Abstract
BACKGROUND-: Silent brain infarcts (SBIs) and white matter hyperintensities are subclinical cerebrovascular lesions associated with incident stroke and cognitive decline. Left ventricular ejection fraction (LVEF) is a predictor of stroke in patients with heart failure, but its association with subclinical brain disease in the general population is unknown. Left ventricular global longitudinal strain (GLS) can detect subclinical cardiac dysfunction even when LVEF is normal. We investigated the relationship of LVEF and GLS with subclinical brain disease in a community-based cohort. METHODS AND RESULTS-: LVEF and GLS were assessed by 2-dimensional and speckle-tracking echocardiography in 439 participants free of stroke and cardiac disease from the Cardiovascular Abnormalities and Brain Lesions (CABL) study. SBIs and white matter hyperintensities were assessed by brain MRI. Mean age of the study population was 69±10 years, 61% were women, LVEF was 63.8±6.4%, GLS was-17.1±3.0%. SBIs were detected in 53 participants (12%), white matter hyperintensity volume was 0.63±0.86%. GLS was significantly lower in participants with SBI versus those without (-15.7±3.5% versus-17.3±2.9%, P<0.01), whereas no difference in LVEF was observed (63.3±8.6% versus 63.8±6.0%, P=0.60). In multivariate analysis, lower GLS was associated with SBI (odds ratio/unit decrease=1.18; 95% confidence interval, 1.05-1.33; P<0.01), whereas LVEF was not (odds ratio/unit increase=1.00; 95% confidence interval, 0.96-1.05; P=0.98). Lower GLS was associated with greater white matter hyperintensity volume (adjusted β=0.11, P<0.05), unlike LVEF (adjusted β=-0.04, P=0.42). CONCLUSIONS-: Lower GLS was independently associated with subclinical brain disease in a community-based cohort without overt cardiac disease. GLS can provide additional information on cerebrovascular risk burden beyond LVEF assessment.
| Original language | English |
|---|---|
| Pages (from-to) | 1105-1111 |
| Number of pages | 7 |
| Journal | Circulation |
| Volume | 128 |
| Issue number | 10 |
| DOIs | |
| State | Published - Sep 3 2013 |
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Keywords
- brain infarction
- echocardiography
- global longitudinal strain
- magnetic resonance imaging
- speckle-tracking
- ventricular ejection fraction
- white matter diseases
ASJC Scopus subject areas
- Physiology (medical)
- Cardiology and Cardiovascular Medicine
Cite this
Subclinical left ventricular dysfunction and silent cerebrovascular disease : The cardiovascular abnormalities and brain lesions (CABL) study. / Russo, Cesare; Jin, Zhezhen; Homma, Shunichi; Elkind, Mitchell S V; Rundek, Tatjana; Yoshita, Mitsuhiro; Decarli, Charles; Wright, Clinton B; Sacco, Ralph L; Di Tullio, Marco R.
In: Circulation, Vol. 128, No. 10, 03.09.2013, p. 1105-1111.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Subclinical left ventricular dysfunction and silent cerebrovascular disease
T2 - The cardiovascular abnormalities and brain lesions (CABL) study
AU - Russo, Cesare
AU - Jin, Zhezhen
AU - Homma, Shunichi
AU - Elkind, Mitchell S V
AU - Rundek, Tatjana
AU - Yoshita, Mitsuhiro
AU - Decarli, Charles
AU - Wright, Clinton B
AU - Sacco, Ralph L
AU - Di Tullio, Marco R.
