Association of left atrial function with vascular brain injury: The Atherosclerosis Risk in Communities study
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND AND PURPOSE: Lower left atrial (LA) function is associated with higher dementia risk and may be mechanistically linked through vascular brain injury, an established correlate for higher dementia risk. Using data from the Atherosclerosis Risk in Communities study, we assessed the cross-sectional association between LA function and brain magnetic resonance imaging (MRI) markers of vascular brain injury. METHODS: We included 1488 participants who were free of prevalent dementia, stroke, or atrial fibrillation and who underwent a two-dimensional echocardiogram and brain MRI in 2011-2013 (mean [± standard deviation] age 76 [± 5] years, 60% female, 27% Black). LA function measures (reservoir, conduit, contractile strain) were assessed in quartiles. Brain MRI measures included cerebral microbleeds, brain infarcts, and white matter hyperintensity (WMH) volume. Logistic regression was used for dichotomous outcomes. Linear regression was used for WMH volume. RESULTS: Overall, 343 (23%) and 344 participants (23%) had ≥1 cerebral microbleed or brain infarct. After multivariable adjustments, the lowest LA reservoir and conduit strain quartiles (vs. highest quartile) were associated with higher odds of the presence of ≥1 cerebral microbleed (odds ratios [95% confidence intervals] 1.78 [1.42-2.22] and 1.52 [1.22-1.90]). Compared to the highest quartile, participants in the lowest LA conduit strain quartile had 1.51 (95% confidence interval 1.22-1.88) times higher odds of having ≥1 brain infarct. Lower LA contractile strain was associated with lower odds of brain infarcts. No association with WMH volume was noted. CONCLUSIONS: We found that LA reservoir and conduit strain were associated with cerebral microbleeds and brain infarcts. Lower LA function may be linked to dementia risk via vascular brain injury. Prospective studies are needed to confirm these findings.
Source: European Journal of Neurology
DOI: 10.1111/ene.16549
Institutions: University of Minnesota, University of Brescia, University of Mississippi Medical Center, Johns Hopkins University, National Institutes of Health, National Institute of Neurological Disorders and Stroke, Emory University, Mayo Clinic, Brigham and Women's Hospital, The University of Texas Southwestern Medical Center, University of Maryland, Baltimore
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,600
Awards: G124418500, G1518371162, G1828190173, G184039327, G1924893021, G2339050794, G2652246403, G4750455369, G4819198047, G506570908, G5267790454, G6105589124, G6265038979, Quantifying cardiac structure and function to define the progression to hear failure in African Americans, G6297408039, G6418484092, G6655280461, G6978868085, G716842120, G7243995979, G7276788223, G7326783851, Effect of an Intensive Lifestyle Intervention on the Atrial Fibrillation Substrate, G7579802118, G9000013083, G9000013532, G9000015778, G9000025134, G9000026189, G9000108744, G9000119724, Glucose patterns and cardiac arrhythmias in older adults with diabetes, G912335575, Proteomic signatures to identify pathways underlying the progression to heart failure
OpenAlex ID: W4404594638