Faculty Collaboration Database

Malignant left ventricular hypertrophy and risk of cognitive impairment in SPRINT MIND trial. Am Heart J 2024 Oct;276:31-38

Date

07/28/2024

Pubmed ID

39067559

DOI

10.1016/j.ahj.2024.07.012

Scopus ID

2-s2.0-85200505582 (requires institutional sign-in at Scopus site)

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.

Author List

Kazibwe R, Ahmad MI, Hughes TM, Chen LY, Soliman EZ

Author

Muhammad Imtiaz Ahmad MBBS Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Biomarkers
Cognitive Dysfunction
Dementia
Electrocardiography
Female
Follow-Up Studies
Humans
Hypertrophy, Left Ventricular
Incidence
Male
Middle Aged
Natriuretic Peptide, Brain
Peptide Fragments
Proportional Hazards Models
Risk Assessment
Risk Factors
Troponin T