Association of descending thoracic aortic plaque with brain atrophy and white matter hyperintensities: The Framingham Heart Study

• Type of Material: Article
• Authors: Hugo J. Aparicio, Boston University; Rodica E. Petrea, Boston University; Joseph M. Massaro, National Heart, Lung, and Blood Institute; Warren J. Manning, National Heart, Lung, and Blood Institute; Noriko Oyama-Manabe, Beth Israel Deaconess Medical Center; Alexa S. Beiser, Boston University; Carlos Kase, Emory University; Ralph B. D'Agostino, National Heart, Lung, and Blood Institute; Philip A. Wolf, Boston University; Ramachandran S. Vasan, National Heart, Lung, and Blood Institute; Charles DeCarli, University of California Davis; Christopher J. O'Donnell, National Heart, Lung, and Blood Institute; Sudha Seshadri, Boston University
• Language: English
• Date: 2017-10-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 Elsevier B.V.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.atherosclerosis.2017.06.919
• Title of Journal or Parent Work: Atherosclerosis
• ISSN: 0021-9150
• Volume: 265
• Start Page: 305
• End Page: 311
• Grant/Funding Information: The FHS and research supported by the Boston University School of Medicine are funded by the National Heart, Lung, and Blood Institute (N01-HC-25195; HHSN268201500001I), and by grants from the National Institute of Neurologic Disorders and Stroke (NINDS R01NS017950).; HJA is supported by grants from the National Institute of Aging (NIA T32-AG036697) and the American Heart Association (AHA 15GPSPG23770000).; This project was supported in part by contracts from the NHLBI RO1-HL70279 (WJM) and NIA R01-AG008122 (SS).
• Keywords: Magnetic resonance imaging; White matter; CAROTID-ARTERY ATHEROSCLEROSIS; AGE; CEREBROVASCULAR LESIONS; Cardiac & Cardiovascular Systems; STROKE RISK PROFILE; CARDIOVASCULAR MAGNETIC-RESONANCE; Life Sciences & Biomedicine; Science & Technology; Peripheral Vascular Disease; Atherosclerosis; Cerebrovascular disorders; SMART-MR; COMPUTED-TOMOGRAPHY; TRANSESOPHAGEAL ECHOCARDIOGRAPHY; Aorta; Cardiovascular System & Cardiology; SEX-DIFFERENCES; Brain; Neuroimaging; ISCHEMIC-STROKE
• Research Categories: Biology, Biostatistics; Health Sciences, Medicine and Surgery; Biology, Neuroscience

Abstract

Background and aims Aortic atherosclerosis is an aggregate marker of vascular risk factor exposure and has been associated with intracranial atherosclerosis and stroke. We hypothesized that atherosclerosis of the descending aorta (DAo) could be a risk marker for brain aging and injury. Methods We evaluated 1527 participants (mean age 59.9 years, 53.5% women) in the Framingham Offspring cohort who underwent both aortic and brain MRI. Participants were free of clinical stroke, dementia, or other neurological illness at the time of axial MRI of the thoracic and abdominal DAo and subsequent brain MRI. We related the prevalence and burden of aortic plaque to total cerebral brain volume (TCBV) and white matter hyperintensity volume (WMHV). An additional analysis compared incidence of stroke or TIA in participants with and without DAo plaques. Results Presence of thoracic DAo plaque (8%) was associated with decreased TCBV in sex-pooled analysis (−0.77, SE 0.25, p = 0.002, equivalent to 4.5 years of aging) and with increased WMHV only in men (0.26, SE 0.12, p = 0.032, equivalent to 6.5 years aging). We observed similar associations of DAo plaque burden with TCBV and WMHV. There were 43 strokes and 11 TIAs in prospective follow-up (median 7 years). Presence of DAo plaque was not associated with subsequent stroke or TIA. Conclusions In this cross-sectional community-based study, we found DAo plaque is associated with accelerated brain aging. These data underscore the potential implications of incidentally identified subclinical aortic atherosclerosis and question whether targeted intervention in these high risk individuals can modulate cognitive decline.