Left Ventricular Hypertrophy and Remodeling and Risk of Cognitive Impairment and Dementia: MESA (Multi-Ethnic Study of Atherosclerosis).
Left Ventricular Hypertrophy and Remodeling and Risk of Cognitive Impairment and Dementia: MESA (Multi-Ethnic Study of Atherosclerosis).
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DOI：
10.1161/hypertensionaha.117.10289
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发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Lima JAC
中科院分区：
文献类型：
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作者：
Moazzami K;Ostovaneh MR;Ambale Venkatesh B;Habibi M;Yoneyama K;Wu C;Liu K;Pimenta I;Fitzpatrick A;Shea S;McClelland RL;Heckbert S;Gottesman RF;Bluemke DA;Hughes TM;Lima JAC
在基线时无临床确认的心血管疾病的大型人群中，关于左心室结构和功能与未来认知障碍和痴呆之间的纵向关联的信息有限。本研究的目的是探讨动脉粥样硬化队列多种族研究中心脏结构和功能与痴呆和认知障碍风险之间的关系。在基线时使用磁共振成像对4，999名无临床诊断的心血管疾病和痴呆的参与者进行了左心室结构和功能的测量。从住院出院记录中确定可能的临床痴呆事件。认知功能的评估使用的测试解决全球认知功能，处理速度和记忆。采用考克斯比例风险回归模型评估左心室结构和功能指标与临床诊断的痴呆发生率和认知能力的相关性，该模型调整了人口统计学、心血管危险因素和心血管事件。在12年的中位随访期间，记录了130例可能的痴呆事件。较高的左心室质量指数（HR 1.01，95%CI 1.00-1.02）和左心室质量体积比（HR 2.37，95%CI 1.25-4.43）与痴呆事件以及认知功能受损独立相关。左心室功能的测量与痴呆或认知障碍的风险无关。总之，在一个多种族队列的参与者没有临床检测到的心血管疾病和痴呆的基线，左心室肥大和向心性重塑独立相关的事件痴呆和认知功能障碍。
Limited information exists regarding the longitudinal association between the left ventricular structure and fucntion and future cognitive impairment and dementia in a large population without clinically recognized cardiovascular disease at baseline. The aim of the present study was to investigate the association between cardiac structure and function and risk of dementia and cognitive impairment in the Multi-Ethnic Study of Atherosclerosis cohort. Measures of left ventricular structure and function were determined using magnetic resonance imaging at baseline in 4,999 participants free of clinically diagnosed cardiovascular disease and dementia. Probable incident clinical dementia was ascertained from hospitalization discharge records. Cognitive function was evaluated using tests addressing global cognitive function, processing speed, and memory. Associations of measures of left ventricular structure and function with the incidence of clinically diagnosed dementia and cognitive performance were evaluated using Cox proportional hazard regression models adjusted for demographics, cardiovascular risk factors, and cardiovascular events. During a median follow-up of 12 years, 130 probable incident dementia cases were documented. Higher left ventricular mass index (HR 1.01, 95%CI 1.00–1.02), and LV mass to volume ratio (HR 2.37, 95%CI 1.25–4.43) were independently associated with incident dementia, as well as impaired cognitive function. Measures of left ventricular function were not associated with risk of dementia or cognitive impairment. In conclusion, in a multiethnic cohort of participants without clinically detected cardiovascular disease and dementia at baseline, left ventricular hypertrophy and concentric remodeling were independently associated with incident dementia and cognitive impairment.