Total Cerebral Blood Flow and Mortality in Old Age: a 12-year Follow-up Study

Overview

Journal Neurology

Specialty Neurology

Date 2013 Nov 1

PMID 24174588

Citations 13

Authors

Behnam Sabayan

Jeroen van der Grond

Rudi G Westendorp

J Wouter Jukema

Ian Ford

Brendan M Buckley

Naveed Sattar

Matthias J P van Osch

Mark A van Buchem

Anton J M de Craen

Affiliations

Soon will be listed here.

Abstract

Objective: To examine the association of total cerebral blood flow (CBF) with all-cause, noncardiovascular, and cardiovascular mortality in older subjects at risk of cardiovascular disease.

Methods: We included 411 subjects with a mean age of 74.5 years from the MRI substudy of the Prospective Study of Pravastatin in the Elderly at Risk. Total CBF was measured at baseline, and occurrence of death was recorded in an average follow-up period of 11.8 years. For each participant, total CBF was standardized for brain parenchymal volume. Cox regression models were used to estimate risk of all-cause, noncardiovascular, and cardiovascular mortality in relation to CBF.

Results: Mortality rates among participants in low, middle, and high thirds of total CBF were 52.1, 41.5, and 28.7 per 1,000 person-years, respectively. Compared with participants in the high third of CBF, participants in the low third had 1.88-fold (95% confidence interval [CI]: 1.30-2.72) higher risk of all-cause mortality, 1.66-fold (95% CI: 1.06-2.59) higher risk of noncardiovascular mortality, and 2.50-fold (95% CI: 1.28-4.91) higher risk of cardiovascular mortality. Likewise, compared with participants in the high third of CBF, participants in the middle third had 1.44-fold (95% CI: 0.98-2.11) higher risk of all-cause mortality, 1.29-fold (95% CI: 0.82-2.04) higher risk of noncardiovascular mortality, and 1.86-fold (95% CI: 0.93-3.74) higher risk of cardiovascular mortality. These associations were independent of prevalent vascular status and risk factors.

Conclusions: Low total CBF is linked with higher risk of all-cause, noncardiovascular, and cardiovascular mortality in older people independent of clinical cardiovascular status.

Citing Articles

Changes in Cerebral Hemodynamics and Progression of Subclinical Vascular Brain Disease: A Population-Based Cohort Study.

Ma Y, Bos D, Wolters F, Niessen W, Hofman A, Ikram M Stroke. 2024; 56(1):95-104.

PMID: 39633567 PMC: 11661930. DOI: 10.1161/STROKEAHA.124.047593.

Automated Quantification of Total Cerebral Blood Flow from Phase-Contrast MRI and Deep Learning.

Kim J, Lee H, Oh S, Jang J, Lee H J Imaging Inform Med. 2024; 37(2):563-574.

PMID: 38343224 PMC: 11031545. DOI: 10.1007/s10278-023-00948-0.

Early-Frame [F]Florbetaben PET/MRI for Cerebral Blood Flow Quantification in Patients with Cognitive Impairment: Comparison to an [O]Water Gold Standard.

Fettahoglu A, Zhao M, Khalighi M, Vossler H, Jovin M, Davidzon G J Nucl Med. 2023; 65(2):306-312.

PMID: 38071587 PMC: 10858379. DOI: 10.2967/jnumed.123.266273.

Vertebral artery hypoplasia influences age-related differences in blood flow of the large intracranial arteries.

Miller K, Gallo S, Rivera-Rivera L, Corkery A, Howery A, Johnson S Aging Brain. 2023; 1:100019.

PMID: 36911510 PMC: 9997135. DOI: 10.1016/j.nbas.2021.100019.

Imputation models and error analysis for phase contrast MR cerebral blood flow measurements.

Shah P, Doyle E, Wood J, Borzage M Front Physiol. 2023; 14:1096297.

PMID: 36891147 PMC: 9988286. DOI: 10.3389/fphys.2023.1096297.

References

BAKKER C, Kouwenhoven M, Hartkamp M, Hoogeveen R, Mali W . Accuracy and precision of time-averaged flow as measured by nontriggered 2D phase-contrast MR angiography, a phantom evaluation. Magn Reson Imaging. 1995; 13(7):959-65. DOI: 10.1016/0730-725x(95)02005-e. View

Ulrich-Lai Y, Herman J . Neural regulation of endocrine and autonomic stress responses. Nat Rev Neurosci. 2009; 10(6):397-409. PMC: 4240627. DOI: 10.1038/nrn2647. View

