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Magnetic Resonance Imaging of Cardiovascular Function and the Brain: Is Dementia a Cardiovascular-Driven Disease?

Albert de Roos1, Jeroen van der Grond2, Gary Mitchell2

  • 1From Leiden University Medical Center, Department of Radiology, The Netherlands (A.d.R., J.v.d.G., J.W.); and Cardiovascular Engineering, Inc, Norwood, MA (G.M.). a.de_roos@lumc.nl.

Circulation
|June 1, 2017
PubMed

Insights

Aortic stiffening, common with aging and hypertension, impairs brain blood flow, potentially causing cognitive decline and dementia. Early detection via MRI may offer preventative strategies for this cardiovascular-brain link.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Medical Imaging

Background:

  • The proximal aorta regulates cerebral blood flow and pulsatility.
  • Aortic stiffening, linked to aging and hypertension, negatively impacts brain and heart health.
  • This can lead to cerebral small vessel disease, heart failure, cognitive decline, and vascular dementia.

Purpose of the Study:

  • To explore the pathophysiological link between aortic stiffening and cognitive decline.
  • To highlight cardiovascular disease's role in dementia.
  • To identify potential targets for prevention and treatment.

Main Methods:

  • Utilizing magnetic resonance imaging (MRI) to assess proximal aorta and left ventricle function.
  • Measuring aortic arch pulse wave velocity and distensibility.
  • Evaluating early and late signs of cerebral small vessel disease (microbleeds, white matter hyperintensities) using MRI.
  • Exploring advanced MRI techniques for preclinical changes in white matter and brain microvascular pulsatility.

Main Results:

  • Aortic stiffening is a significant risk factor for brain damage and heart failure.
  • Cerebral small vessel disease and heart failure are associated with cognitive decline and vascular dementia.
  • MRI can detect functional and structural changes in the aorta and brain relevant to cognitive impairment.

Conclusions:

  • Cardiovascular disease, particularly aortic stiffening, is a key contributor to cognitive decline and dementia.
  • Early detection and intervention targeting the cardiovascular-brain axis are crucial.
  • Advanced MRI techniques show promise for diagnosing preclinical changes and guiding preventative strategies.

Keywords:
aortabraincardiovascular diseasemagnetic resonance imagingpulse wave velocity

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