Key result
Longer ventricular repolarization (QT interval) was associated with worse baseline cognitive performance on the Stroop Test (3.02 seconds worse per SD increase; 95% CI 0.31-5.73), but not with decline.
Why the study?
The study aimed to evaluate cross-sectional and longitudinal associations of ECG-based QT, QTc, JT, JTc, and QRS intervals with cognitive function and brain MRI measurements in older adults at increased cardiovascular risk.
Are ECG-based ventricular repolarization and depolarization intervals associated with cognitive function and brain MRI measurements in older adults?
Cohort (n=4,627)
Are ECG-based ventricular repolarization and depolarization intervals associated with cognitive function and brain MRI measurements in older adults?
Mean Difference: 3.02 (95% CI 0.31–5.73)
Longer ventricular repolarization intervals are associated with worse baseline cognitive performance in older adults, but not with longitudinal cognitive decline or structural brain changes.
ECG intervals show no robust links to cognition or brain MRI in older adults at CV risk; leaves open any predictive role.
We aimed to investigate the cross-sectional and longitudinal associations of electrocardiogram (ECG)-based QT, QTc, JT, JTc, and QRS intervals with cognitive function and brain magnetic resonance imaging (MRI) measurements in a cohort of older individuals at increased risk for cardiovascular disease, but free of known arrhythmias. We studied 4627 participants (54% female, mean age 75 years) enrolled in the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER). Ten-second ECGs were conducted at baseline. Cognitive function was tested at baseline and repeated during a mean follow-up time of 3.2 years. Structural MRIs were conducted in a subgroup of 535 participants. Analyses were performed with multivariable (repeated) linear regression models and adjusted for cardiovascular risk-factors, co-morbidities, and cardiovascular drug use. At baseline, longer QT, JT, JTc-but not QTc and QRS intervals-were associated with a worse cognitive performance. Most notably, on the Stroop Test, participants performed 3.02 (95% CI 0.31; 5.73) seconds worse per standard deviation higher QT interval, independent of cardiovascular risk factors and medication use. There was no association between longer ventricular de- or repolarization and structural brain measurements. Therefore, specifically ventricular repolarization was associated with worse cognitive performance in older individuals at baseline but not during follow-up.
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Zonneveld et al. (2020) conducted a cohort in Increased risk for cardiovascular disease, free of known arrhythmias (n=4,627). Longer ventricular repolarization and depolarization intervals (QT, QTc, JT, JTc, QRS) vs. Shorter intervals was evaluated on Cognitive performance on the Stroop Test (3.02 seconds worse per SD higher QT interval, 95% CI 0.31-5.73). Longer ventricular repolarization (QT interval) was associated with worse baseline cognitive performance on the Stroop Test (3.02 seconds worse per SD increase; 95% CI 0.31-5.73), but not with decline.
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