Brain Atrophy, N-Terminal Brain Natriuretic Peptide, and Carotid Disease: Interconnecting Relationships Between Cerebral Perfusion, Cardiovascular Disease, Inflammation, and Cognitive Decline.

Abstract

In this issue, Sabayan et al1 discuss their findings from the AGES-Reykjavik study, on the association between brain atrophy and baseline N-terminal brain natriuretic peptide (NT-proBNP), a marker of cardiac dysfunction, and carotid intima–media thickness (CIMT), a marker of carotid atherosclerosis burden. They found that both higher NT-proBNP and CIMT were associated with longer term decline in total brain and gray matter volume but not with white matter volume. The highest rates of brain volume decline (at ≈3 times that seen in normal ageing) were seen in subjects with both high NT-proBNP and CIMT, and this was independent of age, education, and cardiovascular factors. See accompanying article on page 2246 Strengths of the study include the longitudinal population (volunteer) design with brain volumes measured both at baseline and after 5 years and the determination of both cardiac and carotid markers in the same large sample. The authors acknowledge the possibility that selection bias may …