title: Aβ Amyloid Pathology Affects the Hearts of Patients With Alzheimer's Disease: Mind the Heart.
abstract: BACKGROUND
  Individually, heart failure (HF) and Alzheimer's disease (AD) are severe threats to population health, and their potential coexistence is an alarming prospect. In addition to sharing analogous epidemiological and genetic profiles, biochemical characteristics, and common triggers, the authors recently recognized common molecular and pathological features between the 2 conditions. Whereas cognitive impairment has been linked to HF through perfusion defects, angiopathy, and inflammation, whether patients with AD present with myocardial dysfunction, and if the 2 conditions bear a common pathogenesis as neglected siblings are unknown.
  
  
  OBJECTIVE
  Here, the authors investigated whether amyloid beta (Aβ) protein aggregates are present in the hearts of patients with a primary diagnosis of AD, affecting myocardial function.
  
  
  METHODS
  The authors examined myocardial function in a retrospective cross-sectional study from a cohort of AD patients and age-matched controls. Imaging and proteomics approaches were used to identify and quantify Aβ deposits in AD heart and brain specimens compared with controls. Cell shortening and calcium transients were measured on isolated adult cardiomyocytes.
  
  
  RESULTS
  Echocardiographic measurements of myocardial function suggest that patients with AD present with an anticipated diastolic dysfunction. As in the brain, Aβ40and Aβ42are present in the heart, and their expression is increased in AD.
  
  
  CONCLUSIONS
  Here, the authors provide the first report of the presence of compromised myocardial function and intramyocardial deposits of Aβ in AD patients. The findings depict a novel biological framework in which AD may be viewed either as a systemic disease or as a metastatic disorder leading to heart, and possibly multiorgan failure. AD and HF are both debilitating and life-threatening conditions, affecting enormous patient populations. Our findings underline a previously dismissed problem of a magnitude that will require new diagnostic approaches and treatments for brain and heart disease, and their combination.
authors.affiliation: Cardiovascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Luca
authors.initials: L
authors.lastname: Troncone
authors.affiliation: Cardiovascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Marco
authors.initials: M
authors.lastname: Luciani
authors.affiliation: Cardiovascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Matthew
authors.initials: M
authors.lastname: Coggins
authors.affiliation: Cardiovascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Elissa H
authors.initials: EH
authors.lastname: Wilker
authors.affiliation: Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Cheng-Ying
authors.initials: CY
authors.lastname: Ho
authors.affiliation: Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Kari Elise
authors.initials: KE
authors.lastname: Codispoti
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Frosch
authors.affiliation: Department of Neurology, University of Texas Medical Branch Health, Galveston, Texas.
authors.forename: Rakez
authors.initials: R
authors.lastname: Kayed
authors.affiliation: Cardiovascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Division of Cardiology Massachusetts General Hospital, Boston, Massachusetts. Electronic address: fdelmont@bidmc.harvard.edu.
authors.forename: Federica
authors.initials: F
authors.lastname: Del Monte
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000378:metabolism; D000544:Alzheimer Disease / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D016229:Amyloid beta-Peptides / Q000378:metabolism*; D001921:Brain / Q000378:metabolism / Q000648:ultrastructure; D009202:Cardiomyopathies / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D015151:Immunoblotting; D007150:Immunohistochemistry; D008297:Male; D046529:Microscopy, Electron, Transmission; D009206:Myocardium / Q000378:metabolism* / Q000648:ultrastructure; D012189:Retrospective Studies
chemical_list: D016229:Amyloid beta-Peptides
keywords: amyloidosis; cardiomyopathy; dementia; heart failure; protein aggregates