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

Abstract

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.

Differences in cognitive performance and cognitive decline across European regions: a population-based prospective cohort study

“…We initially identified covariates based on previous literature as sociodemographic and health-related characteristics related to the risk of low cognitive performance and cognitive decline [1,5,[29][30][31][32][33][34]. Selected sociodemographic characteristics include age, gender (women vs. men), years of education, civil status (partner vs. no partner), employment status (currently working vs. not working), residence (urban vs. rural).…”

Socioeconomic position in childhood and cognitive aging in Europe

“…Information on clinical and social risk factors, as potential mediators in the association of SEP with cognition, was initially identified based on the literature [24][25][26][27][28][29][30] and availability in the SHARE dataset. From those, we chose variables that were associated with the composite cognitive score at the level of p < 0.05 in at least 4 waves, after adjustment for age, sex, and years of education.…”

Relationship between heart and brain: a new piece of the puzzle

“…Previous studies found that HF is associated with a damage in brain areas that could contribute to cognitive deficits, development of cognitive impairment as well as dementia including Alzheimer's disease . Worse cognitive function was observed already at early stages of left ventricular dysfunction and furthermore, even in younger people without cardiovascular disease, there was an association between subclinical cardiac dysfunction and subtle injury of the brain …”

“…Interestingly, the study participants were on average as young as middle‐aged at the time of their first hospitalization for HF. This is of interest because the burden of HF is increasing in some subgroups of young people and therefore the strategies to prevent HF would likely have the greatest impact if applied early in life …”

“…This adds an additional piece into the understanding of the complex interplay between social and biological mechanisms that emerge across the lifespan and may result in HF and cognitive impairment. Cognitive performance before the onset of HF or cardiac dysfunction has not been taken into account in previous studies of the heart–brain axis . Is it of interest for future studies to which extent the association of HF and cognitive impairment would persist, if the previous level of cognition was accounted for.…”