Objective: To study the associations of comprehensive measures of cardiac structure and function with multidimensional neurocognitive measures.
Patients and methods: The Echocardiographic Study of Latinos is a population-based cohort of Hispanic/Latino adults older than 45 years enrolled from October 1, 2011, through June 30, 2014. Neurocognitive measures included Word Fluency (WF), Brief-Spanish English Verbal Learning Test (B-SEVLT), and Digit Symbol Substitution Test. The B-SEVLT included B-SEVLT-recall and B-SEVLT-sum. Echocardiographic measures included cardiac structure, systolic and diastolic function, and myocardial strain. Multivariable regression models were fit using survey statistics and sampling probabilities.
Results: A total of 1794 participants (mean age, 56±0.5 years; 56% women) were included in the analysis. In the adjusted model, higher left ventricular mass index was associated with lower B-SEVLT-sum and Digit Symbol Substitution Test scores. Left ventricular systolic dysfunction was associated with lower WF scores. Abnormal left ventricular geometry was associated with lower B-SEVLT-sum scores. Higher relative wall thickness was associated with B-SEVLT-recall and B-SEVLT-sum scores. Mitral annular relaxation velocities were associated with lower B-SEVLT-recall, B-SEVLT-sum, and WF scores. Higher mitral inflow to annular early diastolic velocity ratio was associated with lower B-SEVLT-recall and B-SEVLT-sum scores. Diastolic dysfunction was associated with lower B-SEVLT-sum scores. Finally, lower global longitudinal strain was associated with lower WF scores.
Conclusion: Alterations in cardiac structure, systolic and diastolic function, and myocardial strain were associated with worse neurocognitive function. Further study is needed to determine the mechanisms (ie, impairment of cerebral flow and silent brain infarctions) mediating these heart-brain associations.
Keywords: B-SEVLT, Brief-Spanish English Verbal Learning Test; BMI, body mass index; CVH, cardiovascular health; DSST, Digit Symbol Substitution Test; E/e′ ratio, ratio of the early mitral inflow velocity to the mitral annular early diastolic velocity; ECHO-SOL, Echocardiographic Study of Latinos; EF, ejection fraction; GLS, global longitudinal strain; HCHS/SOL, Hispanic Community Health Study/Study of Latinos; LA, left atrial; LAVI, left atrial volume index; LV, left ventricular; LVESV, left ventricular end-systolic volume; LVMI, left ventricular mass index; RWT, relative wall thickness; SIS, Six-Item Screener; S′, peak systolic annular velocity; WF, Word Fluency; e′, mitral annular early diastolic velocity.