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Clinical and Imaging Markers of Cardiac Function and Brain Health: A Meta-Analysis of Community-Based Studies.

TitleClinical and Imaging Markers of Cardiac Function and Brain Health: A Meta-Analysis of Community-Based Studies.
Publication TypeJournal Article
Year of Publication2025
AuthorsYaqub, A, Bis, JC, Frenzel, S, Koini, M, Mbangdadji, D, Peloso, GM, Talluri, R, Alonso, A, Bahls, M, Bülow, R, Dörr, M, Felix, S, Fohner, A, Friedrich, N, Hofer, E, Kavousi, M, Launer, LJ, Le, T, Longstreth, W, Mosley, TH, Vernooij, MW, Völzke, H, Wittfeld, K, Beiser, AS, Grabe, HJ, Gudnason, V, Ikram, MArfan, Psaty, BM, Schmidt, R, Simino, J, Seshadri, S, Wolters, FJ
Corporate/Institutional Authorsas Cross-Cohort Collaboration
JournalNeurology
Volume104
Issue8
Paginatione213421
Date Published2025 Apr 22
ISSN1526-632X
KeywordsAged, Brain, Cohort Studies, Echocardiography, Female, Heart Failure, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Prospective Studies, White Matter
Abstract<p><b>BACKGROUND AND OBJECTIVES: </b>Cardiac dysfunction and heart failure are linked to cognitive impairment, but the underlying brain pathology remains undetermined. We investigated associations between cardiac function (measured by echocardiography or cardiac MRI), clinical heart failure, and structural markers on brain MRI, including volumes of gray and white matter (WM), the hippocampus, and white matter hyperintensities (WMHs).</p><p><b>METHODS: </b>We leverage data from 7 prospective, community-based cohorts across Europe and the United States, all part of the Cross-Cohort Collaboration. The included cohorts were the Age, Gene/Environment Susceptibility-Reykjavik Study, Atherosclerosis Risk in Communities study, Austrian Stroke Prevention Study, Cardiovascular Health Study, Framingham Heart Study, Rotterdam Study, and Study of Health in Pomerania (SHIP-START and SHIP-TREND). Each cohort performed cross-sectional multivariable linear regression analyses, after which estimates were pooled through random-effects meta-analysis. Heterogeneity was assessed by the index (%).</p><p><b>RESULTS: </b>Among 10,889 participants (mean age: 66.8 years, range 52.0-76.0; 56.7% women), markers of systolic dysfunction were consistently associated with smaller total brain volume (TBV) (e.g., adjusted standardized mean difference for moderate to severe dysfunction -0.19, 95% CI -0.31 to -0.07, = 20%). Impaired relaxation and restrictive diastolic dysfunction were also associated with smaller TBV (e.g., for impaired relaxation -0.08, 95% CI -0.15 to -0.01, = 32%) and hippocampal volume (-0.18, 95% CI -0.33 to -0.03, = 0%), with similar results for the E/A-ratio. Systolic and diastolic dysfunction was not consistently associated with volume of WMHs. Among 5 cohorts with available data, 302 (3.4%) participants had clinical heart failure, which was associated with smaller brain volumes, particularly in the hippocampus (-0.13, 95% CI -0.23 to -0.02, = 1%).</p><p><b>DISCUSSION: </b>In this large study among community-dwelling adults, subclinical cardiac dysfunction was associated with brain imaging markers of neurodegeneration. These findings encourage longitudinal investigations on the effect of maintaining cardiac function on brain health.</p>
DOI10.1212/WNL.0000000000213421
Alternate JournalNeurology
PubMed ID40138616
PubMed Central IDPMC11981472
ePub date: 
25/03