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Associations of Echocardiography Markers and Vascular Brain Lesions: The ARIC Study.

TitleAssociations of Echocardiography Markers and Vascular Brain Lesions: The ARIC Study.
Publication TypeJournal Article
Year of Publication2018
AuthorsJohansen MC, Shah AM, Lirette ST, Griswold M, Mosley TH, Solomon SD
Secondary AuthorsGottesman RF
JournalJ Am Heart Assoc
Volume7
Issue24
Paginatione008992
Date Published2018 12 18
ISSN2047-9980
KeywordsAge Factors, Aged, Aged, 80 and over, Brain Infarction, Cross-Sectional Studies, Echocardiography, Doppler, Female, Humans, Hypertrophy, Left Ventricular, Leukoencephalopathies, Magnetic Resonance Imaging, Male, Predictive Value of Tests, Prospective Studies, Risk Assessment, Risk Factors, Stroke Volume, United States, Ventricular Dysfunction, Left, Ventricular Function, Left, Ventricular Remodeling
Abstract

Background Associations between subtle changes in cardiac and cerebral structure and function are not well understood, with some studies suggesting that subclinical cardiac changes may be associated with markers of vascular brain insult. Methods and Results Data from the ARIC (Atherosclerosis Risk in Communities) Study (5th ARIC visit; 2011-2013; N=1974) were used to explore relationships between abnormalities of cardiac structure/function and subclinical brain disease and to test specific associations between those cardiac and vascular brain changes that share a common mechanism. In adjusted models white matter hyperintensities were 0.66 cm greater (95% confidence interval [CI] 0.08-1.25) for every 1-mm increase in left ventricular LV wall thickness and 0.64 cm greater (95% CI 0.19-1.08) for every 10 g/m increase in LV mass index, both markers of LV structure. Odds of brain infarction also increased with greater LV wall thickness (odds ratio 1.11, 95% CI 1.01-1.23 per 1 mm) and larger LV mass (odds ratio 1.08, 95% CI 1.00-1.17 per 10 g/m). Higher ejection fraction (per 5%), a marker of systolic function, was significantly associated with decreased odds of overall infarct (odds ratio 0.85, 95% CI 0.77-0.95), but not with cortical infarction (odds ratio 0.92, 95% CI 0.78-1.08). Conclusions Among elderly participants in a large cohort study, subclinical markers of LV structure and LV systolic dysfunction were associated with increased odds of brain infarction and more white matter hyperintensities, independent of other vascular risk factors. This suggests end-organ dysfunction occurs in the heart and brain in parallel, with further studies needed to determine causality.

DOI10.1161/JAHA.118.008992
Alternate JournalJ Am Heart Assoc
PubMed ID30526268
PubMed Central IDPMC6405621
Grant ListU01 HL096812 / HL / NHLBI NIH HHS / United States
U01 HL096917 / HL / NHLBI NIH HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
U01 HL096814 / HL / NHLBI NIH HHS / United States
U01 HL096899 / HL / NHLBI NIH HHS / United States
K24 AG052573 / AG / NIA NIH HHS / United States
P20 GM121334 / GM / NIGMS NIH HHS / United States
U54 GM115428 / GM / NIGMS NIH HHS / United States