Associations of echocardiography markers and vascular brain lesions

The ARIC study

Michelle Johansen, Amil M. Shah, Seth T. Lirette, Michael Griswold, Thomas H. Mosley, Scott D. Solomon, Rebecca F Gottesman

Research output: Contribution to journalArticle

Abstract

Background-Associations between subtle changes in cardiac and cerebral structure and function are not well understood, with some studies suggesting that subclinical cardiac changes may be associated with markers of vascular brain insult. Methods and Results-Data from the ARIC (Atherosclerosis Risk in Communities) Study (5th ARIC visit; 2011-2013; N=1974) were used to explore relationships between abnormalities of cardiac structure/function and subclinical brain disease and to test specific associations between those cardiac and vascular brain changes that share a common mechanism. In adjusted models white matter hyperintensities were 0.66 cm3greater (95% confidence interval [CI] 0.08-1.25) for every 1-mm increase in left ventricular LV wall thickness and 0.64 cm3greater (95% CI 0.19-1.08) for every 10 g/m2increase in LV mass index, both markers of LV structure. Odds of brain infarction also increased with greater LV wall thickness (odds ratio 1.11, 95% CI 1.01-1.23 per 1 mm) and larger LV mass (odds ratio 1.08, 95% CI 1.00-1.17 per 10 g/m2). Higher ejection fraction (per 5%), a marker of systolic function, was significantly associated with decreased odds of overall infarct (odds ratio 0.85, 95% CI0.77-0.95), but not with cortical infarction (odds ratio 0.92, 95% CI0.78-1.08). Conclusions-Among elderly participants in a large cohort study, subclinical markers of LV structure and LV systolic dysfunction were associated with increased odds of brain infarction and more white matter hyperintensities, independent of other vascular risk factors. This suggests end-organ dysfunction occurs in the heart and brain in parallel, with further studies needed to determine causality.

Original languageEnglish (US)
Article numbere008992
JournalJournal of the American Heart Association
Volume7
Issue number24
DOIs
StatePublished - Dec 1 2018

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Blood Vessels
Echocardiography
Atherosclerosis
Odds Ratio
Confidence Intervals
Brain Infarction
Brain
Brain Diseases
Causality
Infarction
Cohort Studies
White Matter

Keywords

  • Brain infarction
  • Cardiology
  • Echocardiography
  • White matter disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Associations of echocardiography markers and vascular brain lesions : The ARIC study. / Johansen, Michelle; Shah, Amil M.; Lirette, Seth T.; Griswold, Michael; Mosley, Thomas H.; Solomon, Scott D.; Gottesman, Rebecca F.

In: Journal of the American Heart Association, Vol. 7, No. 24, e008992, 01.12.2018.

Research output: Contribution to journalArticle

Johansen, Michelle ; Shah, Amil M. ; Lirette, Seth T. ; Griswold, Michael ; Mosley, Thomas H. ; Solomon, Scott D. ; Gottesman, Rebecca F. / Associations of echocardiography markers and vascular brain lesions : The ARIC study. In: Journal of the American Heart Association. 2018 ; Vol. 7, No. 24.
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abstract = "Background-Associations between subtle changes in cardiac and cerebral structure and function are not well understood, with some studies suggesting that subclinical cardiac changes may be associated with markers of vascular brain insult. Methods and Results-Data from the ARIC (Atherosclerosis Risk in Communities) Study (5th ARIC visit; 2011-2013; N=1974) were used to explore relationships between abnormalities of cardiac structure/function and subclinical brain disease and to test specific associations between those cardiac and vascular brain changes that share a common mechanism. In adjusted models white matter hyperintensities were 0.66 cm3greater (95{\%} confidence interval [CI] 0.08-1.25) for every 1-mm increase in left ventricular LV wall thickness and 0.64 cm3greater (95{\%} CI 0.19-1.08) for every 10 g/m2increase in LV mass index, both markers of LV structure. Odds of brain infarction also increased with greater LV wall thickness (odds ratio 1.11, 95{\%} CI 1.01-1.23 per 1 mm) and larger LV mass (odds ratio 1.08, 95{\%} CI 1.00-1.17 per 10 g/m2). Higher ejection fraction (per 5{\%}), a marker of systolic function, was significantly associated with decreased odds of overall infarct (odds ratio 0.85, 95{\%} CI0.77-0.95), but not with cortical infarction (odds ratio 0.92, 95{\%} CI0.78-1.08). Conclusions-Among elderly participants in a large cohort study, subclinical markers of LV structure and LV systolic dysfunction were associated with increased odds of brain infarction and more white matter hyperintensities, independent of other vascular risk factors. This suggests end-organ dysfunction occurs in the heart and brain in parallel, with further studies needed to determine causality.",
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T2 - The ARIC study

