Left Atrial Myocardial Mechanics: Association With Cognitive Dysfunction, Cerebrovascular Disease, and Circulating Biomarkers
Cognitive Decline
DOI:
10.1161/jaha.123.036931
Publication Date:
2025-04-08T03:19:48Z
AUTHORS (15)
ABSTRACT
Background The relationship of left atrial ( LA ) strain with cognition in the absence fibrillation is poorly understood. We investigated association cognitive impairment and its pathogenetic subtype (vascular [ VCI ] or neurodegenerative) underlying mechanisms via associations circulating neuroimaging markers cerebrovascular disease. Methods Results (reservoir, conduit LAScd ], contractile) was determined using speckle‐tracking echocardiography a prospective memory clinic cohort brain magnetic resonance imaging, neuropsychological assessments, biomarker measurements. Cognitive classified as neurodegenerative presence significant disease, respectively. Among 251 subjects (age 75±8 years, 59% women) without , 178 (71%) had (20% mild, 14% moderate, 37% dementia); these impairments, 58% were 42% neurodegenerative. Only associated more severe (moderate/dementia versus none/mild, adjusted odds ratio [aOR for lowest highest tertile >2) specifically, worse Mini‐Mental State Examination score on testing. independently (versus neurodegenerative; aOR tertile, 4.22 [95% CI, 1.59–11.2]) not (circulating pTau ‐181 [phosphorylated tau‐181], isolated lobar cerebral microbleeds). Both reservoir increased burden small vessel disease but only correlated biomarkers, reflecting inflammation, neurotrophic processes, neuronal damage. Conclusions Reduced impairment, primarily vascular origin, higher may be at‐risk .
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