Associations Between Left Ventricular Structure, Function, and Cerebral Amyloid: The ARIC-PET Study
Michelle C Johansen1, Thomas H Mosley2, David S Knopman3
1From the The Johns Hopkins University School of Medicine, Baltimore, MD (M.C.J., D.F.W., R.F.G.).
Insights
Cardiovascular disease markers, specifically left ventricular diameter, are linked to elevated beta-amyloid (Aβ) brain deposits, a key Alzheimer's pathology. This suggests a connection between heart health and Alzheimer's disease development.
Area of Science:
- Neurology
- Cardiology
- Gerontology
Background:
- Cardiovascular disease is a known risk factor for cognitive decline.
- The specific mechanisms linking cardiovascular disease to cognitive decline are not fully understood.
- Alzheimer's disease is characterized by beta-amyloid (Aβ) pathology.
Purpose of the Study:
- To investigate the association between subclinical cardiac structure and function echocardiogram indices and Aβ deposition in nondemented individuals.
- To test the hypothesis that cardiac pathology markers correlate with Aβ brain burden.
Main Methods:
- Three hundred six nondemented participants from the Atherosclerosis Risk in Communities Study were enrolled.
- Participants underwent florbetapir positron emission tomography to assess Aβ deposition and 2D echocardiography for cardiac evaluation.
- Multivariable logistic regression was used to analyze cross-sectional associations between echocardiogram markers and elevated Aβ.
Main Results:
- An increased end-diastolic left ventricular diameter was significantly associated with doubled odds of elevated global cortical Aβ.
- This association remained significant even when excluding participants with mild cognitive impairment.
- The findings indicate a link between left ventricular structural changes and Aβ deposition.
Conclusions:
- A significant association was found between a left ventricular structure marker and elevated Aβ deposition, as detected by positron emission tomography.
- Further prospective research is needed to determine the temporal relationship between cardiac changes and amyloid deposition.
Abstract:
Background and Purpose- Cardiovascular disease is a known risk factor for cognitive decline, although the mechanisms remain unclear. We hypothesize that Aβ (β-amyloid), a core pathology of Alzheimer's disease, will be associated with subclinical cardiac structure and function echocardiogram indices. Methods- Three hundred six nondemented participants from the ARIC study (Atherosclerosis Risk in Communities Study) underwent florbetapir positron emission tomography and 2D echocardiography (echo). Cross-sectional associations between echo markers of left ventricular structure and function and global cortical Aβ (≥1.2 standardized uptake value ratio were evaluated using multivariable logistic regression with interaction terms when appropriate. Results- Participants ranged in age from 67 to 88 years, were 57% female and 42% black. Per 1 cm increase in end-diastolic left ventricular diameter, the odds of elevated florbetapir standardized uptake value ratio doubled (odds ratio, 2.04 [95% CI, 1.10-3.77]), with similar findings when excluding mild cognitive impairment (odds ratio, 2.61 [95% CI, 1.22-5.59]). Conclusions- We have demonstrated a significant association between a marker of left ventricular structure and elevated florbetapir standardized uptake value ratio, identified using positron emission tomography. Ongoing prospective work will help determine if changes in cardiac structure and function either precede, or occur simultaneously with deposition of amyloid.
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