Lower Cardiac Output is Associated with Greater White Matter Hyperintensities in Older Adults with Cardiovascular Disease

Overview

Journal J Am Geriatr Soc

Specialty Geriatrics

Date 2007 Jul 5

PMID 17608877

Citations 63

Authors

Angela L Jefferson

David F Tate

Athena Poppas

Adam M Brickman

Robert H Paul

John Gunstad

Ronald A Cohen

Affiliations

Soon will be listed here.

Abstract

Objectives: To preliminarily examine the association between cardiac output, a measure of systemic blood flow, and structural brain magnetic resonance imaging indices of white matter hyperintensities (WMHs).

Design: Cross-sectional.

Setting: University medical setting.

Participants: Thirty-six older adults without dementia with prevalent cardiovascular disease (aged 56-85).

Measurements: Cardiac output, WMHs.

Results: Partial correlations, adjusting for age and history of hypertension, yielded an inverse relationship between WMHs adjacent to subcortical nuclei and cardiac output (correlation coefficient=-0.48, P=.03); as cardiac output decreased, WMHs increased significantly. No significant associations were found between cardiac output and total WMHs or periventricular WMHs.

Conclusion: These preliminary data suggest that systemic blood flow, measured according to cardiac output, is inversely associated with WMHs adjacent to the subcortical nuclei. Cerebrovascular degeneration and the chronicity of hypoperfusion may exacerbate the susceptibility of white matter integrity to alterations in blood flow in older adults.

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References

de Leeuw F, de Groot J, Oudkerk M, Witteman J, Hofman A, van Gijn J . Aortic atherosclerosis at middle age predicts cerebral white matter lesions in the elderly. Stroke. 2000; 31(2):425-9. DOI: 10.1161/01.str.31.2.425. View

de Groot J, de Leeuw F, Oudkerk M, van Gijn J, Hofman A, Jolles J . Cerebral white matter lesions and cognitive function: the Rotterdam Scan Study. Ann Neurol. 2000; 47(2):145-51. DOI: 10.1002/1531-8249(200002)47:2<145::aid-ana3>3.3.co;2-g. View

Raz N . The cognitive correlates of white matter abnormalities in normal aging: a quantitative review. Neuropsychology. 2000; 14(2):224-32. DOI: 10.1037//0894-4105.14.2.224. View

de Leeuw F, de Groot J, Oudkerk M, Kors J, Hofman A, van Gijn J . Atrial fibrillation and the risk of cerebral white matter lesions. Neurology. 2000; 54(9):1795-801. DOI: 10.1212/wnl.54.9.1795. View

Takahashi W, Takagi S, Ide M, Shohtsu A, Shinohara Y . Reduced cerebral glucose metabolism in subjects with incidental hyperintensities on magnetic resonance imaging. J Neurol Sci. 2000; 176(1):21-7. DOI: 10.1016/s0022-510x(00)00286-0. View

de Leeuw F, de Groot J, Oudkerk M, Witteman J, Hofman A, van Gijn J . Hypertension and cerebral white matter lesions in a prospective cohort study. Brain. 2002; 125(Pt 4):765-72. DOI: 10.1093/brain/awf077. View

Marstrand J, Garde E, Rostrup E, Ring P, ROSENBAUM S, Mortensen E . Cerebral perfusion and cerebrovascular reactivity are reduced in white matter hyperintensities. Stroke. 2002; 33(4):972-6. DOI: 10.1161/01.str.0000012808.81667.4b. View

Shibata M, Ohtani R, Ihara M, Tomimoto H . White matter lesions and glial activation in a novel mouse model of chronic cerebral hypoperfusion. Stroke. 2004; 35(11):2598-603. DOI: 10.1161/01.STR.0000143725.19053.60. View

Folstein M, Folstein S, McHugh P . "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3):189-98. DOI: 10.1016/0022-3956(75)90026-6. View

10.

Alexander G, DeLong M, Strick P . Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annu Rev Neurosci. 1986; 9:357-81. DOI: 10.1146/annurev.ne.09.030186.002041. View

11.

Kertesz A, Black S, Tokar G, Benke T, Carr T, Nicholson L . Periventricular and subcortical hyperintensities on magnetic resonance imaging. 'Rims, caps, and unidentified bright objects'. Arch Neurol. 1988; 45(4):404-8. DOI: 10.1001/archneur.1988.00520280050015. View

12.

Kozachuk W, DeCarli C, Schapiro M, Wagner E, Rapoport S, Horwitz B . White matter hyperintensities in dementia of Alzheimer's type and in healthy subjects without cerebrovascular risk factors. A magnetic resonance imaging study. Arch Neurol. 1990; 47(12):1306-10. DOI: 10.1001/archneur.1990.00530120050009. View

13.

Moulinier L, Venet T, Schiller N, Kurtz T, Morris Jr R, Sebastian A . Measurement of aortic blood flow by Doppler echocardiography: day to day variability in normal subjects and applicability in clinical research. J Am Coll Cardiol. 1991; 17(6):1326-33. DOI: 10.1016/s0735-1097(10)80143-3. View

14.

Saxena P, Schoemaker R . Organ blood flow protection in hypertension and congestive heart failure. Am J Med. 1993; 94(4A):4S-12S. View

15.

Munoz D, Hastak S, Harper B, Lee D, Hachinski V . Pathologic correlates of increased signals of the centrum ovale on magnetic resonance imaging. Arch Neurol. 1993; 50(5):492-7. DOI: 10.1001/archneur.1993.00540050044013. View

16.

Fazekas F, Kleinert R, Offenbacher H, Schmidt R, Kleinert G, Payer F . Pathologic correlates of incidental MRI white matter signal hyperintensities. Neurology. 1993; 43(9):1683-9. DOI: 10.1212/wnl.43.9.1683. View

17.

Schmidt R, Fazekas F, Offenbacher H, Dusek T, ZACH E, Reinhart B . Neuropsychologic correlates of MRI white matter hyperintensities: a study of 150 normal volunteers. Neurology. 1993; 43(12):2490-4. DOI: 10.1212/wnl.43.12.2490. View

18.

Lindgren A, Roijer A, Rudling O, Norrving B, Larsson E, Eskilsson J . Cerebral lesions on magnetic resonance imaging, heart disease, and vascular risk factors in subjects without stroke. A population-based study. Stroke. 1994; 25(5):929-34. DOI: 10.1161/01.str.25.5.929. View

19.

Waldemar G, Christiansen P, Larsson H, Hogh P, Laursen H, Lassen N . White matter magnetic resonance hyperintensities in dementia of the Alzheimer type: morphological and regional cerebral blood flow correlates. J Neurol Neurosurg Psychiatry. 1994; 57(12):1458-65. PMC: 1073224. DOI: 10.1136/jnnp.57.12.1458. View

20.

Hatazawa J, Shimosegawa E, Satoh T, Toyoshima H, Okudera T . Subcortical hypoperfusion associated with asymptomatic white matter lesions on magnetic resonance imaging. Stroke. 1997; 28(10):1944-7. DOI: 10.1161/01.str.28.10.1944. View