Association Between Heart Rate and Subclinical Cerebrovascular Disease in the Elderly

被引:33
作者
Nakanishi, Koki [1 ]
Jin, Zhezhen [2 ]
Homma, Shunichi [1 ]
Elkind, Mitchell S. V. [3 ]
Rundek, Tatjana [4 ,5 ]
Lee, Seitetz C. [1 ]
Tugcu, Aylin [1 ]
Yoshita, Mitsuhiro [7 ]
DeCarli, Charles [8 ]
Wright, Clinton B. [4 ,5 ]
Sacco, Ralph L. [4 ,5 ,6 ]
Di Tullio, Marco R. [1 ]
机构
[1] Columbia Univ, Dept Med, New York, NY USA
[2] Columbia Univ, Dept Biostat, New York, NY USA
[3] Columbia Univ, Dept Neurol & Epidemiol, New York, NY USA
[4] Univ Miami, Miller Sch Med, Dept Neurol, Miami, FL 33136 USA
[5] Univ Miami, Miller Sch Med, Dept Publ Hlth Sci, Miami, FL 33136 USA
[6] Univ Miami, Miller Sch Med, Dept Human Genet, Miami, FL 33136 USA
[7] Hokuriku Natl Hosp, Dept Neurol, Nanto, Toyama, Japan
[8] Univ Calif Davis, Dept Neurol, Davis, CA 95616 USA
关键词
echocardiography; heart rate; magnetic resonance imaging; multivariate analysis; odds ratio; WHITE-MATTER HYPERINTENSITY; SILENT BRAIN INFARCTS; SYMPATHETIC-NERVE ACTIVITY; OBSTRUCTIVE SLEEP-APNEA; LEFT-VENTRICULAR MASS; CARDIOVASCULAR-DISEASE; CEREBRAL-CIRCULATION; ARTERIAL STIFFNESS; NORTHERN MANHATTAN; RISK-FACTOR;
D O I
10.1161/STROKEAHA.117.019355
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-Although increased heart rate (HR) is a predictor of cardiovascular events and mortality, its possible association with subclinical cerebrovascular disease, which is prevalent in the elderly, has not been evaluated. This study aimed to investigate the association of daytime, nighttime, 24-hour HR, and HR variability with subclinical cerebrovascular disease in an elderly cohort without history of stroke. Methods-The study cohort consisted of 680 participants (mean age, 73 +/- 7 years; 42% men) in sinus rhythm who underwent 24-hour ambulatory blood pressure and HR monitoring, 2-dimensional echocardiography, and brain magnetic resonance imaging as part of the CABL study (Cardiac Abnormalities and Brain Lesion). Subclinical cerebrovascular disease was defined as silent brain infarcts and white matter hyperintensity volume (WMHV). The relationship of HR measures with the presence of silent brain infarct and upper quartile of log WMHV (log WMHV4) was analyzed. Results-Presence of silent brain infarct was detected in 93 participants (13.7%); mean log WMHV was -0.92 +/- 0.93 (median, -1.05; min, -5.88; max, 1.74). Multivariate analysis showed that only nighttime HR (adjusted odds ratio, 1.29 per 10 bpm; 95% confidence interval, 1.03-1.61; P=0.026) was significantly associated with log WMHV4, independent of traditional cardiovascular risk factors, ambulatory systolic blood pressure, and echocardiographic parameters. No similar association was observed for daytime HR and HR variability. There was no significant association between all HR measures and silent brain infarct. Conclusions-In a predominantly elderly cohort, elevated nighttime HR was associated with WMHV, suggesting an independent role of HR in subclinical cerebrovascular disease.
引用
收藏
页码:319 / 324
页数:6
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