Carotid β-stiffness index is associated with slower processing speed but not working memory or white matter integrity in healthy middle-aged/older adults

Aging is associated with increased carotid artery stiffness, a predictor of incident stroke, and reduced cognitive performance and brain white matter integrity (WMI) in humans. Therefore, we hypothesized that higher carotid stiffness/lower compliance would be independently associated with slower processing speed, higher working memory cost, and lower WMI in healthy middle-aged/older (MA/O) adults. Carotid β-stiffness ( P < 0.001) was greater and compliance ( P < 0.001) was lower in MA/O ( n = 32; 64.4 ± 4.3 yr) vs. young ( n = 19; 23.8 ± 2.9 yr) adults. MA/O adults demonstrated slower processing speed (27.4 ± 4.6 vs. 35.4 ± 5.0 U/60 s, P < 0.001) and higher working memory cost (−15.4 ± 0.14 vs. −2.2 ± 0.05%, P < 0.001) vs. young adults. Global WMI was lower in MA/O adults ( P < 0.001) and regionally in the frontal lobe ( P = 0.020) and genu ( P = 0.009). In the entire cohort, multiple regression analysis that included education, sex, and body mass index, carotid β-stiffness index (B = −0.53 ± 0.15 U, P = 0.001) and age group (B = −4.61 ± 1.7, P = 0.012, adjusted R2 = 0.4) predicted processing speed but not working memory cost or WMI. Among MA/O adults, higher β-stiffness (B = −0.60 ± 0.18, P = 0.002) and lower compliance (B = 0.93 ± 0.26, P = 0.002) were associated with slower processing speed but not working memory cost or WMI. These data suggest that greater carotid artery stiffness is independently and selectively associated with slower processing speed but not working memory among MA/O adults. Carotid artery stiffening may modulate reductions in processing speed earlier than working memory with healthy aging in humans. NEW & NOTEWORTHY Previously, studies investigating the relation between large elastic artery stiffness, cognition, and brain structure have focused mainly on aortic stiffness in aged individuals with cardiovascular disease risk factors and other comorbidities. This study adds to the field by demonstrating that the age-related increases in carotid artery stiffness, but not aortic stiffness, is independently and selectively associated with slower processing speed but not working memory among middle-aged/older adults with low cardiovascular disease risk factor burden.

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Abstract 18689: Lower Carotid Artery Compliance and Greater Carotid β-stiffness Index are Associated With Slower Processing Speed and Reduced Working Memory Performance in Older Healthy Adults

Circulation ◽

10.1161/circ.132.suppl_3.18689 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Lyndsey E DuBose ◽

Michelle W Voss ◽

Timothy B Weng ◽

Kaitlyn M Dubishar ◽

Abbi Lane-Cordova ◽

...

Keyword(s):

Older Adults ◽

Working Memory ◽

Carotid Artery ◽

Processing Speed ◽

Aortic Stiffness ◽

Memory Performance ◽

Stiffness Index ◽

Brain White Matter ◽

Artery Stiffness ◽

Carotid Artery Compliance

Introduction: Higher central elastic artery stiffness is associated with greater brain white matter hyperintensity volume and lower cognitive performance in older adults. However, it is unknown if higher central artery stiffness is related to regional decreases in brain white matter integrity (WMI) and reductions in working memory or processing speed. We hypothesized that greater large elastic artery stiffness would be associated with lower working memory and slower processing speed as well as lower regional WMI in older adults. Methods: In young (n=19; 23.8 ± 0.7 yrs) and older (n=22; 64.4 ± 4.2 yrs; range 60-71 yrs) healthy adults, aortic stiffness (carotid-femoral pulse wave velocity, cfPWV, via tonometry) and carotid artery compliance and β-stiffness index (carotid artery ultrasound and tonometry) were determined non-invasively. WMI was assessed by fractional anisotrophy (FA) (3T MRI) from diffusion tensor images. An N-Back task and letter and pattern comparison tests were performed as measures of working memory and processing speed, respectively. d’Prime, a measure of signal detection, was calculated on the N-Back task as a ratio of positive ‘hits’ to ‘false alarm’ responses. Results: cfPWV (8.4 ± 0.5 vs. 5.2 ± 0.2 m/sec, P<0.01) and carotid β-stiffness (11.3 ± 0.9 vs. 6.1 ± 0.7 U, P<0.01) were greater and carotid compliance (0.16 ± 0.02 vs. 0.07 ± 0.01 mm/mmHg, P<0.01) was lower in older vs. young adults. Carotid β, but not aortic, stiffness was associated with slower processing speed on letter (10.7 ± 0.5 vs. 13.5 ± 0.6 units/ 30 sec, p<0.01) and pattern (16.6 ± 0.6 vs. 22.0 ± 0.7 units/30 sec, p<0.01) comparison tasks and reduced working memory (1.8 ± 0.2 vs. 3.1± 0.2, P<0.01) in older vs. young adults. Lower carotid compliance was associated with slower performance on the letter (r=0.55, P<0.01) and pattern (r=0.54, P<0.01) tests and lower d’Prime (r=0.48, P<0.05). Greater β-stiffness was related to pattern comparison scores only (r=-0.54, P<0.01). Aortic stiffness, carotid compliance and β-stiffness were not related to WMI in any brain region. Conclusions: Our results suggest that lower carotid artery compliance and greater β-stiffness are associated with reduced working memory performance and slower processing speed but not regional WMI in older adults.

