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Giacona JM, Chia R, Kositanurit W, Wang J, Ayers C, Pandey A, Kozlitina J, Drazner MH, Garg S, de Lemos JA, Zhang R, Hajjar I, Yu FF, Lacritz L, Vongpatanasin W. Associations Between Cardiac Function and Brain Health in Diverse Middle-Aged Adults: The Dallas Heart Study-2. JACC. ADVANCES 2024; 3:100777. [PMID: 38939405 PMCID: PMC11198548 DOI: 10.1016/j.jacadv.2023.100777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/26/2023] [Accepted: 10/09/2023] [Indexed: 06/29/2024]
Abstract
Background Previous studies have linked cardiovascular risk factors during midlife to cognitive function in later life. However, few studies have looked at the association between cardiac function, brain structure, and cognitive function and even less have included diverse middle-aged populations. Objectives The objective of this study was to determine associations between cardiac and brain structure and function in a multiethnic cohort of middle-aged adults. Methods A cross-sectional study was conducted in participants of the Dallas Heart Study phase 2 (N = 1,919; 46% Black participants). Left ventricular (LV) mass, LV ejection fraction, LV concentricity, and peak systolic strain (LV Ecc) were assessed by cardiac magnetic resonance imaging. White matter hyperintensities (WMH) volume was measured by fluid attenuated inversion recovery magnetic resonance imaging. The Montreal Cognitive Assessment was used to measure cognitive functioning. Associations between cardiac and brain measures were determined using multivariable linear regression after adjusting for cardiovascular risk factors, education level, and physical activity. Results LV ejection fraction was associated with total Montreal Cognitive Assessment score (β = 0.06 [95% CI: 0.003-0.12], P = 0.042) and LV Ecc was associated with WMH volume (β = 0.08 [95% CI: 0.01-0.14], P = 0.025) in the overall cohort without significant interaction by race/ethnicity. Higher LV mass and concentricity were associated with larger WMH volume in the overall cohort (β = 0.13 [95% CI: 0.03-0.23], P = 0.008 and 0.10 [95% CI: 0.03-0.17], P = 0.005). These associations were more predominant in Black than White participants (β = 0.17 [95% CI: 0.04-0.30] vs β = -0.009 [95% CI: -0.16 to 0.14], P = 0.036 and β = 0.22 [95% CI: 0.13-0.32] vs β = -0.11 [95% CI: -0.21 to -0.01], P < 0.0001, for LV mass and concentricity, respectively). Conclusions Subclinical cardiac dysfunction indicated by LVEF was associated with lower cognitive function. Moreover, LV mass and concentric remodeling were associated with higher WMH burden, particularly among Black individuals.
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Affiliation(s)
- John M. Giacona
- Hypertension Section, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ricardo Chia
- Hypertension Section, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Weerapat Kositanurit
- Hypertension Section, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Jijia Wang
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Colby Ayers
- Cardiology Division, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ambarish Pandey
- Cardiology Division, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Julia Kozlitina
- Eugene McDermott Center for Human Growth and Development, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Mark H. Drazner
- Cardiology Division, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Sonia Garg
- Cardiology Division, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - James A. de Lemos
- Cardiology Division, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Rong Zhang
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ihab Hajjar
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Frank F. Yu
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Laura Lacritz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Wanpen Vongpatanasin
- Hypertension Section, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Cardiology Division, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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