflammation in Early Stages of Heart Failure in Mice

Vascular Cognitive Impairment Linked to Brain Endothelium Inflammation in Early Stages of Heart Failure in Mice

Subclinical Cardiac Dysfunction and Brain Health in Midlife: CARDIA (Coronary Artery Risk Development in Young Adults) Brain Magnetic Resonance Imaging Substudy

Association of early left ventricular dysfunction with advanced magnetic resonance white matter and gray matter brain measures: The CARDIA study

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