Abstract 12741: Malignant Left Ventricular Hypertrophy and Risk of Cognitive Impairment or Probable Dementia: A Post Hoc Analysis of the SPRINT Trial

Abstract

Background: Left ventricular hypertrophy (LVH) accompanied by biomarker of myocardial injury as measured by high sensitivity cardiac troponin (hs-cTnT) and neurohormonal activation, as measured by N-terminal pro-B-type natriuretic peptide (NT-proBNP), indicates a malignant form of LVH. While malignant LVH has been linked to poor CVD outcomes, its association with cognitive outcomes is unclear. Aim: To examine the association of malignant LVH with cognitive outcomes in the Systolic Blood Pressure Intervention Trial (SPRINT). Hypothesis: Malignant LVH is associated with incident cognitive outcomes. Methods: We performed a post hoc analysis of 8,027 SPRINT participants with at least one cognitive assessment. Participants were classified into six groups based on the presence or absence of LVH assessed by 12-lead electrocardiogram (ECG), and elevations in levels of hs-cTnT ≥14 ng/L or NT-proBNP ≥125 pg/mL at baseline visit. The adjudicated outcome of incident probable dementia or mild cognitive impairment (MCI) or a composite outcome of probable dementia or mild cognitive impairment. Cox proportional hazard models were used to examine the association of baseline LVH/biomarker groups with incident cognitive outcomes. Results: During a median follow-up of 5 years, 597, 306, and 818 participants developed MCI, dementia, and composite outcome respectively. Compared with participants without LVH or elevated biomarkers, participants with LVH or elevated biomarkers, either in isolation or combined, had a higher risk of MCI and composite outcome. Highest risk for composite outcome was observed in those with concomitant LVH and elevated levels of both biomarkers. There was no significant association between LVH/biomarkers with incident probable dementia except for those with concomitant LVH and elevated levels of both biomarkers ( Table ). Conclusions: Among SPRINT participants, malignant LVH is associated with mild cognitive impairment and probable dementia.