Cross-Sectional Association Between Left Ventricular Geometric Patterns, Cortical Cerebral Microinfarcts, and Cognition
Jiannan Huang1, Caroline Robert2, Lieng-Hsi Ling3,4
1Saw Swee Hock School of Public Health National University of Singapore and National University Health System Singapore.
Insights
Concentric left ventricular hypertrophy is linked to cerebral microinfarcts and dementia. These microinfarcts may mediate the relationship between heart geometry and cognitive decline.
Area of Science:
- Cardiology
- Neurology
- Radiology
Background:
- Left ventricular (LV) geometric patterns are linked to cognitive impairment and cerebral small vessel disease.
- Cortical cerebral microinfarcts (CMIs) are novel MRI markers of cerebral small vessel disease and risk factors for cognitive dysfunction.
- Investigating the link between LV geometry, CMIs, and cognition is crucial for understanding heart-brain interactions.
Purpose of the Study:
- To investigate the cross-sectional relationship between LV geometric patterns, cortical CMIs, and cognitive function.
- To determine if LV geometry influences cortical CMI development.
- To elucidate the connection between LV geometry, CMIs, and cognitive impairment.
Main Methods:
- 261 patients (75.3±6.8 years) from a memory clinic were analyzed.
- LV geometry was assessed using echocardiography; cortical CMIs were graded via 3T MRI.
- Statistical analyses included regression models and mediation analysis to assess relationships and effects.
Main Results:
- Concentric LV hypertrophy showed a significant association with higher cortical CMI counts (RR 3.85) and increased odds of dementia (OR 2.86).
- Cortical CMIs partially mediated the association between concentric LV hypertrophy and cognitive function.
- The findings highlight a potential pathway from cardiac structure to brain health.
Conclusions:
- Concentric LV hypertrophy is significantly associated with cortical CMIs and dementia.
- Cortical CMIs may play a mediating role in the relationship between LV geometry and cognitive decline.
- Further research is needed to confirm the role of CMIs in LV geometry-cognition associations.
Background:
Left ventricular (LV) geometric patterns are associated with cognitive impairment and cerebral small vessel disease. As a novel magnetic resonance imaging marker of cerebral small vessel disease and a risk factor for cognitive dysfunction, cortical cerebral microinfarcts (CMIs) have been associated with heart disease through mechanisms including cardioembolism and cerebral hypoperfusion. Further investigation is required to determine whether cortical CMIs could arise from hemodynamic changes related to LV geometry, thus elucidating the connection between LV geometry and cognitive function. This study aims to investigate the cross-sectional relationship between LV geometric patterns, cortical CMIs, and cognition.
Methods And Results:
A total of 261 patients, aged 75.3±6.8 years, were enrolled from a memory clinic study. LV dimensions were obtained using 2-dimensional echocardiography. LV mass index and relative wall thickness were determined to categorize LV geometric patterns. Cortical CMIs were graded on 3T magnetic resonance imaging. Cognition was assessed using neuropsychological tests and clinical diagnosis. Linear, zero-inflated Poisson, and logistic regression were employed for continuous, count, and binary outcomes, respectively. Mediation analysis was conducted to examine the mediation effect of cortical CMIs. A significant association was observed between concentric LV hypertrophy and cortical CMI counts (rate ratio, 3.85 [95% CI, 1.85-8.01]), as well as the odds of having dementia (odds ratio, 2.86 [95% CI, 1.07-7.89]), in the fully adjusted model. Cortical CMIs may partly explain the relationship between concentric LV hypertrophy and cognitive function.
Conclusions:
Concentric LV hypertrophy was associated with cortical CMIs and dementia. Further verification is warranted to determine the role of cortical CMIs in the association between LV geometry and cognition.
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