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Abstract 081: Obesity-related Reductions in Cardiac Baroreflex Sensitivity and Higher 24-hour Blood Pressure Variability Are Not Related to Carotid Artery and Aortic Stiffness in Young And Middle-aged Adults

Hypertension ◽

10.1161/hyp.68.suppl_1.081 ◽

2016 ◽

Vol 68 (suppl_1) ◽

Author(s):

Seth Holwerda ◽

Jess Fiedorowicz ◽

Lyndsey DuBose ◽

Amy Stroud ◽

Tiwa Ajibewa ◽

...

Keyword(s):

Blood Pressure ◽

Carotid Artery ◽

Blood Pressure Variability ◽

Aortic Stiffness ◽

Baroreflex Sensitivity ◽

Normal Weight ◽

Middle Aged ◽

Cvd Risk ◽

Cross Sectional ◽

Artery Stiffness

Alterations in cardiac baroreflex sensitivity (BRS) and 24-hr blood pressure variability (24-hr BPV) are independent predictors of increased cardiovascular disease (CVD) risk, and occur in individuals with obesity. Obese humans are also likely to have a higher large elastic artery stiffness compared with normal-weight individuals. While an increase in stiffness of carotid and aortic arteries, the anatomical sites where baroreceptors reside, may likely be responsible in part for the decline in cardiac BRS with advancing age in adults, it remains unclear whether 1) elevated carotid and aortic stiffness are also directly associated with obesity-associated reductions in cardiac BRS in young/middle-aged individuals, and 2) if reduced BRS with obesity is associated with elevated 24hr BPV. We tested the hypothesis that lower BRS would be associated with higher carotid and aortic stiffness and 24hr BPV in young and middle-aged individuals with obesity. In a cross-sectional design, 22 normal-weight (body mass index, BMI 24.5 ± 0.6 kg/m 2 ; age 35±2 yrs; 8M/14F) and 22 obese (BMI 34.2 ± 1.1 kg/m 2 ; age 39 ± 2 yrs; 8M/14F) individuals underwent measures of spontaneous cardiac BRS (sequence technique), carotid artery β-stiffness (carotid tonometry and B-mode ultrasound of common carotid artery), aortic stiffness (carotid-femoral pulse wave velocity, CFPWV), and 24-hr-systolic BPV (24 hr ambulatory BP monitoring). A significant relation between cardiac BRS and 24-hr systolic BPV (r=-0.42, P<0.01) was corroborated by lower cardiac BRS (11.7±1.2 vs. 16.8±1.7 ms/mmHg, P<0.05) and higher 24-hr BPV (12.4±0.6 vs. 10.1±0.4 mmHg SD, P<0.05) among obese compared with normal-weight subjects. In contrast, carotid β-stiffness (7.8±0.6 vs. 6.9±0.4 U, P>0.05) and CFPWV (745±71 vs. 611±19 cm/s, P=0.07) were not significantly different between groups despite greater average 24-hr systolic BP in the obese vs. normal weight subjects (127±2 vs. 118±1 mmHg, P<0.05). These preliminary data suggest that an increase in carotid artery and aortic stiffness may not precede the decline in cardiac BRS and increase in 24hr BPV in young and middle-aged obese individuals, suggesting non-arterial stiffness related mechanisms for obesity-related reductions in cardiac BRS.

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Cognitive Performance is Lower Among Individuals with Overlap Syndrome than with COPD or Obstructive Sleep Apnea Alone: Role of Carotid Artery Stiffness

Journal of Applied Physiology ◽

10.1152/japplphysiol.00477.2020 ◽

2021 ◽

Author(s):

