Cardiac dysfunction in relation to vascular brain injury, cognitive impairment and depressive symptoms; The Heart-Brain Connection Study

Abstract Introduction Cardiovascular disease is an independent contributor to cognitive impairment. With imminent rise in chronic cardiovascular disease, a better understanding of its effects on brain health warranted. Impaired blood flow the one main hypothesized mechanisms linking with abnormal aging. Purpose To investigate relations between (subclinical) cardiac dysfunction and vascular injury, impairment depressive symptoms, side-by-side comparison biomarkers imaging parameters. Methods Multicenter, cross-sectional, observational cohort study among 559 participants: 431 manifest (heart failure [HF], carotid occlusive or impairment) 128 control participants, all without dementia. Participants underwent 3T heart-brain MRI testing. Determinants were (NT-proBNP high-sensitive Troponin-I) left ventricular (LV) functional parameters by (LV ejection fraction, output, LV global function index). Outcome measures cerebral small vessel (CSVD) (presence white matter hyperintensities, microbleeds, lacunar infarcts perivascular spaces), CSVD score (0–4), ≥1 domain (memory, language, attention-psychomotor speed executive functioning) symptoms (Geriatric Depression Scale-15 >5). Interaction analyses used effect modification patient group; results are reported pooled stratified accordingly. Results In patients controls, but not those HF, associated impairment, following associations: LVEF <50% (OR 4.67 [1.37–15.95]) (RR 1.38 [1.06–1.81]); index 0.71 [0.58–0.86]), 0.90 [0.84–0.96]) 0.84 [0.72–0.97]). 0.82 [0.71–0.95]) output 0.81 [0.71–0.93]) also all. These from age, sex, hypertension, diabetes, waist-hipratio, history ischemic heart transient attack stroke. Cardiac univariably outcome measures, multivariable analysis. Conclusion This indicates that subclinical dysfunction, as assessed MRI, independently symptoms. Of parameters, showed most robust relations, indicating performance more closely related poorer than merely systolic function. clinically severity was other measures. Funding Acknowledgement Type funding sources: Public grant(s) – National budget only. Main source(s): The Netherlands CardioVascular Research Initiative; Dutch Heart Foundation