A new study suggests that silent brain infarction (SBI) and cerebral small vessel disease (CSVD) are more common among individuals with heart conditions, potentially leading to an increased risk of stroke and dementia. The research, which analyzed over 220 previously published studies, found that changes to blood vessels in the brain were detectable in individuals with atrial fibrillation, coronary artery disease, heart failure or cardiomyopathy, heart valve disease, and patent foramen ovale. These changes, including SBI and CSVD, were linked to vascular cognitive impairment and could eventually progress to vascular dementia.
Dr. Michael Ross MacDonald, a cardiologist not involved in the study, explained that when tiny blood vessels in the brain become narrow or blocked, they can prevent blood from reaching certain areas of the brain over time. This damage can accumulate and result in symptoms of vascular cognitive impairment, ultimately progressing to vascular dementia. The study, published in the journal Neurology, revealed that SBI was found in approximately one in three individuals with heart disease, with additional findings including white matter lesions, asymptomatic microbleeds, and brain atrophy.
Dr. Gregory Bix, a clinical neuroscience researcher, highlighted the importance of recognizing SBI and CSVD as cardiovascular health conditions that contribute to cerebrovascular injury. These conditions, which often have insidious onset and are missed in the early stages, are major contributors to vascular dementia – the second leading cause of dementia after Alzheimer’s disease. The prevalence of these changes in the brain’s vascular system was observed in individuals with heart disease regardless of whether they had previously experienced a stroke.
Lead study author Dr. Zien Zhou emphasized the need for routine brain imaging for individuals with heart conditions, as changes to blood vessels in the brain can increase susceptibility to brain bleeds from common medications used to treat or prevent blood clots. Zhou pointed to aging, hypertension, type 2 diabetes, high cholesterol, and smoking as potential factors contributing to these hidden changes in the brain’s vascular system. Further research is needed to determine if routine brain imaging for patients undergoing anticoagulation therapy could reduce risks of bleeding in the brain.
Despite the clear correlation between heart disease and SBI and CSVD highlighted in the study, it remains to be determined whether one condition causes the other. Dr. Bix recommended that individuals with atrial defibrillation, coronary artery disease, heart failure or cardiomyopathy, heart valve disease should undergo brain scanning to assess for these changes. The study findings underscore the importance of early detection and monitoring of SBI and CSVD in individuals with heart conditions to mitigate the risks of stroke and dementia associated with these conditions. Further research is needed to explore the mechanisms underlying the relationship between heart disease and changes in the brain’s vascular system.
