Heart Disease Protein Linked to Brain Damage

In community-dwelling middle-aged and elderly persons, subclinical cardiac dysfunction as reflected by serum N-terminal pro–B-type natriuretic peptide (NT-proBNP) levels is associated with global and microstructural MRI markers of subclinical brain damage, new Radiology research shows.

Hazel I. Zonneveld, MD, of Erasmus MC University Medical Center in Rotterdam, the Netherlands, and colleagues measured serum levels of NT-proBNP in 2,397 participants without dementia or stroke and without clinical diagnosis of heart disease who were drawn from the population-based Rotterdam Study.

They found a higher NT-proBNP level was associated with smaller total brain volume and was predominantly driven by gray matter volume. Higher NT-proBNP level was associated with larger white matter lesion volume, with lower fractional anisotropy and higher mean diffusivity of normal-appearing white matter.

“Our findings suggest that the heart and brain are intimately linked, even in presumably healthy individuals. This is essential since cardiac dysfunction and subclinical brain damage are growing problems,” the authors write.

Structural and microstructural MR imaging markers
Structural and microstructural MR imaging markers of subclinical brain damage. The left side of each image corresponds to right side of the brain. A,T1-weighted image. B, Fluid-attenuated inversion recovery image shows white matter lesions (arrowhead) and lacunar infarct (arrow). C, Three-dimensional T2* gradient-echo MR image shows cerebral microbleeds (arrow). D, Tissue segmentation, with each tissue type represented by a different color. CSF = cerebral spinal fluid, GM = gray matter, WM = white matter. E, Diffusion-tensor imaging map of fractional anisotropy. F, Diffusion-tensor imaging map of mean diffusivity.

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