Prevalent Cardiovascular Disease and Atrial Fibrillation in Relation to Cerebral Small Vessel Disease Burden

Area of Science:

• Neurology and Cardiology
• Neuroimaging and Cardiovascular Health

Background:

• Cardiovascular disease (CVD) is a significant risk factor for stroke and dementia.
• Shared risk factors between CVD, stroke, and dementia may involve cerebral small vessel disease (CSVD).
• Atrial fibrillation (AF) is a common cardiac arrhythmia often co-occurring with CVD.

Purpose of the Study:

• To investigate the association between prevalent cardiovascular disease (CVD) and atrial fibrillation (AF).
• To determine the relationship between CVD and AF with the burden of cerebral small vessel disease (CSVD).
• To explore specific CSVD markers associated with CVD and AF.

Main Methods:

• Assessed composite CVD (coronary heart disease, heart failure) and AF in 3413 participants.
• Utilized a multi-marker CSVD score (0-5) based on cerebral microbleeds, perivascular spaces, white matter hyperintensity, siderosis, and infarcts.
• Employed logistic regression analyses, adjusted for demographics and vascular risk factors, to relate CVD/AF to CSVD markers.

Main Results:

• Prevalent CVD or AF was present in 11% of participants; 8% had CVD, and 4% had AF.
• 23% of participants showed one CSVD marker, and 9% had two or more.
• Composite CVD and AF were associated with one CSVD marker (OR: 1.38, 95% CI: 1.05-1.84); cerebral microbleeds (CMBs) showed the strongest association with CVD components, especially heart failure.

Conclusions:

• Prevalent cardiovascular disease, including atrial fibrillation, is associated with the presence of cerebral small vessel disease.
• Cerebral microbleeds are specifically linked to components of CVD and AF.
• Findings suggest a connection between cardiovascular health and underlying cerebral small vessel disease.