Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK.
Eur Heart J Cardiovasc Imaging. 2022 Apr 18;23(5):663-672. doi: 10.1093/ehjci/jeab075.
Existing evidence suggests links between brain and cardiovascular health. We investigated associations between cognitive performance and cardiovascular magnetic resonance (CMR) phenotypes in the UK Biobank, considering a range of potential confounders.
We studied 29 763 participants with CMR and cognitive testing, specifically, fluid intelligence (FI, 13 verbal-numeric reasoning questions), and reaction time (RT, a timed pairs matching exercise); both were considered continuous variables for modelling. We included the following CMR metrics: left and right ventricular (LV and RV) volumes in end-diastole and end-systole, LV/RV ejection fractions, LV/RV stroke volumes, LV mass, and aortic distensibility. Multivariable linear regression models were used to estimate the association of each CMR measure with FI and RT, adjusting for age, sex, smoking, education, deprivation, diabetes, hypertension, high cholesterol, prior myocardial infarction, alcohol intake, and exercise level. We report standardized beta-coefficients, 95% confidence intervals, and P-values adjusted for multiple testing. In this predominantly healthy cohort (average age 63.0 ± 7.5 years), better cognitive performance (higher FI, lower RT) was associated with larger LV/RV volumes, higher LV/RV stroke volumes, greater LV mass, and greater aortic distensibility in fully adjusted models. There was some evidence of non-linearity in the relationship between FI and LV end-systolic volume, with reversal of the direction of association at very high volumes. Associations were consistent for men and women and in different ages.
Better cognitive performance is associated with CMR measures likely representing a healthier cardiovascular phenotype. These relationships remained significant after adjustment for a range of cardiometabolic, lifestyle, and demographic factors, suggesting possible involvement of alternative disease mechanisms.
现有证据表明大脑和心血管健康之间存在关联。我们在英国生物库中调查了认知表现与心血管磁共振（CMR）表型之间的关联，考虑了一系列潜在的混杂因素。
我们研究了 29763 名接受 CMR 和认知测试的参与者，具体来说，是流体智力（FI，13 个言语-数字推理问题）和反应时间（RT，一项定时配对匹配练习）；这两者都被视为建模的连续变量。我们包括以下 CMR 指标：舒张末期和收缩末期的左心室和右心室（LV 和 RV）容积、LV/RV 射血分数、LV/RV 心搏量、LV 质量和主动脉顺应性。多变量线性回归模型用于估计每个 CMR 指标与 FI 和 RT 的关联，调整了年龄、性别、吸烟、教育、贫困、糖尿病、高血压、高胆固醇、既往心肌梗死、饮酒和运动水平。我们报告了标准化β系数、95%置信区间和 P 值，这些值经过了多次测试调整。在这个主要由健康人群组成的队列中（平均年龄 63.0±7.5 岁），更好的认知表现（FI 更高，RT 更低）与完全调整后的模型中更大的 LV/RV 容积、更高的 LV/RV 心搏量、更大的 LV 质量和更大的主动脉顺应性相关。FI 与 LV 收缩末期容积之间的关系存在一定的非线性，在体积非常高时，关联的方向发生逆转。这些关联在男性和女性以及不同年龄组中都是一致的。
更好的认知表现与 CMR 测量值相关，这些测量值可能代表更健康的心血管表型。在调整了一系列心血管代谢、生活方式和人口统计学因素后，这些关系仍然显著，这表明可能涉及替代的疾病机制。
