Identify abnormal cardiac chamber size and hemodynamic parameters on cardiac MRI as predictors of advancing cerebral small vessel disease (CSVD) on brain MRI.

CSVD is a common age-related disorder with its accumulation leading to gait disturbances, mood changes and cognitive decline. Abnormal cardiac structure and function has been hypothesized to either be contributing to advancement of CSVD or develop in parallel. Previously, we identified both normal and significantly abnormal left atrial and right ventricular chamber sizes on 2D transthoracic echocardiogram (TTE) were associated advanced CSVD, while moderately abnormal sizes were predictors of the worst CSVD burden. However, TTE has significant limitations including a degree of subjectivity to its findings. This follow up study utilizes cardiac MRI for obtaining cardiac structural and functional parameters due to its increased objectivity. 

This is a retrospective analysis of University of Utah Health patients from January 2014 to December 2019. We included patients who completed both a cardiac and brain MRI within one year of each other. The primary outcome was the burden of CSVD measured by the total small vessel disease (tSVD) score. Multivariate ordinal logistic regression models to the tSVD score were used with individual predictors of cardiac MRI measurements and adjusted for potential confounders.

A total of 333 individuals are included. The mean (SD) age is 61 (15) years with 63% male (n=211). The  tSVD score will be analyzed with structural and functional parameters from cardiac MRI readings adjusted for demographic and other pertinent clincoradiographic data.

Prior research indicates that cardiac morphology is associated with WMH on brain MRI, however the results have been inconsistent. This finding may be possible due to differences in imaging modalities. This study aims to corroborate previous results using cardiac MRI parameters as a predictor for advancing CSVD on brain MRI.