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Associations Between Left Ventricular Dysfunction and Brain Structure and Function: Findings From the SABRE (Southall and Brent Revisited) Study

Park, Chloe M., Williams, Emily, Chaturvedi, Nish, Tillin, Therese, Stewart, Robert J., Richards, Marcus, Shibata, Dean, Mayet, Jamil and Hughes, Alun D. (2017) Associations Between Left Ventricular Dysfunction and Brain Structure and Function: Findings From the SABRE (Southall and Brent Revisited) Study Journal of the American Heart Association, 6 (4).

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Abstract

Background Subclinical left ventricular (LV) dysfunction has been inconsistently associated with early cognitive impairment, and mechanistic pathways have been poorly considered. We investigated the cross‐sectional relationship between LV dysfunction and structural/functional measures of the brain and explored the role of potential mechanisms. Method and Results A total of 1338 individuals (69±6 years) from the Southall and Brent Revisited study underwent echocardiography for systolic (tissue Doppler imaging peak systolic wave) and diastolic (left atrial diameter) assessment. Cognitive function was assessed and total and hippocampal brain volumes were measured by magnetic resonance imaging. Global LV function was assessed by circulating N‐terminal pro–brain natriuretic peptide. The role of potential mechanistic pathways of arterial stiffness, atherosclerosis, microvascular disease, and inflammation were explored. After adjusting for age, sex, and ethnicity, lower systolic function was associated with lower total brain (beta±standard error, 14.9±3.2 cm3; P<0.0001) and hippocampal volumes (0.05±0.02 cm3, P=0.01). Reduced diastolic function was associated with poorer working memory (−0.21±0.07, P=0.004) and fluency scores (−0.18±0.08, P=0.02). Reduced global LV function was associated with smaller hippocampal volume (−0.10±0.03 cm3, P=0.004) and adverse visual memory (−0.076±0.03, P=0.02) and processing speed (0.063±0.02, P=0.006) scores. Separate adjustment for concomitant cardiovascular risk factors attenuated associations with hippocampal volume and fluency only. Further adjustment for the alternative pathways of microvascular disease or arterial stiffness attenuated the relationship between global LV function and visual memory. Conclusions In a community‐based sample of older people, measures of LV function were associated with structural/functional measures of the brain. These associations were not wholly explained by concomitant risk factors or potential mechanistic pathways.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
NameEmailORCID
Park, Chloe M.UNSPECIFIEDUNSPECIFIED
Williams, Emilye.d.williams@surrey.ac.ukUNSPECIFIED
Chaturvedi, NishUNSPECIFIEDUNSPECIFIED
Tillin, ThereseUNSPECIFIEDUNSPECIFIED
Stewart, Robert J.UNSPECIFIEDUNSPECIFIED
Richards, MarcusUNSPECIFIEDUNSPECIFIED
Shibata, DeanUNSPECIFIEDUNSPECIFIED
Mayet, JamilUNSPECIFIEDUNSPECIFIED
Hughes, Alun D.UNSPECIFIEDUNSPECIFIED
Date : 18 April 2017
Identification Number : 10.1161/JAHA.116.004898
Copyright Disclaimer : © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Uncontrolled Keywords : Arterial stiffness; Brain imaging; Brain volumes; Cognitive function; Cognitive impairment; Left ventricular dysfunction; Microvascular dysfunction
Additional Information : An accompanying Table S1 is available at http://jaha.ahajournals.org/content/6/4/e004898/DC1/embed/inline-supplementary-material-1.pdf
Depositing User : Clive Harris
Date Deposited : 12 Jul 2017 09:16
Last Modified : 12 Jul 2017 09:16
URI: http://epubs.surrey.ac.uk/id/eprint/841609

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