Abstract MP25: Brain Atrophy And White Matter Injury In Relation To Cardiovascular Risk Factors And Race/ethnicity: The Multi-ethnic Study Of Atherosclerosis

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Thomas R Austin ◽  
Susan R Heckbert ◽  
Ilya M Nasrallah ◽  
Guray Erus ◽  
Lisa M Desiderio ◽  
...  
Keyword(s):  
Risk Factors ◽  
Socioeconomic Status ◽  
Diffusion Coefficient ◽  
Cardiovascular Risk ◽  
White Matter ◽  
Cardiovascular Risk Factors ◽  
Brain Mri ◽  
Lesion Volume ◽  
Apparent Diffusion ◽  
Race Ethnicity

Introduction: Cardiovascular risk factors are associated with cognitive decline and dementia. Brain magnetic resonance imaging (MRI) provides sensitive measurement of cerebral atrophy and small vessel disease, reflecting multiple pathologies leading to dementia. However, large brain MRI studies include primarily white participants. We investigated associations in the diverse Multi-Ethnic Study of Atherosclerosis (MESA). Hypothesis: Cardiovascular and sociodemographic risk factors are associated with brain morphology and white matter injury in a racially and ethnically diverse population. Methods: In MESA, brain MRI was performed in 2018-2019 with automated measurement of total brain volume, gray and white matter (GM, WM) volume, and measures of WM injury including WM lesion volume, WM fractional anisotropy, and WM apparent diffusion coefficient. In cross-sectional analyses, we assessed the association of race/ethnicity with MRI measures, with and without adjustment for cardiovascular risk factors, education, and socioeconomic status. In a multivariable model, we assessed the association of cardiovascular risk factors with brain MRI measures. All analyses of volumes, including WM lesion volume, were adjusted for total intracranial volume. Results: MRI data were complete in 1,051 participants; 40% were white, 15% Chinese-American, 25% African-American, and 20% Hispanic. Mean (standard deviation, SD) age was 73 (8) years and 53% of participants were women. Adjusted for age and sex, African-American participants had slightly greater total brain and WM volume than white participants. Adjusted for age and sex, African-American participants had on average more WM injury than whites as measured by higher WM lesion volume (46.7% higher, 95% CI: 19.9, 79.4%) and lower fractional anisotropy (-0.20 SD, 95% CI: -0.34, -0.05); these associations were attenuated after additional adjustment for cardiovascular risk factors and socioeconomic status (24.3% higher WM lesion volume, 95% CI: 0.0, 54.3; -0.06 SD fractional anisotropy, 95% CI: -0.22, 0.09). Conversely, all non-white race/ethnic groups had slightly less WM injury than white participants as estimated by apparent diffusion coefficient. Overall, greater age, diabetes, current smoking, high systolic blood pressure, and treated hypertension were strongly associated with more WM injury; in addition, age and diabetes were strongly associated with lower brain volumes. Conclusions: We found little evidence of differences in measures of brain atrophy and WM injury by race/ethnicity after adjustment for cardiovascular risk factors and socioeconomic status. Findings of differences by race/ethnicity in apparent diffusion coefficient are intriguing and need further investigation. Consistent with previous studies, age, diabetes, current smoking and hypertension were strongly and consistently associated with WM injury.

scholarly journals Strong and specific associations between cardiovascular risk factors and white matter micro- and macrostructure in healthy aging

2019 ◽  
Vol 74 ◽  
pp. 46-55 ◽  
Author(s):  
Delia Fuhrmann ◽  
David Nesbitt ◽  
Meredith Shafto ◽  
James B. Rowe ◽  
Darren Price ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
White Matter ◽  
Cardiovascular Risk Factors ◽  
Healthy Aging

Abstract MP47: The Association of Socioeconomic Status with Subclinical Myocardial Damage

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Anna E Fretz ◽  
Andrea L Schneider ◽  
John McEvoy ◽  
Ron Hoogeveen ◽  
Christie M Ballantyne ◽  
...  
Keyword(s):  
Risk Factors ◽  
Socioeconomic Status ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Low Income ◽  
Myocardial Damage ◽  
Low Ses ◽  
12Th Grade ◽  
Low Education ◽  
Prevalence Ratios

