Atrial function: Association with cerebrovascular disease and cognitive dysfunction

• Published in: Alzheimer's & dementia 2024-12, Vol.20 (S2), p.n/a
• Main Authors: Tan, Eugene, Hilal, Saima, Chan, Siew‐Pang, Sim, Ming Ann, Lai, Mitchell Kim Peng, Chong, Joyce R, Robert, Caroline, Hazli, Hazliza, Gong, Lingli, Berboso, Josephine, Venketasubramanian, Narayanaswamy, Tan, Boon Yeow, Richards, Arthur Mark, Chen, Christopher, Lieng‐Hsi, Ling
• Format: Article
• Language: English
• Subjects: Biomarkers
• ISSN: 1552-5260; 1552-5279
• DOI: 10.1002/alz.088067

Background The relationships of left atrial (LA) dysfunction with cognition are poorly understood. We investigated the associations of LA function with cognitive impairment, etiologic‐subtype (neurodegenerative vs. vascular[VCI]), neuroimaging markers of cerebrovascular disease (CeVD) and circulating biomarkers, in subjects without AF. Method In this prospective cohort study of subjects recruited from memory clinics with brain magnetic resonance imaging (MRI), neuropsychological assessments, circulating biomarker measurements, LA strain (reservoir [LASr], conduit [LAScd], contractile) was determined using 2D speckle‐tracking echocardiography. VCI was defined as vascular dementia or cognitive impairment no dementia(CIND)/Alzheimer’s dementia with significant CeVD, and neurodegenerative defined as CIND/dementia without significant CeVD on neuroimaging. Result Among 251 subjects (age 75±8years, 59% female, 178(71%) had cognitive impairment (37% dementia, 14% moderate CIND, 20% mild CIND), of which 58% were VCI and 42% neurodegenerative. LAScd was the only LA strain parameter independently associated with more severe (moderate CIND/dementia vs. mild CIND/no cognitive impairment) grades of cognitive impairment (lowest vs. highest tertile: adjusted odds ratio[AOR] 2.50, p=0.015), and worse MMSE scores, visuomotor construction and memory on neuropsychological testing (p0.05). LAScd and LASr were both associated with increased burden of CeVD including intracranial stenoses, cortical infarcts, lacunes, cerebral microinfarcts, microbleeds and white matter hyperintensities and correlated with cardiac‐specific biomarkers (p