The Missing Link in the Pathophysiology of Vascular Cognitive Impairment: Design of the Heart-Brain Study

Hooghiemstra, Astrid M.; Bertens, Anne Suzanne; Leeuwis, Anna E.; Bron, Esther E.; Bots, Michiel L.; Rocca, Hans‐Peter Brunner‐La; Craen, Anton J. M. de; Geest, Rob J. van der; Greving, Jacoba P.; Kappelle, L. Jaap; Niessen, Wiro J.; Oostenbrugge, Robert J. van; Osch, Matthias J.P. van; Roos, Albert de; Rossum, Albert C. van; Biessels, Geert-Jan; Buchem, Mark A. van; Daemen, M. J. A. P.; Flier, Wiesje M. van der

doi:10.1159/000480738

Cited by 47 publications

(68 citation statements)

References 67 publications

(49 reference statements)

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“…Various scans for both the brain and the heart were acquired at each of the centers. For details about the scans acquired and the selection criteria for the subjects the readers are referred to the publication of van Buchem et al [22] and to the study design publication of Hooghiemstra et al [25]. The institutional review board approved this study, and all patients were informed and provided written consent.…”

Section: Methodsmentioning

confidence: 99%

Quantification of aortic pulse wave velocity from a population based cohort: a fully automatic method

Shahzad

Shankar

Amier

et al. 2019

Journal of Cardiovascular Magnetic Resonance

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Background Aortic pulse wave velocity (PWV) is an indicator of aortic stiffness and is used as a predictor of adverse cardiovascular events. PWV can be non-invasively assessed using magnetic resonance imaging (MRI). PWV computation requires two components, the length of the aortic arch and the time taken for the systolic pressure wave to travel through the aortic arch. The aortic length is calculated using a multi-slice 3D scan and the transit time is computed using a 2D velocity encoded MRI (VE) scan. In this study we present and evaluate an automatic method to quantify the aortic pulse wave velocity using a large population-based cohort. Methods For this study 212 subjects were retrospectively selected from a large multi-center heart-brain connection cohort. For each subject a multi-slice 3D scan of the aorta was acquired in an oblique-sagittal plane and a 2D VE scan acquired in a transverse plane cutting through the proximal ascending and descending aorta. PWV was calculated in three stages: ( i ) a multi-atlas-based segmentation method was developed to segment the aortic arch from the multi-slice 3D scan and subsequently estimate the length of the proximal aorta, ( ii ) an algorithm that delineates the proximal ascending and descending aorta from the time-resolved 2D VE scan and subsequently obtains the velocity-time flow curves was also developed, and ( iii ) automatic methods that can compute the transit time from the velocity-time flow curves were implemented and investigated. Finally the PWV was obtained by combining the aortic length and the transit time. Results Quantitative evaluation with respect to the length of the aortic arch as well as the computed PWV were performend by comparing the results of the novel automatic method to those obtained manually. The mean absolute difference in aortic length obtained automatically as compared to those obtained manually was 3.3 ± 2.8 mm ( p < 0.05 ), the manual inter-observer variability on a subset of 45 scans was 3.4 ± 3.4 mm ( p = 0.49 ). Bland-Altman analysis between the automataic method and the manual methods showed a bias of 0.0 (-5.0,5.0) m/s for the foot-to-foot approach, -0.1 (-1.2, 1.1) and -0.2 (-2.6, 2.1) m/s for the half-max and the cross-correlation methods, respectively. Conclusion We proposed and evaluated a fully automatic method to calculate the PWV on a large set of multi-center MRI scans. It was observed that the overall results obtained had very good agreement with manual analysis. Our proposed automatic method would be very beneficial for large population based studies, where manual analysis requires a lot of manpower.

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Section: Methodsmentioning

confidence: 99%

Quantification of aortic pulse wave velocity from a population based cohort: a fully automatic method

Shahzad

Shankar

Amier

et al. 2019

Journal of Cardiovascular Magnetic Resonance

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“…It has been speculated that the occurrence of cerebral infarction (CI) caused by most heart diseases may be associated with the reduction of cardiac output (1). Hooghiemstra et al (2) think that the hemodynamic balance of the 'heart-brain axis' is the key factor in maintaining brain structure and any node problem may lead to cerebrovascular disease in the vascular pathway from the heart to the brain. Recent studies have indicated that left ventricular diastolic (LVD) dysfunction may occur in hypertensive patients when their heart structure is still normal (3).…”

Section: Introductionmentioning

confidence: 99%

Left ventricular diastolic dysfunction is associated with cerebral infarction in young hypertensive patients: A retrospective case‑control study

