Abstract MP27: Cardiovascular Biomarkers and MRI-defined Small Vessel Disease of the Brain in the Atherosclerosis Risk in Communities (ARIC) Study

Abstract

Background: Cerebrovascular and cardiovascular disease share common risk factors. Thus, biomarkers associated with subclinical cardiac injury may also be associated with silent cerebral injury. We hypothesized that levels of N-terminal brain natriuretic peptide (NT-proBNP) and cardiac troponin T measured with a highly sensitive assay (hs-cTnT) are associated with silent brain infarcts (BI) and white matter lesions (WML) on magnetic resonance imaging (MRI) in the Atherosclerosis Risk In Communities (ARIC) study. Methods: Brain MRI was performed at ARIC visit 3 (1993-1995) on 1920 participants. NT-proBNP and hs-cTnT were measured in all individuals at ARIC visit 4 (1996-1998). A subset (N=1112) of those individuals who had the initial MRI at Visit 3, had a follow up MRI in 2004-2006. We analyzed the association of NT-proBNP and hs-cTnT with the presence of MRI defined BI and WML on the initial MRI and on the follow-up MRI in participants without coronary heart disease and stroke. BI was defined as an area of abnormal signal intensity in a vascular distribution, ≥ 3 millimeters in size, and without mass effect. WML were estimated as the total volume of periventricular and subcortical white matter-signal abnormality. Results: In the adjusted model, individuals in the highest NT-proBNP quartile had significantly more BI and WML on the baseline MRI and more incident BI and WML progression on the follow up MRI when compared to the lowest quartile (Table). In the same model, individuals in the highest hs-cTnT category had significantly more BI and WML on the initial MRI and more WML progression on the follow up MRI when compared to the lowest category. Incident BIs were significantly more common in the 0.009 to ≤0.013 μg/L troponin category but not in the highest one, when compared to the lowest category (Table). Conclusion: NT-proBNP and hs-cTnT are independently associated with silent MRI-defined BI and WML suggesting that biomarkers for subclinical cardiac injury may also be useful to identify individuals with subclinical cerebral injury.