New research presented at the ESC 2025 Congress highlights the crucial role of left ventricular (LV) geometry in shaping brain structure and cognitive performance, underscoring the deep interconnection of cardiovascular and neurological health.
The study, led by Prof. P.G. Masci and the Brain–Heart Axis Group at King’s College London, analyzed data from 15,519 UK Biobank participants (median age 64 years, 49% female), all free from stroke and neurodegenerative disease.
Using confirmatory factor analysis of 18 cardiovascular MRI biomarkers, investigators derived composite measures of LV systolic function, diastolic function, ventricular geometry (gGeom), and arterial stiffness. These were compared against brain MRI features—including hippocampal volume, gray matter, and white matter integrity—as well as cognitive performance metrics.
Key results showed:
- LV geometry (gGeom) was the strongest predictor of hippocampal volume in both women (β=0.082, p=1.1×10⁻⁸) and men (β=0.039, p=0.01).
- gGeom was the only CV phenotype linked to better cognition, with higher fluid intelligence (β=0.042 in females; β=0.060 in males) and faster reaction times.
- Mediation analysis confirmed that hippocampal volume explained the cognitive benefits of LV geometry across sexes.
- Other cardiac phenotypes—systolic and diastolic function and arterial stiffness—showed weaker, inconsistent associations with brain structure and were unrelated to cognition.
The study offers compelling evidence that maintaining favorable cardiac geometry may be central to healthy cognitive aging, potentially opening avenues for integrated prevention strategies against both cardiovascular disease and dementia.
