1. Malignant left ventricular hypertrophy and risk of cognitive impairment in SPRINT MIND trial.
- Author
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Kazibwe R, Ahmad MI, Hughes TM, Chen LY, and Soliman EZ
- Subjects
- Humans, Male, Female, Aged, Middle Aged, Troponin T blood, Follow-Up Studies, Risk Factors, Incidence, Proportional Hazards Models, Risk Assessment methods, Hypertrophy, Left Ventricular epidemiology, Hypertrophy, Left Ventricular diagnosis, Hypertrophy, Left Ventricular blood, Cognitive Dysfunction epidemiology, Cognitive Dysfunction blood, Cognitive Dysfunction diagnosis, Cognitive Dysfunction etiology, Peptide Fragments blood, Natriuretic Peptide, Brain blood, Biomarkers blood, Electrocardiography, Dementia epidemiology, Dementia blood, Dementia diagnosis, Dementia etiology
- Abstract
Background: The association of malignant left ventricular hypertrophy (LVH), a specific subphenotype of LVH characterized by elevated levels of high-sensitivity cardiac troponin (hs-cTnT) or N-terminal pro-B-type natriuretic peptide (NT-proBNP), with cognitive decline remains understudied., Methods: This post-hoc analysis included a total of 8,027 (67.9 ± 9.3 years) SPRINT MIND trial participants who had with at least 1 follow-up cognitive assessment. Participants were classified into 6 groups on the basis of LVH status on electrocardiogram (ECG), and elevations in levels of hs-cTnT ≥14 ng/L or NT-proBNP ≥125 pg/mL at baseline visit. Multivariate Cox proportional hazard models were used to examine the association of LVH/biomarker groups with incident probable dementia, mild cognitive impairment (MCI) and a composite of MCI/probable dementia., Results: Over a median follow-up period of 5 years, there were 306, 597, and 818 incidents of MCI, probable dementia and a composite of MCI/probable dementia, respectively. Compared with participants without LVH and normal biomarker levels, those with concomitant LVH and elevated levels of both biomarkers were associated with a higher risk of probable dementia (HR, 2.50; 95% CI (1.26-4.95), MCI (HR, 1.78; 95% CI (0.99-3.23) and the composite of MCI/ probable dementia (HR, 1.89; 95% CI, 1.16-3.10)., Conclusions: Among SPRINT participants, malignant LVH is associated with incident probable dementia and mild cognitive impairment. These findings underscore the potential utility of measuring hs-cTnT and NT-proBNP levels when LVH is detected on ECG, aiding in the differentiation of individuals with a favorable risk for cognitive impairment from those with a higher risk., (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Published
- 2024
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