冠動脈疾患と認知機能低下を結びつける主要マーカーを特定(Concordia researchers identify key marker linking coronary artery disease to cognitive decline)

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2025-11-25 カナダ・コンコルディア大学

コンコルディア大学の研究チームは、冠動脈疾患(CAD)と認知機能低下を結びつける重要なバイオマーカーを特定した。研究者らは大規模疫学データと脳画像データを解析し、血中の高感度トロポニン(hs-cTn)が、心疾患リスクだけでなく、軽度認知障害や脳萎縮の進行とも強く関連することを発見した。hs-cTn が高い人は、脳白質の微細損傷や血管性変化が多く、記憶・注意・処理速度などの認知指標が有意に低かった。また、他の心血管リスク因子を調整してもこの関連は保持され、hs-cTn が心血管・脳血管の両面を反映する指標である可能性が示唆された。研究者らは、心血管の健康が脳の老化に及ぼす影響を評価するための新しい臨床指標として hs-cTn が有望であり、早期介入によって認知低下を防ぐ戦略構築に寄与できるとしている。

<関連情報>

冠動脈疾患を有する高齢者における多変量白質微細構造変化 Multivariate White Matter Microstructure Alterations in Older Adults with Coronary Artery Disease

Stefanie A. Tremblay, Zacharie Potvin-Jutras, Dalia Sabra, Ali Rezaei, Safa Sanami, Christine Gagnon, Brittany Intzandt, Amélie Mainville-Berthiaume, Lindsay Wright, Ilana R. Leppert, Christine L. Tardif, Christopher J. Steele, Josep Iglesies-Grau, Anil Nigam, Louis Bherer and Claudine J. Gauthier
Journal of Neuroscience  Published: 24 September 2025
DOI:https://doi.org/10.1523/JNEUROSCI.0790-25.2025

Abstract

Patients with coronary artery disease (CAD) face an increased risk of cognitive impairment, dementia, and stroke. While white matter (WM) lesions are frequently reported in patients with CAD, the effects on WM microstructure alterations remain largely unknown. We aimed to identify WM microstructural alterations in individuals with CAD compared with healthy controls (HC) and to examine their relationships with cognitive performance. Forty-three (43) patients with CAD (35 males and 8 females) and 36 HC (26 males and 10 females) aged 50 and older underwent comprehensive neuropsychological testing and multimodal 3 T magnetic resonance imaging (MRI). A novel multivariate approach—the Mahalanobis distance (D2)—was used to quantify WM abnormalities as the amount of deviation from the HC reference group. D2 integrates multiple MRI-derived diffusion-weighted imaging, R1 relaxometry, and magnetization transfer imaging metrics, while accounting for covariance between metrics. Relationships between WM D2 and cognition (executive function and processing speed) were also assessed. Compared with HCs, patients with CAD had higher D2 values in the whole WM (p = 0.015) and in the right anterior and bilateral middle cerebral artery territories (p < 0.05). Myelin-sensitive metrics, particularly R1 relaxation rate and MT saturation, were the most important contributors to D2. Processing speed was positively associated with greater R1 in both the whole WM and left middle cerebral artery territory. These findings suggest that greater WM microstructural alterations observed in patients with CAD were mainly driven by differences in myelin content. These alterations may contribute to a heightened risk of cognitive impairment.

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