From the The Johns Hopkins University School of Medicine, Baltimore, MD (M.C.J., D.F.W., R.F.G.).
University of Mississippi Medical Center, Jackson, MS (T.H.M.).
Stroke. 2019 Dec;50(12):3622-3624. doi: 10.1161/STROKEAHA.119.027220. Epub 2019 Oct 10.
Background and Purpose- Cardiovascular disease is a known risk factor for cognitive decline, although the mechanisms remain unclear. We hypothesize that Aβ (β-amyloid), a core pathology of Alzheimer's disease, will be associated with subclinical cardiac structure and function echocardiogram indices. Methods- Three hundred six nondemented participants from the ARIC study (Atherosclerosis Risk in Communities Study) underwent florbetapir positron emission tomography and 2D echocardiography (echo). Cross-sectional associations between echo markers of left ventricular structure and function and global cortical Aβ (≥1.2 standardized uptake value ratio were evaluated using multivariable logistic regression with interaction terms when appropriate. Results- Participants ranged in age from 67 to 88 years, were 57% female and 42% black. Per 1 cm increase in end-diastolic left ventricular diameter, the odds of elevated florbetapir standardized uptake value ratio doubled (odds ratio, 2.04 [95% CI, 1.10-3.77]), with similar findings when excluding mild cognitive impairment (odds ratio, 2.61 [95% CI, 1.22-5.59]). Conclusions- We have demonstrated a significant association between a marker of left ventricular structure and elevated florbetapir standardized uptake value ratio, identified using positron emission tomography. Ongoing prospective work will help determine if changes in cardiac structure and function either precede, or occur simultaneously with deposition of amyloid.
背景与目的-心血管疾病是认知能力下降的已知危险因素，尽管其机制尚不清楚。我们假设阿尔茨海默病的核心病理学 Aβ（β-淀粉样蛋白）与亚临床心脏结构和功能超声心动图指标有关。方法-来自 ARIC 研究（社区动脉粥样硬化风险研究）的 306 名非痴呆参与者接受了 florbetapir 正电子发射断层扫描和 2D 超声心动图（echo）检查。使用多变量逻辑回归评估了左心室结构和功能的超声心动图标志物与全皮质 Aβ（≥1.2 标准化摄取比值之间的横断面关联，并在适当情况下使用交互项。结果-参与者年龄在 67 岁至 88 岁之间，女性占 57%，黑人占 42%。舒张末期左心室直径每增加 1 厘米，高 florbetapir 标准化摄取比值的几率增加一倍（优势比，2.04 [95%CI，1.10-3.77]），排除轻度认知障碍后也有类似的发现（优势比，2.61 [95%CI，1.22-5.59]）。结论-我们已经证明了左心室结构标志物与正电子发射断层扫描中使用的 florbetapir 标准化摄取比值升高之间存在显著关联。正在进行的前瞻性研究将有助于确定心脏结构和功能的变化是先于淀粉样蛋白沉积发生，还是与淀粉样蛋白沉积同时发生。
