TY - JOUR
T1 - Lower cardiac index levels relate To lower cerebral blood flow in older adults
AU - Jefferson, Angela L.
AU - Liu, Dandan
AU - Gupta, Deepak K.
AU - Pechman, Imberly R.
AU - Watchmaker, Jennifer M.
AU - Gordon, Elizabeth A.
AU - Rane, Swati
AU - Bell, Susan P.
AU - Mendes, Lisa A.
AU - Davis, L. Taylor
AU - Gifford, Katherine A.
AU - Hohman, Timothy J.
AU - Wang, Thomas J.
AU - Donahue, Manus J.
N1 - Funding Information:
This research was supported by Alzheimer’s Association IIRG-08-88733 (A.L.J.), R01-AG034962 (A.L.J.), R01-NS100980 (A.L.J.), K24-AG046373 (A.L.J.), Paul B. Beeson Career Development Award in Aging K23-AG045966 (K.A.G.), Paul B. Beeson Career Development Award in Aging K23-AG048347 (S.P.B.), K12-HD043483 (K.A.G., S.P.B., T.J.H.), K01-AG049164 (T.J.H.), K12-HL109019 (D.K.G.), R01-NS078828 (M.J.D.), R01-NS097763 (M.J.D.), American Heart Association 14GRNT20150004 (M.J.D.), UL1-TR000445 (Vanderbilt Clinical Translational Science Award), and the Vanderbilt Memory & Alzheimer’s Center.
Publisher Copyright:
© 2017 American Academy of Neurology. Unauthorized reproduction of this article is prohibited.
PY - 2017/12
Y1 - 2017/12
N2 - Objective: To assess cross-sectionally whether lower cardiac index relates to lower resting cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) among older adults. Methods: Vanderbilt Memory and Aging Project participants free of stroke, dementia, and heart failure were studied (n = 314, age 73 ± 7 years, 59% male, 39% with mild cognitive impairment). Cardiac index (liters per minute per meter squared) was quantified from echocardiography. Resting CBF (milliliters per 100 grams per minute) and hypercapnia-induced CVR were quantified from pseudo-continuous arterial spin-labeling MRI. Linear regressions with ordinary least-square estimates related cardiac index to regional CBF, with adjustment for age, education, race/ethnicity, Framingham Stroke Risk Profile score (systolic blood pressure, antihypertensive medication use, diabetes mellitus, current cigarette smoking, left ventricular hypertrophy, prevalent cardiovascular disease [CVD], atrial fibrillation), APOE ϵ4 status, cognitive diagnosis, and regional tissue volume. Results: Lower cardiac index corresponded to lower resting CBF in the left (β = 2.4, p = 0.001) and right (β = 2.5, p = 0.001) temporal lobes. Results were similar when participants with prevalent CVD and atrial fibrillation were excluded (left temporal lobe β = 2.3, p = 0.003; right temporal lobe β = 2.5, p = 0.003). Cardiac index was unrelated to CBF in other regions assessed (p > 0.25) and CVR in all regions (p > 0.05). In secondary cardiac index × cognitive diagnosis interaction models, cardiac index and CBF associations were present only in cognitively normal participants and affected a majority of regions assessed with effects strongest in the left (p < 0.0001) and right (p < 0.0001) temporal lobes. Conclusions: Among older adults without stroke, dementia, or heart failure, systemic blood flow correlates with cerebral CBF in the temporal lobe, independently of prevalent CVD, but not CVR.
AB - Objective: To assess cross-sectionally whether lower cardiac index relates to lower resting cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) among older adults. Methods: Vanderbilt Memory and Aging Project participants free of stroke, dementia, and heart failure were studied (n = 314, age 73 ± 7 years, 59% male, 39% with mild cognitive impairment). Cardiac index (liters per minute per meter squared) was quantified from echocardiography. Resting CBF (milliliters per 100 grams per minute) and hypercapnia-induced CVR were quantified from pseudo-continuous arterial spin-labeling MRI. Linear regressions with ordinary least-square estimates related cardiac index to regional CBF, with adjustment for age, education, race/ethnicity, Framingham Stroke Risk Profile score (systolic blood pressure, antihypertensive medication use, diabetes mellitus, current cigarette smoking, left ventricular hypertrophy, prevalent cardiovascular disease [CVD], atrial fibrillation), APOE ϵ4 status, cognitive diagnosis, and regional tissue volume. Results: Lower cardiac index corresponded to lower resting CBF in the left (β = 2.4, p = 0.001) and right (β = 2.5, p = 0.001) temporal lobes. Results were similar when participants with prevalent CVD and atrial fibrillation were excluded (left temporal lobe β = 2.3, p = 0.003; right temporal lobe β = 2.5, p = 0.003). Cardiac index was unrelated to CBF in other regions assessed (p > 0.25) and CVR in all regions (p > 0.05). In secondary cardiac index × cognitive diagnosis interaction models, cardiac index and CBF associations were present only in cognitively normal participants and affected a majority of regions assessed with effects strongest in the left (p < 0.0001) and right (p < 0.0001) temporal lobes. Conclusions: Among older adults without stroke, dementia, or heart failure, systemic blood flow correlates with cerebral CBF in the temporal lobe, independently of prevalent CVD, but not CVR.
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U2 - 10.1212/WNL.0000000000004707
DO - 10.1212/WNL.0000000000004707
M3 - Article
C2 - 29117962
AN - SCOPUS:85038265360
SN - 0028-3878
VL - 89
SP - 2327
EP - 2334
JO - Neurology
JF - Neurology
IS - 23
ER -