Parameters of Left Ventricular Mass and Dementia
Moving the Literature Forward
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See related article, pp 429–436
Left ventricular (LV) hypertrophy is a marker of heart and other end-organ damage. It reflects chronic exposure to multiple cardiovascular risk factors, including sustained arterial hypertension.1 In 1987, prevalence estimates of LV hypertrophy ranged from 23% to 43% in people with moderate-to-severe hypertension.2 Not only is LV hypertrophy a risk factor for cardiovascular pathology and brain injury,1 it is also a risk factor for lowered levels of cognition and all-cause probable dementia.3 The possibility of an LV hypertrophy–dementia association was first raised in a study by Kähönen-Väre et al.4 These investigators reported a 2-fold increase in the concurrent diagnosis of dementia in people exhibiting LV hypertrophy, although concurrent relations do not rule out a bidirectional relationship between these variables. A prospective design with longitudinal tracking of dementia is necessary. In the Rotterdam Study,5 LV hypertrophy was associated with a 5-year decline in performance on a dementia rating scale, but evidence of data from a rating scale is incomplete. The article by Moazzami et al6 in this issue of Hypertension is the first to reveal a positive prospective association between LV mass and probable dementia defined by hospital records.
The study by Moazzami et al6 used a large (n=4999), ethnically diverse US sample from the Multi-Ethnic Study of Atherosclerosis (2000–2012). Cardiac magnetic resonance imaging, a technique superior to imaging techniques used in previous research, was used to obtain multiple measures of LV structure and function at baseline. Participants were contacted every 9 to 12 months during the study …