Background: The association between socioeconomic status (SES) and clinical cardiovascular events is well established. However, little is known about the relationship between SES and subclinical myocardial damage, as assessed by a novel highly sensitive assay for cardiac troponin T (hs-cTnT). Methods: We conducted a cross-sectional analysis of 11,411 participants from the ARIC Study with no history of cardiovascular disease who had hs-cTnT measured at visit 2 (1990-1992). SES was defined using either annual household income, categorized as: low (<$16,000), mid-level ($16,000 - $34,999), high (≥ $35,000), or lifetime educational attainment, categorized as: low (<12th grade), mid-level (12th grade/some college) and high (college degree or higher). hs-cTnT was categorized as non-elevated (<14 ng/L) and elevated (≥ 14ng/L). Poisson regression was used to generate prevalence ratios for elevated hs-cTnT, separately by level of income and education after adjusting for demographic, clinical, and behavioral factors. Results: Persons with low income or low education were more likely to have subclinical myocardial damage as assessed by elevated hs-cTnT (≥14ng/L). Adjusted prevalence ratios for elevated troponin comparing low to high levels of income and education were 1.74 (95% CI: 1.32, 2.29) and 1.54 (95% CI: 1.21, 1.97), respectively (Table, Model 1). These results were slightly attenuated, but remained statistically significant after adjusting for cardiovascular risk factors and health behaviors (Models 2 and 3). Race-stratified results demonstrate a somewhat stronger and only significant association of low education with subclinical myocardial damage in blacks compared to whites (PR 1.83 vs 1.05, p-interaction =0.08). There was no race interaction with income (p-interaction =0.33). Conclusions: Low SES was associated with elevated hs-cTnT, independent of cardiovascular risk factors, especially in blacks. Further research is needed to explore how low SES contributes to subclinical myocardial damage.

The Potential Role of Peritumoral Apparent Diffusion Coefficient Evaluation in Differentiating Glioblastoma and Solitary Metastatic Lesions of the Brain

2021 ◽  
Vol 17 ◽  
Author(s):  
Murat Tepe ◽  
Suzan Saylisoy ◽  
Ugur Toprak ◽  
Ibrahim Inan
Keyword(s):  
Diffusion Coefficient ◽  
White Matter ◽  
Apparent Diffusion Coefficient ◽  
Sensitivity And Specificity ◽  
Brain Mri ◽  
Solitary Metastasis ◽  
Metastatic Lesions ◽  
Institutional Review ◽  
Apparent Diffusion ◽  
Adc Values

Objective: Differentiating glioblastoma (GBM) and solitary metastasis is not always possible using conventional magnetic resonance imaging (MRI) techniques. In conventional brain MRI, GBM and brain metastases are lesions with mostly similar imaging findings. In this study, we investigated whether apparent diffusion coefficient (ADC) ratios, ADC gradients, and minimum ADC values in the peritumoral edema tissue can be used to discriminate between these two tumors. Methods: This retrospective study was approved by the local institutional review board with a waiver of written informed consent. Prior to surgical and medical treatment, conventional brain MRI and diffusion-weighted MRI (b = 0 and b = 1000) images were taken from 43 patients (12 GBM and 31 solitary metastasis cases). Quantitative ADC measurements were performed on the peritumoral tissue from the nearest segment to the tumor (ADC1), the middle segment (ADC2), and the most distant segment (ADC3). The ratios of these three values were determined proportionally to calculate the peritumoral ADC ratios. In addition, these three values were subtracted from each other to obtain the peritumoral ADC gradients. Lastly, the minimum peritumoral and tumoral ADC values, and the quantitative ADC values from the normal appearing ipsilateral white matter, contralateral white matter and ADC values from cerebrospinal fluid (CSF) were recorded. Results: For the differentiation of GBM and solitary metastasis, ADC3 / ADC1 was the most powerful parameter with a sensitivity of 91.7% and specificity of 87.1% at the cut-off value of 1.105 (p < 0.001), followed by ADC3 / ADC2 with a cut-off value of 1.025 (p = 0.001), sensitivity of 91.7%, and specificity of 74.2%. The cut-off, sensitivity and specificity of ADC2 / ADC1 were 1.055 (p = 0.002), 83.3%, and 67.7%, respectively. For ADC3 – ADC1, the cut-off value, sensitivity and specificity were calculated as 150 (p < 0.001), 91.7% and 83.9%, respectively. ADC3 – ADC2 had a cut-off value of 55 (p = 0.001), sensitivity of 91.7%, and specificity of 77.4 whereas ADC2 – ADC1 had a cut-off value of 75 (p = 0.003), sensitivity of 91.7%, and specificity of 61.3%. Among the remaining parameters, only the ADC3 value successfully differentiated between GBM and metastasis (GBM 1802.50 ± 189.74 vs. metastasis 1634.52 ± 212.65, p = 0.022). Conclusion: The integration of the evaluation of peritumoral ADC ratio and ADC gradient into conventional MR imaging may provide valuable information for differentiating GBM from solitary metastatic lesions.

scholarly journals Brain white-matter hyperintensities and treatment outcome in major depressive disorder

2006 ◽  
Vol 188 (2) ◽  
pp. 180-185 ◽  
Author(s):  
Dan V. Iosifescu ◽  
Perry F. Renshaw ◽  
In Kyoon Lyoo ◽  
Ho Kyu Lee ◽  
Roy H. Perlis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Major Depressive Disorder ◽  
Treatment Outcome ◽  
Cardiovascular Risk ◽  
White Matter ◽  
Depressive Disorder ◽  
Cardiovascular Risk Factors ◽  
White Matter Hyperintensities ◽  
Major Depressive ◽  
Brain White Matter

