DOI: 10.1161/circ.148.suppl_1.12181 ISSN: 0009-7322

Abstract 12181: Association of Left Atrial Function With Vascular Brain Injury: The Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS)

Wendy Wang, Riccardo M Inciardi, Jorge L Reyes, Thomas Mosley, Michelle C Johansen, Rebecca F Gottesman, Alvaro Alonso, Pamela L Lutsey, Clifford R Jack, Scott Solomon, Amil M Shah, Bruce A Wasserman, Lin Y Chen
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine
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Background: Lower (worse) left atrial (LA) function is associated with higher dementia risk. It is unclear whether lower LA function is associated with vascular brain injury on brain MRI, an established correlate for higher dementia risk. Using data from the Atherosclerosis Risk in Communities (ARIC) study, we assessed the cross-sectional association between LA function measures and brain MRI markers of vascular brain injury (cerebral microbleeds, brain infarcts).

Hypothesis: Participants with lower LA function will be more likely to have presence of

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1 cerebral microbleed or brain infarct.

Methods: ARIC participants who had both an echocardiogram and brain MRI at visit 5 (2011-13) were included. We excluded those with prevalent dementia, stroke, or atrial fibrillation. LA function measures were obtained from 2D-echocardiograms and assessed in quartiles (highest quartile was the reference). Brain MRI measures were assessed as the presence or absence of

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1 cerebral microbleed or brain infarct. Logistic regression was used.

Results: Of the 1502 participants (mean [SD] age 76 [5], 60% female, 27% Black) in this analysis, 345 (23%) and 351 (23%) had

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1 cerebral microbleed or brain infarct present. Compared to the highest quartile, lower LA reservoir and conduit strain quartiles were associated with higher odds of cerebral microbleeds. LA contractile strain was not associated with cerebral microbleeds. Compared to the highest quartile, the lowest LA conduit strain quartile, but not reservoir strain, was associated with higher odds of brain infarcts. LA contractile strain was inversely associated with brain infarcts.

Conclusion: In this community-based cohort, lower LA function was cross-sectionally associated with cerebral microbleeds and brain infarcts. The inverse relationship with LA contractile strain may be due to contractile function compensating for a decrease in early diastolic filling. Prospective studies are needed to confirm these findings.

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