Heart failure is independently associated with white matter lesions: insights from the population-based LIFE-Adult Study
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Date
2021-02
Open Access Location
Journal Title
Journal ISSN
Volume Title
Publisher
John Wiley and Sons Ltd on behalf of European Society of Cardiology
Rights
(c) 2020 The Author/s
CC BY-NC-ND 4.0
CC BY-NC-ND 4.0
Abstract
Aims
White matter lesions (WML) are common structural alterations in the white matter of the brain and their prevalence increases with age. They are associated with cerebral ischaemia and cognitive dysfunction. Patients with heart failure (HF) are at risk for cognitive decline. We hypothesized that the presence and duration of HF are associated with WML.
Methods and results
The LIFE-Adult Study is a population-based study of 10 000 residents of Leipzig, Germany. WML were quantitated in 2490 participants who additionally underwent cerebral MRI using the Fazekas score. Mean age was 64 years, and 46% were female; 2156 (86.6%) subjects had Fazekas score of 0–1, and 334 (13.4%) had Fazekas score of 2–3. Thirty participants had a medical history of HF, 1019 had hypertension, and 51 had a history of stroke. Median left ventricular ejection fraction of the participants with HF was 57% (interquartile ranges 54–62). Age, troponin T, NT-proBNP, body mass index, history of acute myocardial infarction, stroke, HF, and diabetes were positively associated with WML in univariate analysis. On multivariate analysis, age, hypertension, stroke, and HF were independently associated with WML. The odd's ratio for the association of WML (Fazekas 2–3) with HF was 2.8 (95% CI 1.2–6.5; P = 0.019). WML increased with longer duration of HF (P = 0.036 for trend).
Conclusions
In addition to age, hypertension, and stroke, the prevalence and duration of HF are independently associated with WML. This observation sets the stage to investigate the prognostic value of WML in HF and the impact of HF therapies on WML.
Description
Keywords
Cognitive impairment, Heart failure, Magnetic resonance imaging, Population-based study, White matter lesions, Adult, Female, Germany, Heart Failure, Humans, Middle Aged, Stroke Volume, Ventricular Function, Left, White Matter
Citation
Stegmann T, Chu ML, Witte VA, Villringer A, Kumral D, Riedel-Heller SG, Roehr S, Hagendorff A, Laufs U, Loeffler M, Wachter R, Zeynalova S. (2021). Heart failure is independently associated with white matter lesions: insights from the population-based LIFE-Adult Study.. ESC Heart Fail. 8. 1. (pp. 697-704).