Abstract
BACKGROUND
The relationships between coronary or cardiac pathology, cerebral small vessel disease (SVD), Alzheimer’s disease pathology, and vascular cognitive impairment and dementia (VCID) remain unclear.
METHODS
We performed a clinicopathological study in 75 stroke patients enrolled in the prospective Cognitive Function After Stroke (CogFAST) cohort. Comprehensive histopathological examination was performed to characterize the spectrum of pathologies in samples of the main coronary arteries (CorA), and cardiac and brain tissues from stroke survivors diagnosed with post-stroke dementia (PSD; mean age, standard deviation, range, % sex; 88 ± 8 years, 65–99, 55% female) or without dementia (PSND; 86 ± 4 years, 79–94, 45% female).
RESULTS
All subjects exhibited occult or obstructive CorA disease with > 50% clinically defined stenosis in at least one of the main coronary arteries. Linear correlation analysis showed that CorA stenosis was positively related to internal carotid artery stenosis (P < 0.03). CorA stenosis was not associated with pathological measures of cerebral SVD per se or neurodegenerative disorders. Cardiac pathology was highly prevalent, with ≈ 80% of the subjects having at least one feature of cardiac pathology including fibrosis, disarray, and myocyte damage and 62% exhibiting myocardial infarcts. CorA stenosis was associated with higher cardiac pathology score, which was also related to cardiac sympathetic denervation and α-synuclein accumulation in the stellate ganglia. We noted low heart weights (P < 0.001), greater myocardial infarcts (P < 0.001), and greater general cardiac atrophy (P = 0.024) in the PSD compared to the PSND group.
CONCLUSIONS
Our findings suggest there is a relationship between CorA disease and carotid artery disease and that cardiac pathology in elderly stroke survivors may be a factor in the development of delayed dementia after the stroke injury and VCID.
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This post is Copyright: | November 6, 2026
Neuro-Dementia