P103 Heart failure with preserved ejection fruction defines the progression of abnormal brain aging: a prospective study of young-old hypertensive patients. (13th January 2020)

• Record Type: Journal Article
• Authors: Nomoto, K; Kawashima, K; Hirashiki, A; Kokubo, M; Shimizu, A; Arai, H; Toba, K; Murohara, T
• Is Part Of: European heart journal. Volume 41:(2020)Supplement 1
• Publication Date: 2020-01-13
• Subjects: Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/ehjci/ehz872.047
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Funding Acknowledgements: Ministry of Health, Labor and Welfare (MHLW) Geriatrics and Gelontorogy sponsored research funds Background & purpose: Recently, many longitudinal studies have shown that heart failure with reduced ejection fraction (HFrEF) is associated with various types of brain abnormalities: cerebral micro-bleeding, atrophy, or pathologic degeneration (white matter hyperintensity; WMH). These brain abnormalities are known to increase with aging and to be closely associated with cognitive impairment. Heart failure with preserved ejection fraction (HFpEF) also increases with aging, but there have been few longitudinal studies to address the relationship between HFpEF and brain abnormalities. Thus, this longitudinal study aimed to clarify this relationship by focusing on WMH volume. METHODS: The participants were 111 well-controlled hypertensive patients aged between 65 and 75 years with normal LV contraction and no history of symptomatic heart failure, ischemic heart disease, atrial fibrillation, stroke, or cognitive dysfunction. The participants were classified into 3 groups: Low E/e", E/e" < 8; Middle E/e", 8≤ E/e" ≤ 15; and High E/e", E/e" > 15. WMH volume was quantified on brain magnetic resonance imaging using analytical software. RESULTS: During the mean 2.6 ± 1.0-year follow-up period, the rate of increase of WMH volume was significantly higher in the high E/e" group (1.1 ± 1.2 mL/year) than in the low E/e" group (0.30 ± 0.78 mL/year; P = 0.0238). Linear regression analysis including other confounders showed that the only positive association was between the rate of increase of WMH volume and the E/e" ratio (beta- coefficient = 0.225, P = 0.018). CONCLUSION: The severity of LV diastolic dysfunction is positively correlated with increasing WMH volume.