TY - JOUR
T1 - Brain volumes and risk of cardiovascular events and mortality. The SMART-MR study
AU - van der Veen, Pieternella H.
AU - Muller, Majon
AU - Vincken, Koen L.
AU - Mali, Willem P. T. M.
AU - van der Graaf, Yolanda
AU - Geerlings, Mirjam I.
AU - Algra, A.
AU - Doevendans, P. A.
AU - van der Graaf, Y.
AU - Grobbee, D. E.
AU - Rutten, G. E. H. M.
AU - Kappelle, L. J.
AU - Mali, W. P. T. M.
AU - Moll, F. L.
AU - Visseren, F. L. J.
PY - 2014/7
Y1 - 2014/7
N2 - Brain atrophy is a strong predictor for cognitive decline and dementia, and these are, in turn, associated with increased mortality in the general population. Patients with cardiovascular disease have more brain atrophy and a higher morbidity and mortality. We investigated if brain volumes on magnetic resonance imaging were associated with the risk of cardiovascular events and mortality in patients with manifest arterial disease (n= 1215; mean age 58years). Automated brain segmentation was used to quantify intracranial volume, and volumes of total brain, sulcal cerebrospinal fluid, and ventricles. After a median follow-up of 8.3years, 184 patients died, 49 patients had an ischemic stroke, and 100 patients had an ischemic cardiac complication. Smaller relative brain volumes increased the risk of all-cause death (hazard ratio [HR] per standard deviation decrease in total brain volume: 1.58, 95% confidence interval [95% CI]: 1.33-1.88), vascular death (HR 1.69, 95% CI: 1.35-2.13), and ischemic stroke (HR 1.96, 95% CI: 1.43-2.69), independent of cardiovascular risk factors. These results suggest that brain volumes are an important determinant of poor outcome in patients with high cardiovascular risk. © 2014 Elsevier Inc.
AB - Brain atrophy is a strong predictor for cognitive decline and dementia, and these are, in turn, associated with increased mortality in the general population. Patients with cardiovascular disease have more brain atrophy and a higher morbidity and mortality. We investigated if brain volumes on magnetic resonance imaging were associated with the risk of cardiovascular events and mortality in patients with manifest arterial disease (n= 1215; mean age 58years). Automated brain segmentation was used to quantify intracranial volume, and volumes of total brain, sulcal cerebrospinal fluid, and ventricles. After a median follow-up of 8.3years, 184 patients died, 49 patients had an ischemic stroke, and 100 patients had an ischemic cardiac complication. Smaller relative brain volumes increased the risk of all-cause death (hazard ratio [HR] per standard deviation decrease in total brain volume: 1.58, 95% confidence interval [95% CI]: 1.33-1.88), vascular death (HR 1.69, 95% CI: 1.35-2.13), and ischemic stroke (HR 1.96, 95% CI: 1.43-2.69), independent of cardiovascular risk factors. These results suggest that brain volumes are an important determinant of poor outcome in patients with high cardiovascular risk. © 2014 Elsevier Inc.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84903366977&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/24582641
U2 - https://doi.org/10.1016/j.neurobiolaging.2014.02.003
DO - https://doi.org/10.1016/j.neurobiolaging.2014.02.003
M3 - Article
C2 - 24582641
SN - 0197-4580
VL - 35
SP - 1624
EP - 1631
JO - Neurobiology of aging
JF - Neurobiology of aging
IS - 7
ER -