BackgroundAn increased incidence of brain white-matter hyperintensities has been described in major depressive disorder, but the impact of such hyperintensities on treatment outcome is still controversial.AimsTo investigate the relationship of brain white-matter hyperintensities with cardiovascular risk factors and with treatment outcome in younger people with major depressive disorder.MethodWe assessed brain white-matter hyperintensities and cardiovascular risk factors in 84 people with major depressive disorder prior to initiating antidepressanttreatment. We also assessed hyperintensities in 35 matched controls.ResultsWe found no significant difference in the prevalence of white-matter hyperintensities between the depression and the control groups. Left-hemisphere subcortical hyperintensities correlated with lower rates of treatment response. We found no correlation between global hyperintensity measures and clinical outcome. Brain white-matter hyperintensities correlated with hypertension and age and with total cardiovascular risk score.ConclusionsSubcortical white-matter hyperintensities in the left hemisphere (but not in other brain areas) may be associated with poor response to antidepressant treatment in major depression.

scholarly journals Long-term cerebral white and gray matter changes after preeclampsia

Neurology ◽  
2017 ◽  
Vol 88 (13) ◽  
pp. 1256-1264 ◽  
Author(s):  
Timo Siepmann ◽  
Henry Boardman ◽  
Amy Bilderbeck ◽  
Ludovica Griffanti ◽  
Yvonne Kenworthy ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
White Matter ◽  
Temporal Lobe ◽  
Gray Matter ◽  
Diffusion Tensor ◽  
Brain Mri ◽  
Risk Profile ◽  
Lesion Volume ◽  
Cardiovascular Risk Profile ◽  
Microstructural Integrity

Objective:To determine whether changes in cerebral structure are present after preeclampsia that may explain increased cerebrovascular risk in these women.Methods:We conducted a case control study in women between 5 and 15 years after either a preeclamptic or normotensive pregnancy. Brain MRI was performed. Analysis of white matter structure was undertaken using voxel-based segmentation of fluid-attenuation inversion recovery sequences to assess white matter lesion volume and diffusion tensor imaging to measure microstructural integrity. Voxel-based analysis of gray matter volumes was performed with adjustment for skull size.Results:Thirty-four previously preeclamptic women (aged 42.8 ± 5.1 years) and 49 controls were included. Previously preeclamptic women had reduced cortical gray matter volume (523.2 ± 30.1 vs 544.4 ± 44.7 mL, p < 0.05) and, although both groups displayed white matter lesions, changes were more extensive in previously preeclamptic women. They displayed increased temporal lobe white matter disease (lesion volume: 23.2 ± 24.9 vs 10.9 ± 15.0 μL, p < 0.05) and altered microstructural integrity (radial diffusivity: 538 ± 19 vs 526 ± 18 × 10−6 mm2/s, p < 0.01), which also extended to occipital and parietal lobes. The degree of temporal lobe white matter change in previously preeclamptic women was independent of their current cardiovascular risk profile (p < 0.05) and increased with time from index pregnancy (p < 0.05).Conclusion:A history of preeclampsia is associated with temporal lobe white matter changes and reduced cortical volume in young women, which is out of proportion to their classic cardiovascular risk profile. The severity of changes is proportional to time since pregnancy, which would be consistent with continued accumulation of damage after pregnancy.

scholarly journals Low Socioeconomic Status Is Associated with Cardiovascular Risk Factors and Outcomes in Systemic Lupus Erythematosus

2012 ◽  
Vol 39 (4) ◽  
pp. 777-783 ◽  
Author(s):  
JANET W. MAYNARD ◽  
HONG FANG ◽  
MICHELLE PETRI
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Socioeconomic Status ◽  
Cardiovascular Risk ◽  
African Americans ◽  
Cardiovascular Risk Factors ◽  
Low Income ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Low Education

Objective.Accelerated atherosclerosis is a major cause of death in systemic lupus erythematosus (SLE), yet little is known about the effect of socioeconomic status. We investigated whether education or income levels are associated with cardiovascular risk factors and outcomes in SLE.Methods.Our study involved a longitudinal cohort of all patients with SLE enrolled in the Hopkins Lupus Cohort from 1987 through September 2011. Socioeconomic status was measured by education level (≥ 12 years or < 12) and income tertiles (> $60,000, $25,000–$60,000, or < $25,000).Results.A total of 1752 patients with SLE were followed prospectively every 3 months. There were 1052 whites and 700 African Americans. Current smoking, obesity, hypertension, and diabetes mellitus were more common in African Americans (p < 0.01 for all), but there was no statistical difference in the frequency of myocardial infarction or stroke. In multivariate analyses stratified by ethnicity, low income was strongly associated with most traditional cardiovascular risk factors in whites, but only with smoking and diabetes in African Americans. In whites, low income increased the risk of both myocardial infarction (OR 3.24, 95% CI 1.41–7.45, p = 0.006) and stroke (OR 2.85, 95% CI 1.56–5.21, p = 0.001); in African Americans, these relationships were not seen. Low education, in contrast, was associated with smoking in both ethnic groups.Conclusion.Low income, not low education, is the socioeconomic status variable associated with cardiovascular risk factors and events. This association is most clearly demonstrable in whites.

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