Abstract
BACKGROUND AND PURPOSE: Although increased heart rate (HR) is a predictor of cardiovascular events and mortality, its possible association with subclinical cerebrovascular disease, which is prevalent in the elderly, has not been evaluated. This study aimed to investigate the association of daytime, nighttime, 24-hour HR, and HR variability with subclinical cerebrovascular disease in an elderly cohort without history of stroke.
METHODS: The study cohort consisted of 680 participants (mean age, 73±7 years; 42% men) in sinus rhythm who underwent 24-hour ambulatory blood pressure and HR monitoring, 2-dimensional echocardiography, and brain magnetic resonance imaging as part of the CABL study (Cardiac Abnormalities and Brain Lesion). Subclinical cerebrovascular disease was defined as silent brain infarcts and white matter hyperintensity volume (WMHV). The relationship of HR measures with the presence of silent brain infarct and upper quartile of log WMHV (log WMHV4) was analyzed.
RESULTS: Presence of silent brain infarct was detected in 93 participants (13.7%); mean log WMHV was -0.92±0.93 (median, -1.05; min, -5.88; max, 1.74). Multivariate analysis showed that only nighttime HR (adjusted odds ratio, 1.29 per 10 bpm; 95% confidence interval, 1.03-1.61; P=0.026) was significantly associated with log WMHV4, independent of traditional cardiovascular risk factors, ambulatory systolic blood pressure, and echocardiographic parameters. No similar association was observed for daytime HR and HR variability. There was no significant association between all HR measures and silent brain infarct.
CONCLUSIONS: In a predominantly elderly cohort, elevated nighttime HR was associated with WMHV, suggesting an independent role of HR in subclinical cerebrovascular disease.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 319-324 |
| Number of pages | 6 |
| Journal | Stroke |
| Volume | 49 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2018 |
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Keywords
- echocardiography
- heart rate
- magnetic resonance imaging
- multivariate analysis
- odds ratio
ASJC Scopus subject areas
- Clinical Neurology
- Cardiology and Cardiovascular Medicine
- Advanced and Specialized Nursing
Cite this
Association Between Heart Rate and Subclinical Cerebrovascular Disease in the Elderly. / Nakanishi, Koki; Jin, Zhezhen; Homma, Shunichi; Elkind, Mitchell S.V.; Rundek, Tatjana; Lee, Seitetz C.; Tugcu, Aylin; Yoshita, Mitsuhiro; DeCarli, Charles; Wright, Clinton B.; Sacco, Ralph L.; Di Tullio, Marco R.
In: Stroke, Vol. 49, No. 2, 01.02.2018, p. 319-324.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Association Between Heart Rate and Subclinical Cerebrovascular Disease in the Elderly
AU - Nakanishi, Koki
AU - Jin, Zhezhen
AU - Homma, Shunichi
AU - Elkind, Mitchell S.V.
AU - Rundek, Tatjana
AU - Lee, Seitetz C.
AU - Tugcu, Aylin
AU - Yoshita, Mitsuhiro
AU - DeCarli, Charles
AU - Wright, Clinton B.
AU - Sacco, Ralph L.
AU - Di Tullio, Marco R.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - BACKGROUND AND PURPOSE: Although increased heart rate (HR) is a predictor of cardiovascular events and mortality, its possible association with subclinical cerebrovascular disease, which is prevalent in the elderly, has not been evaluated. This study aimed to investigate the association of daytime, nighttime, 24-hour HR, and HR variability with subclinical cerebrovascular disease in an elderly cohort without history of stroke.METHODS: The study cohort consisted of 680 participants (mean age, 73±7 years; 42% men) in sinus rhythm who underwent 24-hour ambulatory blood pressure and HR monitoring, 2-dimensional echocardiography, and brain magnetic resonance imaging as part of the CABL study (Cardiac Abnormalities and Brain Lesion). Subclinical cerebrovascular disease was defined as silent brain infarcts and white matter hyperintensity volume (WMHV). The relationship of HR measures with the presence of silent brain infarct and upper quartile of log WMHV (log WMHV4) was analyzed.RESULTS: Presence of silent brain infarct was detected in 93 participants (13.7%); mean log WMHV was -0.92±0.93 (median, -1.05; min, -5.88; max, 1.74). Multivariate analysis showed that only nighttime HR (adjusted odds ratio, 1.29 per 10 bpm; 95% confidence interval, 1.03-1.61; P=0.026) was significantly associated with log WMHV4, independent of traditional cardiovascular risk factors, ambulatory systolic blood pressure, and echocardiographic parameters. No similar association was observed for daytime HR and HR variability. There was no significant association between all HR measures and silent brain infarct.CONCLUSIONS: In a predominantly elderly cohort, elevated nighttime HR was associated with WMHV, suggesting an independent role of HR in subclinical cerebrovascular disease.
AB - BACKGROUND AND PURPOSE: Although increased heart rate (HR) is a predictor of cardiovascular events and mortality, its possible association with subclinical cerebrovascular disease, which is prevalent in the elderly, has not been evaluated. This study aimed to investigate the association of daytime, nighttime, 24-hour HR, and HR variability with subclinical cerebrovascular disease in an elderly cohort without history of stroke.METHODS: The study cohort consisted of 680 participants (mean age, 73±7 years; 42% men) in sinus rhythm who underwent 24-hour ambulatory blood pressure and HR monitoring, 2-dimensional echocardiography, and brain magnetic resonance imaging as part of the CABL study (Cardiac Abnormalities and Brain Lesion). Subclinical cerebrovascular disease was defined as silent brain infarcts and white matter hyperintensity volume (WMHV). The relationship of HR measures with the presence of silent brain infarct and upper quartile of log WMHV (log WMHV4) was analyzed.RESULTS: Presence of silent brain infarct was detected in 93 participants (13.7%); mean log WMHV was -0.92±0.93 (median, -1.05; min, -5.88; max, 1.74). Multivariate analysis showed that only nighttime HR (adjusted odds ratio, 1.29 per 10 bpm; 95% confidence interval, 1.03-1.61; P=0.026) was significantly associated with log WMHV4, independent of traditional cardiovascular risk factors, ambulatory systolic blood pressure, and echocardiographic parameters. No similar association was observed for daytime HR and HR variability. There was no significant association between all HR measures and silent brain infarct.CONCLUSIONS: In a predominantly elderly cohort, elevated nighttime HR was associated with WMHV, suggesting an independent role of HR in subclinical cerebrovascular disease.
KW - echocardiography
KW - heart rate
KW - magnetic resonance imaging
KW - multivariate analysis
KW - odds ratio
UR - http://www.scopus.com/inward/record.url?scp=85044030299&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044030299&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.117.019355
DO - 10.1161/STROKEAHA.117.019355
M3 - Article
C2 - 29284731
AN - SCOPUS:85044030299
VL - 49
SP - 319
EP - 324
JO - Stroke
JF - Stroke
SN - 0039-2499
IS - 2
ER -