Background-—Subclinical left ventricular (LV) dysfunction has been inconsistently associated with early cognitive impairment, and
mechanistic pathways have been poorly considered. We investigated the cross-sectional relationship between LV dysfunction and
structural/functional measures of the brain and explored the role of potential mechanisms.
Method and Results-—A total of 1338 individuals (69 6 years) from the Southall and Brent Revisited study underwent
echocardiography for systolic (tissue Doppler imaging peak systolic wave) and diastolic (left atrial diameter) assessment. Cognitive
function was assessed and total and hippocampal brain volumes were measured by magnetic resonance imaging. Global LV
function was assessed by circulating N-terminal pro–brain natriuretic peptide. The role of potential mechanistic pathways of
arterial stiffness, atherosclerosis, microvascular disease, and inflammation were explored. After adjusting for age, sex, and
ethnicity, lower systolic function was associated with lower total brain (beta standard error, 14.9 3.2 cm3
; P<0.0001) and
hippocampal volumes (0.05 0.02 cm3
, P=0.01). Reduced diastolic function was associated with poorer working memory
(0.21 0.07, P=0.004) and fluency scores (0.18 0.08, P=0.02). Reduced global LV function was associated with smaller
hippocampal volume (0.10 0.03 cm3
, P=0.004) and adverse visual memory (0.076 0.03, P=0.02) and processing speed
(0.063 0.02, P=0.006) scores. Separate adjustment for concomitant cardiovascular risk factors attenuated associations with
hippocampal volume and fluency only. Further adjustment for the alternative pathways of microvascular disease or arterial
stiffness attenuated the relationship between global LV function and visual memory.
Conclusions-—In a community-based sample of older people, measures of LV function were associated with structural/functional
measures of the brain. These associations were not wholly explained by concomitant risk factors or potential mechanistic
pathways.