TY - JOUR
T1 - The Heart-Brain Connection: A Multidisciplinary Approach Targeting a Missing Link in the Pathophysiology of Vascular Cognitive Impairment
AU - van Buchem, Mark A.
AU - Biessels, Geert Jan
AU - la Rocca, Hans Peter Brunner
AU - de Craen, Anton J. M.
AU - van der Flier, Wiesje M.
AU - Ikram, M. Arfan
AU - Kappelle, L. Jaap
AU - Koudstaal, Peter J.
AU - Mooijaart, Simon P.
AU - Niessen, Wiro
AU - van Oostenbrugge, Robert
AU - de Roos, Albert
AU - van Rossum, Albert C.
AU - Daemen, Mat J. A. P.
PY - 2014
Y1 - 2014
N2 - While both cardiac dysfunction and progressive loss of cognitive functioning are prominent features of an aging population, surprisingly few studies have addressed the link between heart and brain function. This is probably due to the monodisciplinary approach to these problems by cardiologists, neurologists, and geriatricians. Recent data indicate that autoregulation of cerebral flow cannot always protect the brain from hypoperfusion when cardiac output is reduced or atherosclerosis is prominent. This suggests a close link between cardiac function and large vessel atherosclerosis on the one hand and brain perfusion and cognitive functioning on the other. In a national research program, we will test the hypothesis that impaired hemodynamic status of both heart and brain is an important and potentially reversible cause of vascular cognitive impairment (VCI) offering promising opportunities for treatment. Using a multidisciplinary approach, we will address the following questions: 1) To what extent do hemodynamic changes contribute to VCI? 2) What are the mechanisms involved? 3) Does improvement of the hemodynamic status lead to improvement of cognitive dysfunction? To this end we will perform clinical studies in elderly patients with clinically manifest VCI, carotid occlusive disease, or heart failure and evaluate their cardiac and large vascular function, atherosclerotic load, and cerebral perfusion with a comprehensive magnetic resonance imaging protocol and thoroughly test their cognitive function. We will also analyze epidemiological data from the Rotterdam Study.
AB - While both cardiac dysfunction and progressive loss of cognitive functioning are prominent features of an aging population, surprisingly few studies have addressed the link between heart and brain function. This is probably due to the monodisciplinary approach to these problems by cardiologists, neurologists, and geriatricians. Recent data indicate that autoregulation of cerebral flow cannot always protect the brain from hypoperfusion when cardiac output is reduced or atherosclerosis is prominent. This suggests a close link between cardiac function and large vessel atherosclerosis on the one hand and brain perfusion and cognitive functioning on the other. In a national research program, we will test the hypothesis that impaired hemodynamic status of both heart and brain is an important and potentially reversible cause of vascular cognitive impairment (VCI) offering promising opportunities for treatment. Using a multidisciplinary approach, we will address the following questions: 1) To what extent do hemodynamic changes contribute to VCI? 2) What are the mechanisms involved? 3) Does improvement of the hemodynamic status lead to improvement of cognitive dysfunction? To this end we will perform clinical studies in elderly patients with clinically manifest VCI, carotid occlusive disease, or heart failure and evaluate their cardiac and large vascular function, atherosclerotic load, and cerebral perfusion with a comprehensive magnetic resonance imaging protocol and thoroughly test their cognitive function. We will also analyze epidemiological data from the Rotterdam Study.
KW - Atherosclerosis
KW - heart
KW - magnetic resonance imaging
KW - vascular cognitive impairment
U2 - 10.3233/JAD-141542
DO - 10.3233/JAD-141542
M3 - Article
C2 - 25213769
SN - 1387-2877
VL - 42
SP - S443-S451
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
ER -