Wen

Wang

2020

Exp Ther Med

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Studies have indicated that hypertension is associated with the occurrence of acute cerebral infarction (CI) in young patients (18-45 years). However, the association between CI and left ventricular diastolic (LVD) dysfunction in young patients with hypertension has rarely been reported. The purpose of the present study was to investigate the association between LVD dysfunction and acute CI in young patients with hypertension. A total of 92 patients with acute CI who had hypertension were selected as the study group (CI group) and 98 young patients with only hypertension were selected as the control group (non-CI group). Blood pressure measurements, LVD functional assessment and cerebral MRI were performed. The χ² test was used to compare the left ventricular diastolic function between the CI and non-CI groups. The results indicated that LVD function of young patients was associated with hypertension and there was a correlation between the decrease in LVD function and the occurrence of acute CI in young patients with hypertension. The incidence of acute CI was higher in patients with decreased LVD function than in those with normal LVD function. In conclusion, hypertension in the young is associated with decreased LVD function and is a risk factor for diastolic dysfunction of the left ventricle. LVD function may be an independent predictor of acute CI in young patients with hypertension and should be considered by clinicians. By predicting the risk of acute CI in young patients with hypertension, LVD testing may aid in the primary prevention of CI or guide early treatment.

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“…Patients with CAO were selected from the Heart-Brain Connection (HBC) study, which is a multicenter cohort study in the Netherlands that focusses on the relation between cardiovascular and hemodynamic measures and cognitive impairment. 7 From all consecutive patients with CAO who participated in the HBC study from November 2014 to March 2017 (data release 1 October 2017), we included all patients with CAO who had experienced an ipsilateral transient ischemic attack (TIA) or nondisabling ischemic stroke more than six months before inclusion. CAO was defined as a complete occlusion of the internal carotid artery and was measured either with ultrasound, magnetic resonance angiography or computed tomography angiography.…”

Section: Methodsmentioning

confidence: 99%

“…The HBC study and SMART study were approved by the Ethics Committee of the Leiden UMC and UMC Utrecht, respectively. 7,8 All patients provided written informed consent.…”

Section: Methodsmentioning

confidence: 99%

Nonfocal transient neurological attacks in patients with carotid artery occlusion

Oudeman

Volkers

Greving

et al. 2018

European Stroke Journal

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Introduction Nonfocal transient neurological attacks (TNAs) are episodes with atypical, nonlocalizing cerebral symptoms. We examined the prevalence of nonfocal TNAs, in patients with and without carotid artery occlusion (CAO). Methods We included 67 patients with CAO and 62 patients without CAO. In both groups, patients had a history of transient ischemic attack (TIA) or nondisabling ischemic stroke in the anterior circulation that had occurred >6 months before inclusion. Patients without CAO did not have ipsilateral or contralateral carotid artery stenosis of ≥50%. All patients were interviewed with a standardized questionnaire on the occurrence of nonfocal TNA symptoms during the preceding six months. We calculated risk ratios (RRs) with 95% confidence intervals (CIs) for the occurrence of ≥1 and ≥2 different nonfocal TNAs after adjustments for age, sex, systolic blood pressure and time interval between most recent TIA or ischemic stroke and administration of the questionnaire. Results Forty-three of all patients (33%) had had one or more nonfocal TNAs in the preceding six months. Nonrotatory dizziness (24%) was reported most often. The prevalence of ≥1 nonfocal TNAs was not significantly different between patients with and without CAO (39% vs. 27%; adjusted RR 1.47, 95% CI 0.83–2.61), but the prevalence of ≥2 or more different nonfocal TNAs was higher in patients with CAO (16% vs. 3%; adjusted RR 4.77, 95% CI 1.20–18.98). In patients with CAO who also had a contralateral carotid or vertebral artery steno-occlusion, nonfocal TNAs occurred more often than in patients without any carotid or vertebral artery steno-occlusion (46% vs. 27%; adjusted RR 2.22, 95% CI 1.08–4.60 for ≥1 and 21% vs. 3%; adjusted RR 8.27, 95% CI 1.83–37.32 for ≥2 nonfocal TNAs). Conclusions Patients with CAO more often experienced multiple nonfocal TNAs than patients without CAO.

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The Missing Link in the Pathophysiology of Vascular Cognitive Impairment: Design of the Heart-Brain Study

Cited by 47 publications

References 67 publications

Quantification of aortic pulse wave velocity from a population based cohort: a fully automatic method

Quantification of aortic pulse wave velocity from a population based cohort: a fully automatic method

Left ventricular diastolic dysfunction is associated with cerebral infarction in young hypertensive patients: A retrospective case‑control study

Nonfocal transient neurological attacks in patients with carotid artery occlusion

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