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. 2017 Oct:265:305-311.
doi: 10.1016/j.atherosclerosis.2017.06.919. Epub 2017 Jun 23.

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

Hugo J Aparicio  1 , Rodica E Petrea  2 , Joseph M Massaro  3 , Warren J Manning  4 , Noriko Oyama-Manabe  5 , Alexa S Beiser  6 , Carlos S Kase  7 , Ralph B D'Agostino  3 , Philip A Wolf  8 , Ramachandran S Vasan  9 , Charles DeCarli  10 , Christopher J O'Donnell  11 , Sudha Seshadri  8
Affiliations

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

Hugo J Aparicio et al. Atherosclerosis. 2017 Oct.

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.

Keywords: Aorta; Atherosclerosis; Brain; Cerebrovascular disorders; Magnetic resonance imaging; Neuroimaging; White matter.

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Conflict of interest statement

Conflict of interest

The authors declared they do not have anything to disclose regarding conflict of interest with respect to this manuscript.

Figures

Figure 1
Figure 1
Transverse cardiovascular magnetic resonance image of the abdominal aorta and an aortic plaque, from a Framingham Offspring Cohort participant. IVC, inferior vena cava; Ao, aorta. Illustration adapted from www.mountsinai.org with permission from Dr. Allan Stewart. Copyright 2016, Icahn School of Medicine at Mount Sinai.
See this image and copyright information in PMC

Comment in

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