title: Relationship between cognitive impairment and echocardiographic parameters: a review.
abstract: With >24 million people affected worldwide, dementia is one of the main public health challenges modern medicine has to face. The path leading to dementia is often long, with a wide spectrum of clinical presentations, and preceded by a long preclinical phase. Previous studies have demonstrated that clinical strokes and covert vascular lesions of the brain contribute to the risk for developing dementia. Although it is not yet known whether preventing such lesions reduces the risk for dementia, it is likely that starting preventive measures early in the course of the disease may be beneficial. Echocardiography is a widely available, relatively inexpensive, noninvasive imaging modality whereby morphologically or hemodynamically derived parameters may be integrated easily into a risk assessment model for dementia. The aim of this review is to analyze the information that has accumulated over the past two decades on the prognostic value of echocardiographic factors in cognitive impairment. The associations between cognitive impairment and echocardiographic parameters, including left ventricular systolic and diastolic indices, left atrial morphologic parameters, cardiac output, left ventricular mass, and aortic root diameter, have previously been reported. In the light of these studies, it appears that echocardiography may help further improve currently used risk assessment models by allowing detection of subclinical cardiac abnormalities associated with future cognitive impairment. However, many limitations, including methodologic heterogeneity and the observational designs of these studies, restrict the scope of these results. Further prospective studies are required before integrating echocardiography into a preventive strategy.
authors.affiliation: Service de Cardiologie, Hôpital Saint Antoine, Assistance Publique - Hôpitaux de Paris, Paris, France; University Paris 6, Faculté de Médecine Pierre et Marie Curie, Paris, France.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Arangalage
authors.affiliation: Service de Cardiologie, Hôpital Saint Antoine, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Ederhy
authors.affiliation: Service de Cardiologie, Hôpital Saint Antoine, Assistance Publique - Hôpitaux de Paris, Paris, France; University Paris 6, Faculté de Médecine Pierre et Marie Curie, Paris, France.
authors.forename: Laurie
authors.initials: L
authors.lastname: Dufour
authors.affiliation: Service de Cardiologie, Hôpital Saint Antoine, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Joffre
authors.affiliation: Service de Cardiologie, Hôpital Saint Antoine, Assistance Publique - Hôpitaux de Paris, Paris, France; University Paris 6, Faculté de Médecine Pierre et Marie Curie, Paris, France.
authors.forename: Clélie
authors.initials: C
authors.lastname: Van der Vynckt
authors.affiliation: Service de Cardiologie, Hôpital Saint Antoine, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lang
authors.affiliation: INSERM Research Center for Epidemiology and Biostatistics (U897), Team Neuroepidemiology, and University of Bordeaux, Bordeaux, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Tzourio
authors.affiliation: Service de Cardiologie, Hôpital Saint Antoine, Assistance Publique - Hôpitaux de Paris, Paris, France; University Paris 6, Faculté de Médecine Pierre et Marie Curie, Paris, France. Electronic address: ariel.cohen@sat.aphp.fr.
authors.forename: Ariel
authors.initials: A
authors.lastname: Cohen
mesh_terms: D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000209:etiology*; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000379:methods*; D006801:Humans; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000000981:diagnostic imaging*
keywords: Dementia; Echocardiography; Mild cognitive impairment; Prevention