Shepherd J, Blauw G, Murphy M, Cobbe S, Bollen E, Buckley B . The design of a prospective study of Pravastatin in the Elderly at Risk (PROSPER). PROSPER Study Group. PROspective Study of Pravastatin in the Elderly at Risk. Am J Cardiol. 1999; 84(10):1192-7. DOI: 10.1016/s0002-9149(99)00533-0. View

Ackerman R . Cerebral blood flow and neurological change in chronic heart failure. Stroke. 2001; 32(11):2462-4. View

Farkas E, Luiten P, Bari F . Permanent, bilateral common carotid artery occlusion in the rat: a model for chronic cerebral hypoperfusion-related neurodegenerative diseases. Brain Res Rev. 2007; 54(1):162-80. DOI: 10.1016/j.brainresrev.2007.01.003. View

Cao J, Arnold A, Manolio T, Polak J, Psaty B, Hirsch C . Association of carotid artery intima-media thickness, plaques, and C-reactive protein with future cardiovascular disease and all-cause mortality: the Cardiovascular Health Study. Circulation. 2007; 116(1):32-8. DOI: 10.1161/CIRCULATIONAHA.106.645606. View

Ho K, Anderson K, Kannel W, Grossman W, Levy D . Survival after the onset of congestive heart failure in Framingham Heart Study subjects. Circulation. 1993; 88(1):107-15. DOI: 10.1161/01.cir.88.1.107. View

Weiller C, Ringelstein E, Reiche W, Buell U . Clinical and hemodynamic aspects of low-flow infarcts. Stroke. 1991; 22(9):1117-23. DOI: 10.1161/01.str.22.9.1117. View

Pfister R, Schneider C . ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: application of natriuretic peptides. Eur Heart J. 2008; 30(3):382-3. DOI: 10.1093/eurheartj/ehn560. View

10.

Smith S, Jenkinson M, Woolrich M, Beckmann C, Behrens T, Johansen-Berg H . Advances in functional and structural MR image analysis and implementation as FSL. Neuroimage. 2004; 23 Suppl 1:S208-19. DOI: 10.1016/j.neuroimage.2004.07.051. View

11.

Sekhon L, Morgan M, Spence I, Weber N . Chronic cerebral hypoperfusion: pathological and behavioral consequences. Neurosurgery. 1997; 40(3):548-56. DOI: 10.1097/00006123-199703000-00025. View

12.

Erecinska M, Silver I . Tissue oxygen tension and brain sensitivity to hypoxia. Respir Physiol. 2001; 128(3):263-76. DOI: 10.1016/s0034-5687(01)00306-1. View

13.

Spilt A, Box F, van der Geest R, Reiber J, Kunz P, Kamper A . Reproducibility of total cerebral blood flow measurements using phase contrast magnetic resonance imaging. J Magn Reson Imaging. 2002; 16(1):1-5. DOI: 10.1002/jmri.10133. View

14.

Admiraal-Behloul F, van den Heuvel D, Olofsen H, van Osch M, van der Grond J, van Buchem M . Fully automatic segmentation of white matter hyperintensities in MR images of the elderly. Neuroimage. 2005; 28(3):607-17. DOI: 10.1016/j.neuroimage.2005.06.061. View

15.

Attwell D, Buchan A, Charpak S, Lauritzen M, MacVicar B, Newman E . Glial and neuronal control of brain blood flow. Nature. 2010; 468(7321):232-43. PMC: 3206737. DOI: 10.1038/nature09613. View

16.

Cechetti F, Pagnussat A, Worm P, Elsner V, Ben J, da Costa M . Chronic brain hypoperfusion causes early glial activation and neuronal death, and subsequent long-term memory impairment. Brain Res Bull. 2011; 87(1):109-16. DOI: 10.1016/j.brainresbull.2011.10.006. View

17.

Downard C, Hulka F, Mullins R, Piatt J, Chesnut R, Quint P . Relationship of cerebral perfusion pressure and survival in pediatric brain-injured patients. J Trauma. 2000; 49(4):654-8; discussion 658-9. DOI: 10.1097/00005373-200010000-00012. View

18.

Pase M, Grima N, Stough C, Scholey A, Pipingas A . Cardiovascular disease risk and cerebral blood flow velocity. Stroke. 2012; 43(10):2803-5. DOI: 10.1161/STROKEAHA.112.666727. View

19.

Shin J, Hyun S, Kim D, Lee S, Jung J, Choi J . Chronic hypoperfusion increases claudin-3 immunoreactivity in rat brain. Neurosci Lett. 2008; 445(2):144-8. DOI: 10.1016/j.neulet.2008.08.082. View

20.

Abizaid A, Horvath T . Brain circuits regulating energy homeostasis. Regul Pept. 2008; 149(1-3):3-10. PMC: 2605273. DOI: 10.1016/j.regpep.2007.10.006. View