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Abstract 11528: Neurotrophic Signaling Pathway Dysregulation, Cardiac Amyloidosis, and Innervation Impairment in the Tg2576 Model of Alzheimer's Disease
Circulation, Volume 146, Issue Suppl_1, Page A11528-A11528, November 8, 2022. Alzheimer’s disease (AD) is a complex and incurable neurodegenerative disorder characterized by cerebral amyloid β (Aβ) deposition and tau pathology, accompanied by a gradual loss of the two main neuromodulators, NGF and BDNF. The progressive degeneration of the cerebral neuro-signaling pathways triggers a gradual decline in neurotrophic factors with significant derangement of the peripheral nervous system. This may culminate in detrimental effects on other organs, including the heart. However, whether and how AD modulates neurotrophins, innervation, and amyloidosis in the cardiac tissue is still undefined. Here, we investigated, for the first time, cardiovascular remodeling and neuro signaling pathway dysregulation in a mouse model of Alzheimer’s disease. Hence, 12 months old Tg2576 transgenic mice, a model of cerebral amyloidosis, were compared to age-matched WT littermates. Echocardiographic analysis showed significant deterioration in LV function, evidenced by a severe decline both in ejection fraction and fraction shortening percentage in the Tg2576 group compared to WT mice. Tg2576 mice exhibited a relevant increase in interstitial fibrosis, with progressive accumulation of amyloid aggregates, resulting in severe cardiac nervous system dysfunction. The transgenic line showed a remarkable decrease in cardiac nerve fiber density, both adrenergic (stained with tyrosine hydroxylase- TH) and regenerating nerve endings (labeled with GAP-43) compared to the WT mice. This myocardial denervation was associated with a robust reduction in NGF and BDNF protein expression both at the neuronal and cardiac level, accompanied by a significant decline in GAP-43 activity in the heart and cerebral cortex lysates of Tg2576 mice. Additionally, human neuroblastoma cells (SH-SY5Y) challenged with human Aβ-40 or Aβ-42 oligomers showed a severe downregulation of both BDNF and GAP-43 protein levels. Overall, our evidence highlights a possible detrimental effect of cerebral amyloidosis on the peripheral nervous system and cardiac tissue, providing potential therapeutic targets, such as the neuro-signaling pathway, to prevent or delay some of the effects caused by AD on the cardiovascular system.
Abstract 12707: The Association Between Beta-Blockers and Outcomes in Patients With Heart Failure and Alzheimer's Disease and Related Dementias
Circulation, Volume 146, Issue Suppl_1, Page A12707-A12707, November 8, 2022. Introduction:Contemporary HFrEF patients are older and have a higher prevalence of cognitive impairment compared to those studied in the original beta-blocker (BB) trials. While BB decrease mortality and morbidity in HFrEF, their use has been linked to higher fall risk and possibly acceleration of cognitive decline among older adults with Alzheimer’s Disease and Related Dementias (ADRD). The risk/benefit trade-off of beta blocker (BB) use in patients with HFrEF and dementia has not been examined.Methods:Using a 100% sample of patients enrolled in Medicare A, B and a 40% sample of D with ≥1 hospitalization for HFrEF between 2008 and 2018, we created a cohort of beneficiaries with HFrEF but no prior diagnosis of ADRD. We then subset to the population to those that developed ADRD in the year after their HFrEF hospitalization and compared BB use pre/post ADRD diagnosis and is association with outcomes using a time varying exposure.Results:The highest 1-year survival after ADRD diagnosis was observed among those continued on BB after ADRD diagnosis, regardless of whether they were on BB before (HR 0.427, 95% CI 0.406, 0.465, p
Abstract 11829: Cardiac Arrhythmias and Associated Mortality Risks in Alzheimer's Disease Patients Following STEMI and NSTEMI Hospitalization
Circulation, Volume 146, Issue Suppl_1, Page A11829-A11829, November 8, 2022. Introduction:Little is known about the outcomes of patients with Alzheimer’s disease (AD) following acute myocardial infarction (AMI).Methods:We used the 2017 National Inpatient Sample, including patients ages ≥60 with a primary diagnosis of STEMI and NSTEMI and those with any diagnostic code for AD. Any differences between AD and non-AD patients were calculated via Chi-square tests. The mortality rates of each group and their odds ratio (aOR) adjusted via multivariable logistic regression were also found.Results:A total of 104,860 cases of STEMI and 352,120 patients of NSTEMI were identified, amongst which 1,130 and 5,810 also had a diagnosis of Alzheimer’s disease. The incidence of Atrial flutter (160 cases, 1416 cases per 10,000 AD patients with STEMI), atrial fibrillation (320 cases, 2832 cases per 10,000 AD patients with STEMI), and long QT syndrome (15 cases, 133 cases per 10,000 AD patients with STEMI) for STEMI patients were higher among the AD patients (p
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