Bown CW, Khan OA, Moore EE, Liu D, Pechman KR, Cambronero FE, Terry JG, Nair S, Davis LT, Gifford KA, Landman BA, Hohman TJ, Carr JJ, Jefferson AL. Elevated Aortic Pulse Wave Velocity Relates to Longitudinal Gray and White Matter Changes. Arteriosclerosis, thrombosis, and vascular biology. 2021 Dec;41(41). 3015-3024. PMID: 34706559 [PubMed] PMCID: PMC8627676
To determine whether baseline aortic stiffness, measured by aortic pulse wave velocity (PWV), relates to longitudinal cerebral gray or white matter changes among older adults. Baseline cardiac magnetic resonance imaging will be used to assess aortic PWV while brain magnetic resonance imaging will be used to assess gray matter and white matter hyperintensity (WMH) volumes at baseline, 18 months, 3 years, 5 years, and 7 years. Approach and Results: Aortic PWV (m/s) was quantified from cardiac magnetic resonance. Multimodal 3T brain magnetic resonance imaging included -weighted imaging for quantifying gray matter volumes and -weighted fluid-attenuated inversion recovery imaging for quantifying WMHs. Mixed-effects regression models related baseline aortic PWV to longitudinal gray matter volumes (total, frontal, parietal, temporal, occipital, hippocampal, and inferior lateral ventricle) and WMH volumes (total, frontal, parietal, temporal, and occipital) adjusting for age, sex, race/ethnicity, education, cognitive diagnosis, Framingham stroke risk profile, (apolipoprotein E)-ε4 carrier status, and intracranial volume. Two hundred seventy-eight participants (73±7 years, 58% male, 87% self-identified as non-Hispanic White, 159 with normal cognition, and 119 with mild cognitive impairment) from the Vanderbilt Memory & Aging Project (n=335) were followed on average for 4.9±1.6 years with PWV measurements occurring from September 2012 to November 2014 and longitudinal brain magnetic resonance imaging measurements occurring from September 2012 to June 2021. Higher baseline aortic PWV was related to greater decrease in hippocampal (β=-3.6 [mm/y]/[m/s]; [95% CI, -7.2 to -0.02] =0.049) and occipital lobe (β=-34.2 [mm/y]/[m/s]; [95% CI, -67.8 to -0.55] =0.046) gray matter volume over time. Higher baseline aortic PWV was related to greater increase in WMH volume over time in the temporal lobe (β=17.0 [mm/y]/[m/s]; [95% CI, 7.2-26.9] <0.001). All associations may be driven by outliers.