TY - JOUR
T1 - Cerebral cortical microinfarcts
T2 - A novel MRI marker of vascular brain injury in patients with heart failure
AU - Ferro, Doeschka
AU - van den Brink, Hilde
AU - Amier, Raquel
AU - van Buchem, Mark
AU - de Bresser, Jeroen
AU - Bron, Esther
AU - Brunner-La Rocca, Hans-Peter
AU - Hooghiemstra, Astrid
AU - Marcks, Nick
AU - van Rossum, Albert
AU - Biessels, Geert Jan
N1 - Funding Information:
Geert Jan Biessels has received funding from ZonMw, The Netherlands, Organisation for Health Research and Development (Vidi grant 917.11.384 & Vici Grant 918.16.616 ).
Funding Information:
We acknowledge the support of the Netherlands CardioVascular Research Initiative : the Dutch Heart Foundation (CVON 2018-28 & 2012-06 Heart Brain Connection), Dutch Federation of University Medical Centres , the Netherlands Organization for Health Research and Development , and the Royal Netherlands Academy of Arts and Sciences .
Publisher Copyright:
© 2020 The Authors
PY - 2020/7/1
Y1 - 2020/7/1
N2 - 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.
AB - 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.
KW - Atherosclerosis
KW - Cerebrovascular disease/stroke
KW - Cognitive impairment
KW - Embolism
KW - Heart failure
UR - http://www.scopus.com/inward/record.url?scp=85083701117&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2020.04.032
DO - 10.1016/j.ijcard.2020.04.032
M3 - Article
C2 - 32331904
SN - 0167-5273
VL - 310
SP - 96
EP - 102
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -