Doeschka Ferro1, Hilde van den Brink2, Raquel Amier3, Mark van Buchem4, Jeroen de Bresser4, Esther Bron5, Hans-Peter Brunner-La Rocca6, Astrid Hooghiemstra7, Nick Marcks6, Albert van Rossum3, Geert Jan Biessels2. 1. Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands. Electronic address: d.a.ferro@umcutrecht.nl. 2. Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands. 3. Department of Cardiology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Science, Amsterdam, the Netherlands. 4. Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands. 5. Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands. 6. Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands. 7. Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands; Department of Medical Humanities, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Abstract
BACKGROUND: Patients with heart failure (HF) are at risk for vascular brain injury. Cerebral cortical microinfarcts (CMIs) are a novel MRI marker of vascular brain injury. This study aims to determine the occurrence of CMIs in patient with HF and their clinical correlates, including haemodynamic status. METHODS: From the Heart-Brain Study, a multicenter prospective cohort study, 154 patients with clinically stable HF without concurrent atrial fibrillation (mean age 69.5 ± 10.1, 32% female) and 124 reference participants without HF (mean age 65.6 ± 7.4, 47% females) were evaluated for CMIs on 3 T MRI. CMI presence in HF was tested for associations with vascular risk profile, cardiac function and history, MRI markers of vascular brain injury and cognitive profile. RESULTS: CMI occurrence was higher in patient with HF (17%) than reference participants (7%); after correction for age and sex OR 2.5 [95% CI 1.1-6.0] p = .032; after additional correction for vascular risk factors OR 2.7 [1.0-7.1] p = .052. In patients with HF, CMI presence was associated with office hypertension (OR 2.7 [1.2-6.5] p = .021) and a lower cardiac index (B = -0.29 [-0.55--0.04] p = .023 independent of vascular risk factors), but not with cause or duration of HF. Presence of CMIs was not associated with cognitive performance in patients with HF. CONCLUSIONS: CMIs are a common occurrence in patients with HF and related to an adverse vascular risk factor profile and severity of cardiac dysfunction. CMIs thus represent a novel marker of vascular brain injury in these patients.
BACKGROUND:Patients with heart failure (HF) are at risk for vascular brain injury. Cerebral cortical microinfarcts (CMIs) are a novel MRI marker of vascular brain injury. This study aims to determine the occurrence of CMIs in patient with HF and their clinical correlates, including haemodynamic status. METHODS: From the Heart-Brain Study, a multicenter prospective cohort study, 154 patients with clinically stable HF without concurrent atrial fibrillation (mean age 69.5 ± 10.1, 32% female) and 124 reference participants without HF (mean age 65.6 ± 7.4, 47% females) were evaluated for CMIs on 3 T MRI. CMI presence in HF was tested for associations with vascular risk profile, cardiac function and history, MRI markers of vascular brain injury and cognitive profile. RESULTS: CMI occurrence was higher in patient with HF (17%) than reference participants (7%); after correction for age and sex OR 2.5 [95% CI 1.1-6.0] p = .032; after additional correction for vascular risk factors OR 2.7 [1.0-7.1] p = .052. In patients with HF, CMI presence was associated with office hypertension (OR 2.7 [1.2-6.5] p = .021) and a lower cardiac index (B = -0.29 [-0.55--0.04] p = .023 independent of vascular risk factors), but not with cause or duration of HF. Presence of CMIs was not associated with cognitive performance in patients with HF. CONCLUSIONS: CMIs are a common occurrence in patients with HF and related to an adverse vascular risk factor profile and severity of cardiac dysfunction. CMIs thus represent a novel marker of vascular brain injury in these patients.
Authors: Bernardo Crespo Pimentel; Thies Ingwersen; Karl Georg Haeusler; Eckhard Schlemm; Nils D Forkert; Deepthi Rajashekar; Pauline Mouches; Alina Königsberg; Paulus Kirchhof; Claudia Kunze; Serdar Tütüncü; Manuel C Olma; Michael Krämer; Dominik Michalski; Andrea Kraft; Timolaos Rizos; Torsten Helberg; Sven Ehrlich; Darius G Nabavi; Joachim Röther; Ulrich Laufs; Roland Veltkamp; Peter U Heuschmann; Bastian Cheng; Matthias Endres; Götz Thomalla Journal: Eur Stroke J Date: 2022-05-25
Authors: Yu Han Koh; Leslie Z W Lew; Kyle B Franke; Adrian D Elliott; Dennis H Lau; Anand Thiyagarajah; Dominik Linz; Margaret Arstall; Phillip J Tully; Bernhard T Baune; Dian A Munawar; Rajiv Mahajan Journal: Europace Date: 2022-09-01 Impact factor: 5.486