Elsevier

JACC: Heart Failure

Volume 11, Issue 1, January 2023, Pages 93-102
JACC: Heart Failure

Clinical Research
Plasma Amyloid-β in Relation to Cardiac Function and Risk of Heart Failure in General Population

https://doi.org/10.1016/j.jchf.2022.09.006Get rights and content
Under a Creative Commons license
open access

Abstract

Background

Amyloid-β (Aβ) may be related to cardiac function. However, there are limited data on the association of plasma Aβ with cardiac function and risk of heart failure (HF) in the general population.

Objectives

This study sought to determine the associations of plasma amyloid-β40 (Aβ40) and amyloid-β42 (Aβ42) with echocardiographic measurements of cardiac dysfunction and with incident HF in the general population.

Methods

The study included 4,156 participants of the population-based Rotterdam Study (mean age: 71.4 years; 57.1% women), who had plasma Aβ samples collected between 2002 and 2005 and had no established dementia and HF at baseline. Multivariable linear regression models were used to explore the cross-sectional association of plasma Aβ with echocardiographic measures. Participants were followed up until December 2016. Cox proportional hazards models were used to assess the association of Aβ levels with incident HF. Models were adjusted for cardiovascular risk factors.

Results

A per 1-SD increase in log-transformed plasma Aβ40 was associated with a 0.39% (95% CI: −0.68 to −0.10) lower left ventricular ejection fraction and a 0.70 g/m2 (95% CI: 0.06-1.34) larger left ventricular mass indexed by body surface area. Aβ42 was not significantly associated with echocardiographic measures cross-sectionally. During follow-up (median: 10.2 years), 472 incident HF cases were identified. A per 1-SD increase in log-transformed Aβ40 was associated with a 32% greater risk of HF (HR: 1.32; 95% CI: 1.15-1.51), and the association was significant in men, but not in women. Higher plasma Aβ42 levels were associated with an increased risk of HF (HR: 1.12; 95% CI: 1.02-1.24), although the association was attenuated after further adjustment for concomitant Aβ40 (HR: 1.03; 95% CI: 0.92-1.16).

Conclusions

Higher levels of Aβ40 were associated with worse cardiac function and higher risk of new onset HF in the general population, in particular among men.

Key Words

amyloid-β40
amyloid-β42
cardiac function
echocardiography
heart failure

Abbreviations and Acronyms

Aβ
amyloid-β
AD
Alzheimer disease
AF
atrial fibrillation
BSA
body surface area
CVD
cardiovascular disease
HF
heart failure
LAD
left atrial diameter
LV
left ventricular
LVEF
left ventricular ejection fraction

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