Abstract
AimsExisting evidence suggests links between brain and cardiovascular health. We investigated associations between cognitive performance and cardiovascular magnetic resonance (CMR) phenotypes in the UK Biobank, considering a range of potential confounders.Methods and resultsWe studied 29 763 participants with CMR and cognitive testing, specifically, fluid intelligence (FI, 13 verbal-numeric reasoning questions), and reaction time (RT, a timed pairs matching exercise); both were considered continuous variables for modelling. We included the following CMR metrics: left and right ventricular (LV and RV) volumes in end-diastole and end-systole, LV/RV ejection fractions, LV/RV stroke volumes, LV mass, and aortic distensibility. Multivariable linear regression models were used to estimate the association of each CMR measure with FI and RT, adjusting for age, sex, smoking, education, deprivation, diabetes, hypertension, high cholesterol, prior myocardial infarction, alcohol intake, and exercise level. We report standardized beta-coefficients, 95% confidence intervals, and P-values adjusted for multiple testing. In this predominantly healthy cohort (average age 63.0 ± 7.5 years), better cognitive performance (higher FI, lower RT) was associated with larger LV/RV volumes, higher LV/RV stroke volumes, greater LV mass, and greater aortic distensibility in fully adjusted models. There was some evidence of non-linearity in the relationship between FI and LV end-systolic volume, with reversal of the direction of association at very high volumes. Associations were consistent for men and women and in different ages.ConclusionBetter cognitive performance is associated with CMR measures likely representing a healthier cardiovascular phenotype. These relationships remained significant after adjustment for a range of cardiometabolic, lifestyle, and demographic factors, suggesting possible involvement of alternative disease mechanisms.
Highlights
Cardiovascular disease and cognitive impairment are growing public health problems, in ageing global populations.[1,2] Existing work suggests interactions across heart–brain organ systems
Cardiovascular risk factors are associated with poorer brain health across grey and white matter macrostructure and microstructure assessed on brain magnetic resonance imaging.[9]
In the UK Biobank, associations of cardiovascular magnetic resonance (CMR) indices of cardiovascular structure and function with cognitive performance measures
Summary
Cardiovascular disease and cognitive impairment are growing public health problems, in ageing global populations.[1,2] Existing work suggests interactions across heart–brain organ systems. Cardiovascular risk factors are associated with poorer brain health across grey and white matter macrostructure and microstructure assessed on brain magnetic resonance imaging.[9]
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