PY - 2013/9/3
Y1 - 2013/9/3
N2 - BACKGROUND-: Silent brain infarcts (SBIs) and white matter hyperintensities are subclinical cerebrovascular lesions associated with incident stroke and cognitive decline. Left ventricular ejection fraction (LVEF) is a predictor of stroke in patients with heart failure, but its association with subclinical brain disease in the general population is unknown. Left ventricular global longitudinal strain (GLS) can detect subclinical cardiac dysfunction even when LVEF is normal. We investigated the relationship of LVEF and GLS with subclinical brain disease in a community-based cohort. METHODS AND RESULTS-: LVEF and GLS were assessed by 2-dimensional and speckle-tracking echocardiography in 439 participants free of stroke and cardiac disease from the Cardiovascular Abnormalities and Brain Lesions (CABL) study. SBIs and white matter hyperintensities were assessed by brain MRI. Mean age of the study population was 69±10 years, 61% were women, LVEF was 63.8±6.4%, GLS was-17.1±3.0%. SBIs were detected in 53 participants (12%), white matter hyperintensity volume was 0.63±0.86%. GLS was significantly lower in participants with SBI versus those without (-15.7±3.5% versus-17.3±2.9%, P<0.01), whereas no difference in LVEF was observed (63.3±8.6% versus 63.8±6.0%, P=0.60). In multivariate analysis, lower GLS was associated with SBI (odds ratio/unit decrease=1.18; 95% confidence interval, 1.05-1.33; P<0.01), whereas LVEF was not (odds ratio/unit increase=1.00; 95% confidence interval, 0.96-1.05; P=0.98). Lower GLS was associated with greater white matter hyperintensity volume (adjusted β=0.11, P<0.05), unlike LVEF (adjusted β=-0.04, P=0.42). CONCLUSIONS-: Lower GLS was independently associated with subclinical brain disease in a community-based cohort without overt cardiac disease. GLS can provide additional information on cerebrovascular risk burden beyond LVEF assessment.
AB - BACKGROUND-: Silent brain infarcts (SBIs) and white matter hyperintensities are subclinical cerebrovascular lesions associated with incident stroke and cognitive decline. Left ventricular ejection fraction (LVEF) is a predictor of stroke in patients with heart failure, but its association with subclinical brain disease in the general population is unknown. Left ventricular global longitudinal strain (GLS) can detect subclinical cardiac dysfunction even when LVEF is normal. We investigated the relationship of LVEF and GLS with subclinical brain disease in a community-based cohort. METHODS AND RESULTS-: LVEF and GLS were assessed by 2-dimensional and speckle-tracking echocardiography in 439 participants free of stroke and cardiac disease from the Cardiovascular Abnormalities and Brain Lesions (CABL) study. SBIs and white matter hyperintensities were assessed by brain MRI. Mean age of the study population was 69±10 years, 61% were women, LVEF was 63.8±6.4%, GLS was-17.1±3.0%. SBIs were detected in 53 participants (12%), white matter hyperintensity volume was 0.63±0.86%. GLS was significantly lower in participants with SBI versus those without (-15.7±3.5% versus-17.3±2.9%, P<0.01), whereas no difference in LVEF was observed (63.3±8.6% versus 63.8±6.0%, P=0.60). In multivariate analysis, lower GLS was associated with SBI (odds ratio/unit decrease=1.18; 95% confidence interval, 1.05-1.33; P<0.01), whereas LVEF was not (odds ratio/unit increase=1.00; 95% confidence interval, 0.96-1.05; P=0.98). Lower GLS was associated with greater white matter hyperintensity volume (adjusted β=0.11, P<0.05), unlike LVEF (adjusted β=-0.04, P=0.42). CONCLUSIONS-: Lower GLS was independently associated with subclinical brain disease in a community-based cohort without overt cardiac disease. GLS can provide additional information on cerebrovascular risk burden beyond LVEF assessment.
KW - brain infarction
KW - echocardiography
KW - global longitudinal strain
KW - magnetic resonance imaging
KW - speckle-tracking
KW - ventricular ejection fraction
KW - white matter diseases
UR - http://www.scopus.com/inward/record.url?scp=84883606787&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84883606787&partnerID=8YFLogxK
U2 - 10.1161/CIRCULATIONAHA.113.001984
DO - 10.1161/CIRCULATIONAHA.113.001984
M3 - Article
C2 - 23902759
AN - SCOPUS:84883606787
VL - 128
SP - 1105
EP - 1111
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 10
ER -