Rachel E. Luehrs ◽

Kerrie L. Moreau ◽

Gary L. Pierce ◽

Frederick Wamboldt ◽

Mark Aloia ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Carotid Artery ◽

Cognitive Performance ◽

Processing Speed ◽

Overlap Syndrome ◽

Stiffness Index ◽

Cvd Risk ◽

Obstructive Sleep ◽

Artery Stiffness ◽

Former Smokers

Background: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are both independently associated with increased cardiovascular disease (CVD) risk and impaired cognitive function. It is unknown if individuals with both COPD and OSA (i.e. overlap syndrome) have greater common carotid artery (CCA) stiffness, an independent predictor of CVD risk, and lower cognitive performance than either COPD or OSA alone. Elevated CCA stiffness is associated with cognitive impairment in former smokers with and without COPD in past studies. Methods: We compared CCA stiffness and cognitive performance between former smokers with overlap syndrome, COPD only, OSA only and former smoker controls using analysis of covariance (ANCOVA) tests to adjust for age, sex, body mass index (BMI), pack-years and post-bronchodilator FEV1/FVC. We also examined the association between carotid artery stiffness and cognitive performance among each group separately. Results: Individuals with overlap syndrome (n=12) had greater CCA β-stiffness index (p=0.015) and lower executive function-processing speed (p=0.019) than individuals with COPD alone (n=47), OSA alone (n=9) and former smoker controls (n=21), differences that remained significant after adjusting for age, BMI, sex, pack-years and FEV1/FVC. Higher CCA β-stiffness index was associated with lower executive function-processing speed in individuals with overlap syndrome (r=-0.58, p=0.047). Conclusion: These data suggest that CCA stiffness is greater and cognitive performance is lower among individuals with overlap syndrome compared with individuals with COPD or OSA alone and that CCA stiffening may be an underlying mechanism contributing to the lower cognitive performance observed in patients with overlap syndrome.

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Relationships between Muscle Strength and Cardiorespiratory Fitness with Carotid Artery Stiffness Index in Community-Dwelling Adults Women

Korean Journal of Sports Science ◽

10.35159/kjss.2019.02.28.1.1147 ◽

2019 ◽

Vol 28 (1) ◽

pp. 1147-1157

Author(s):

Seung-Yu Han ◽

Jin-Kee Park

Keyword(s):

Muscle Strength ◽

Carotid Artery ◽

Cardiorespiratory Fitness ◽

Community Dwelling ◽

Stiffness Index ◽

Artery Stiffness

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Relations of Microvascular Function, Cardiovascular Disease Risk Factors, and Aortic Stiffness in Blacks: The Jackson Heart Study

Journal of the American Heart Association ◽

10.1161/jaha.118.009515 ◽

2018 ◽

Vol 7 (20) ◽

Cited By ~ 1

Author(s):

Leroy L. Cooper ◽

Solomon K. Musani ◽

Floyd Washington ◽

Jonathan Moore ◽

Avnish Tripathi ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Aortic Stiffness ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Microvascular Function ◽

Cardiovascular Disease Risk Factors ◽

Jackson Heart Study ◽

Heart Study

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Abstract 14819: Excess Epicardial Fat Volume is Associated With Increased Cardiovascular Structural and Functional Abnormalities in Menopausal Women Regardless of Body Weight: The Higher the Epicardial Fat Volume, the Higher the Abnormalities

Circulation ◽

10.1161/circ.142.suppl_3.14819 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Mahfouz EL SHAHAWY ◽

Susan Tucker ◽

Lillee Izadi ◽

Antonella Sabatini

Keyword(s):

Disease Risk ◽

Cardiovascular Disease Risk ◽

Significant Risk ◽

Epicardial Fat ◽

Ct Scanner ◽

Cvd Risk ◽

Artery Stiffness ◽

Epicardial Fat Volume ◽

Asymptomatic Subjects ◽

Fat Volume

Background: It has been reported that an increase in epicardial fat volume (EFV) has been associated with an increase in cardiovascular structural and functional abnormalities (CVSFA). Purpose: The purpose of this study is to assess whether a step-wise increase in EFV is associated with a proportional increase in CVSFA. Methods: We screened 2,756 asymptomatic subjects, ages 20-79, for CVD risk using the Early Cardiovascular Disease Risk Scoring System (ECVDRS), which consists of 10 tests; 7 are vascular and 3 are cardiac. The vascular tests are: large (C1) and small (C2) artery stiffness, blood pressure (BP) at rest and post-mild protocol exercise (PME), CIMT, abdominal aorta ultrasound, retinal photography, and microalbuminuria. The 3 cardiac tests are: Pro-BNP, ECG, and LV ultrasound. Additional tests are waist circumference, BMI, fasting blood sugar, lipid profile, and CRP. 596 out of the total subjects were asymptomatic, and out of these 220 (37%) underwent cardiac CT for coronary artery calcium scoring (CACS) and EFV determination using Siemens Somatom Definition Dual source CT scanner 64x2. 107 out of the 220 were females (48%). These females were divided into 5 groups based on their EFV: 24 with < 69cm 3 ; 33 between 70cm 3 and 94cm 3 ; 16 between 95cm 3 and 119cm 3 ; 20 between 120cm 3 and 144cm 3 ; and 14 >145cm 3 . Results: As noted in the table, a step-wise increase in EFV was associated with proportional increases in CVSFA, specifically CACS, resting BP, abnormal rise in BP-PME, CRP, and triglycerides. An increase in EFV was noticeably associated with an increase in resting blood BP by a 10mmHg difference between the group whose EFV < 120cm 3 and those whose EFV is > 120cm 3 . Conclusions: Based on our data, we feel that excess EFV appears to be the villain for most CVSFA. Accordingly, we urge all healthcare professionals that it is time to focus on early and accurate assessment of this significant risk marker, which is the culprit for many CVD risk factors. Early detect to protect.

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