AU - Johansen, Michelle

AU - Shah, Amil M.

AU - Lirette, Seth T.

AU - Griswold, Michael

AU - Mosley, Thomas H.

AU - Solomon, Scott D.

AU - Gottesman, Rebecca F

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N2 - Background-Associations between subtle changes in cardiac and cerebral structure and function are not well understood, with some studies suggesting that subclinical cardiac changes may be associated with markers of vascular brain insult. Methods and Results-Data from the ARIC (Atherosclerosis Risk in Communities) Study (5th ARIC visit; 2011-2013; N=1974) were used to explore relationships between abnormalities of cardiac structure/function and subclinical brain disease and to test specific associations between those cardiac and vascular brain changes that share a common mechanism. In adjusted models white matter hyperintensities were 0.66 cm3greater (95% confidence interval [CI] 0.08-1.25) for every 1-mm increase in left ventricular LV wall thickness and 0.64 cm3greater (95% CI 0.19-1.08) for every 10 g/m2increase in LV mass index, both markers of LV structure. Odds of brain infarction also increased with greater LV wall thickness (odds ratio 1.11, 95% CI 1.01-1.23 per 1 mm) and larger LV mass (odds ratio 1.08, 95% CI 1.00-1.17 per 10 g/m2). Higher ejection fraction (per 5%), a marker of systolic function, was significantly associated with decreased odds of overall infarct (odds ratio 0.85, 95% CI0.77-0.95), but not with cortical infarction (odds ratio 0.92, 95% CI0.78-1.08). Conclusions-Among elderly participants in a large cohort study, subclinical markers of LV structure and LV systolic dysfunction were associated with increased odds of brain infarction and more white matter hyperintensities, independent of other vascular risk factors. This suggests end-organ dysfunction occurs in the heart and brain in parallel, with further studies needed to determine causality.

AB - Background-Associations between subtle changes in cardiac and cerebral structure and function are not well understood, with some studies suggesting that subclinical cardiac changes may be associated with markers of vascular brain insult. Methods and Results-Data from the ARIC (Atherosclerosis Risk in Communities) Study (5th ARIC visit; 2011-2013; N=1974) were used to explore relationships between abnormalities of cardiac structure/function and subclinical brain disease and to test specific associations between those cardiac and vascular brain changes that share a common mechanism. In adjusted models white matter hyperintensities were 0.66 cm3greater (95% confidence interval [CI] 0.08-1.25) for every 1-mm increase in left ventricular LV wall thickness and 0.64 cm3greater (95% CI 0.19-1.08) for every 10 g/m2increase in LV mass index, both markers of LV structure. Odds of brain infarction also increased with greater LV wall thickness (odds ratio 1.11, 95% CI 1.01-1.23 per 1 mm) and larger LV mass (odds ratio 1.08, 95% CI 1.00-1.17 per 10 g/m2). Higher ejection fraction (per 5%), a marker of systolic function, was significantly associated with decreased odds of overall infarct (odds ratio 0.85, 95% CI0.77-0.95), but not with cortical infarction (odds ratio 0.92, 95% CI0.78-1.08). Conclusions-Among elderly participants in a large cohort study, subclinical markers of LV structure and LV systolic dysfunction were associated with increased odds of brain infarction and more white matter hyperintensities, independent of other vascular risk factors. This suggests end-organ dysfunction occurs in the heart and brain in parallel, with further studies needed to determine causality.

KW - Brain infarction

KW - Cardiology

KW - Echocardiography

KW - White matter disease

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