Subtle signs of atrial cardiomyopathy and left ventricular diastolic dysfunction are associated with reduced cognitive function: results from the Hamburg City Health Study

Abstract

Background
Atrial fibrillation is associated with cognitive dysfunction. Atrial cardiomyopathy has been correlated with both entities. We aimed to characterize the association of echocardiographic parameters of atrial cardiomyopathy with cognitive function and cerebral changes.

Methods
Participants of the population-based Hamburg City Health Study underwent in-depth transthoracic echocardiography and cognitive function testing, the Animal Naming Test (ANT), the Trail Making Test A (TMT-A) and B (TMT-B), 10-word learning test and cerebral magnetic resonance imaging.

Results
After excluding individuals with stroke or depression, data from 7852 individuals were available. In multi-variable-adjusted regression analyses, the E/e’-ratio was associated with the level of impairment in the ANT (− 0.19 per one standard deviation [SD] increase, 95% confidence interval [CI] − 0.36–[− 0.01]) and the TMT-A (0.01 per one SD increase, 95% CI 0.003–0.020). Left atrial global peak strain was associated with positive performance in the TMT-A and B (-0.01 per one SD increase [95% CI − 0.02–(− 0.002)] and − 0.02 per one SD increase [95% CI − 0.03–(− 0.01)], respectively) and the immediate recall of the 10-word learning test (0.11 per one SD increase, 95% CI 0.02–0.20). The E/e’-ratio was positively associated with the total and periventricular white matter hyperintensity load in age- and sex-adjusted regression analyses though statistical significance was lost after multi-variable adjustment.

Conclusions
Subclinical echocardiographic signs of atrial cardiomyopathy and left ventricular diastolic dysfunction are associated with impaired performance in cognitive tests in the population. Our data provide evidence of the clinically important cardio-cerebral axis, relating cardiac dysfunction with cognitive performance.

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Cited By

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Prognostic Value of Cardiac Strain in Cognitive Impairment: A Systematic Review

Polyana Evangelista Lima, Anthony Rodrigues de Vasconcelos · 2026

Medical Sciences

Metrics

2

Citations

44

References

Details

Published: Nov 27, 2024
Vol/Issue: 114(12)
Pages: 1658-1670
License: View

Authors

Department of General and Interventional Cardiology, University Heart & Vascular Center Hamburg Eppendorf, Hamburg, Germany (C.B., R.B.S.); German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck (C.B., R.B.S.).

From the Department of Medicine II (S.B., T.Z., P.S.W., R.B.S., T.F.M.) and Institute of Clinical Chemistry and Laboratory Medicine (K.J.L.), Johannes Gutenberg University Mainz, Mainz, Germany; UK Clinical Research Collaboration Center of Excellence for Public Health, Queens University of Belfast, Belfast, Northern Ireland (F.K., J.Y., A.E.); Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, Ninewells Hospital, University of Dundee, Dundee, Scotland (H.T.-P.); National...

From the Department of Medicine II (S.B., T.Z., P.S.W., R.B.S., T.F.M.) and Institute of Clinical Chemistry and Laboratory Medicine (K.J.L.), Johannes Gutenberg University Mainz, Mainz, Germany; UK Clinical Research Collaboration Center of Excellence for Public Health, Queens University of Belfast, Belfast, Northern Ireland (F.K., J.Y., A.E.); Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, Ninewells Hospital, University of Dundee, Dundee, Scotland (H.T.-P.); National...

Funding

H2020 European Research Council Award: 648131

Bundesministerium für Bildung und Forschung Award: 01ZX1408A

Deutsche Stiftung für Herzforschung Award: (F/29/19)

Deutsche Herzstiftung Award: Wolfgang Seefried project funding

ERACoSysMed3 Award: 031L0239

Universitätsklinikum Hamburg-Eppendorf (UKE)

Cite This Article

Amelie H. Ohlrogge, Stephan Camen, Lina Nagel, et al. (2024). Subtle signs of atrial cardiomyopathy and left ventricular diastolic dysfunction are associated with reduced cognitive function: results from the Hamburg City Health Study. Clinical Research in Cardiology, 114(12), 1658-1670. https://doi.org/10.1007/s00392-024-02581-5

Subtle signs of atrial cardiomyopathy and left ventricular diastolic dysfunction are associated with reduced cognitive function: results from the Hamburg City Health Study

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