Association Between Heart Rate and Subclinical Cerebrovascular Disease in the Elderly

Koki Nakanishi, Zhezhen Jin, Shunichi Homma, Mitchell S.V. Elkind, Tatjana Rundek, Seitetz C. Lee, Aylin Tugcu, Mitsuhiro Yoshita, Charles DeCarli, Clinton B Wright, Ralph L Sacco, Marco R. Di Tullio

Research output: Contribution to journalArticle

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Abstract

BACKGROUND AND PURPOSE: Although increased heart rate (HR) is a predictor of cardiovascular events and mortality, its possible association with subclinical cerebrovascular disease, which is prevalent in the elderly, has not been evaluated. This study aimed to investigate the association of daytime, nighttime, 24-hour HR, and HR variability with subclinical cerebrovascular disease in an elderly cohort without history of stroke.

METHODS: The study cohort consisted of 680 participants (mean age, 73±7 years; 42% men) in sinus rhythm who underwent 24-hour ambulatory blood pressure and HR monitoring, 2-dimensional echocardiography, and brain magnetic resonance imaging as part of the CABL study (Cardiac Abnormalities and Brain Lesion). Subclinical cerebrovascular disease was defined as silent brain infarcts and white matter hyperintensity volume (WMHV). The relationship of HR measures with the presence of silent brain infarct and upper quartile of log WMHV (log WMHV4) was analyzed.

RESULTS: Presence of silent brain infarct was detected in 93 participants (13.7%); mean log WMHV was -0.92±0.93 (median, -1.05; min, -5.88; max, 1.74). Multivariate analysis showed that only nighttime HR (adjusted odds ratio, 1.29 per 10 bpm; 95% confidence interval, 1.03-1.61; P=0.026) was significantly associated with log WMHV4, independent of traditional cardiovascular risk factors, ambulatory systolic blood pressure, and echocardiographic parameters. No similar association was observed for daytime HR and HR variability. There was no significant association between all HR measures and silent brain infarct.

CONCLUSIONS: In a predominantly elderly cohort, elevated nighttime HR was associated with WMHV, suggesting an independent role of HR in subclinical cerebrovascular disease.

Original languageEnglish (US)
Pages (from-to)319-324
Number of pages6
JournalStroke
Volume49
Issue number2
DOIs
StatePublished - Feb 1 2018

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Cerebrovascular Disorders
Heart Rate
Brain
Blood Pressure
Echocardiography
Cohort Studies
Multivariate Analysis
Stroke
Odds Ratio
Magnetic Resonance Imaging

Keywords

  • echocardiography
  • heart rate
  • magnetic resonance imaging
  • multivariate analysis
  • odds ratio

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Nakanishi, K., Jin, Z., Homma, S., Elkind, M. S. V., Rundek, T., Lee, S. C., ... Di Tullio, M. R. (2018). Association Between Heart Rate and Subclinical Cerebrovascular Disease in the Elderly. Stroke, 49(2), 319-324. https://doi.org/10.1161/STROKEAHA.117.019355

Association Between Heart Rate and Subclinical Cerebrovascular Disease in the Elderly. / Nakanishi, Koki; Jin, Zhezhen; Homma, Shunichi; Elkind, Mitchell S.V.; Rundek, Tatjana; Lee, Seitetz C.; Tugcu, Aylin; Yoshita, Mitsuhiro; DeCarli, Charles; Wright, Clinton B; Sacco, Ralph L; Di Tullio, Marco R.

In: Stroke, Vol. 49, No. 2, 01.02.2018, p. 319-324.

Research output: Contribution to journalArticle

Nakanishi, K, Jin, Z, Homma, S, Elkind, MSV, Rundek, T, Lee, SC, Tugcu, A, Yoshita, M, DeCarli, C, Wright, CB, Sacco, RL & Di Tullio, MR 2018, 'Association Between Heart Rate and Subclinical Cerebrovascular Disease in the Elderly', Stroke, vol. 49, no. 2, pp. 319-324. https://doi.org/10.1161/STROKEAHA.117.019355
Nakanishi, Koki ; Jin, Zhezhen ; Homma, Shunichi ; Elkind, Mitchell S.V. ; Rundek, Tatjana ; Lee, Seitetz C. ; Tugcu, Aylin ; Yoshita, Mitsuhiro ; DeCarli, Charles ; Wright, Clinton B ; Sacco, Ralph L ; Di Tullio, Marco R. / Association Between Heart Rate and Subclinical Cerebrovascular Disease in the Elderly. In: Stroke. 2018 ; Vol. 49, No. 2. pp. 319-324.
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abstract = "BACKGROUND AND PURPOSE: Although increased heart rate (HR) is a predictor of cardiovascular events and mortality, its possible association with subclinical cerebrovascular disease, which is prevalent in the elderly, has not been evaluated. This study aimed to investigate the association of daytime, nighttime, 24-hour HR, and HR variability with subclinical cerebrovascular disease in an elderly cohort without history of stroke.METHODS: The study cohort consisted of 680 participants (mean age, 73±7 years; 42{\%} men) in sinus rhythm who underwent 24-hour ambulatory blood pressure and HR monitoring, 2-dimensional echocardiography, and brain magnetic resonance imaging as part of the CABL study (Cardiac Abnormalities and Brain Lesion). Subclinical cerebrovascular disease was defined as silent brain infarcts and white matter hyperintensity volume (WMHV). The relationship of HR measures with the presence of silent brain infarct and upper quartile of log WMHV (log WMHV4) was analyzed.RESULTS: Presence of silent brain infarct was detected in 93 participants (13.7{\%}); mean log WMHV was -0.92±0.93 (median, -1.05; min, -5.88; max, 1.74). Multivariate analysis showed that only nighttime HR (adjusted odds ratio, 1.29 per 10 bpm; 95{\%} confidence interval, 1.03-1.61; P=0.026) was significantly associated with log WMHV4, independent of traditional cardiovascular risk factors, ambulatory systolic blood pressure, and echocardiographic parameters. No similar association was observed for daytime HR and HR variability. There was no significant association between all HR measures and silent brain infarct.CONCLUSIONS: In a predominantly elderly cohort, elevated nighttime HR was associated with WMHV, suggesting an independent role of HR in subclinical cerebrovascular disease.",
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AU - Lee, Seitetz C.

AU - Tugcu, Aylin

AU - Yoshita, Mitsuhiro

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KW - odds ratio

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