EXCESSIVE PULSATILE POWER IN CAROTID ARTERIES IS ASSOCIATED REDUCED COGNITIVE FUNCTION: PULSATILE AND STEADY STATE ARTERIAL HEMODYNAMICS IN TWO COMMUNITY-BASED COHORTS
Bibliographic record
Abstract
Objective: Increased pressure and/or flow pulsatility in the carotid arteries have been adversely associated with cerebral structure and function. We postulated that increased power(product of pressure and flow) pulsatility is even harmful to the microcirculation of high-flow organs. We aimed to investigate the associations of carotid pressure, flow, and power pulsatility with cognitive function and pulsatile and steady state hemodynamics in proximal aorta and carotid arteries. Design and method: A total 1855 adult aged > = 30 years old were recruited for measurements of echocardiography and carotid sonography. We obtained hemodynamic parameters including pressure, flows, and power at proximal aorta and both carotid arteries. Proximal aortic pressure was determined by the tonometry waveform measured at common carotid arteries, calibrated by mean and diastolic pressure of brachial pressure. Pulsatility indexes(PIs) of pressure, flow and power in the proximal aorta and carotid arteries were calculated as the pulsatile value divided by mean value. We modelled the aorta-carotid interface with a large parent vessel(proximal aorta) branching into small (carotid) and large(distal aorta) daughter vessels and calculated the reflection coefficient and transmitting coefficient from aortic and carotid characteristic impedances. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA) score. Results: The pulsatile component was 10.3%(105/996mW) and 4.2%(11/268mW) of total aortic and carotid power, respectively. PIs of aortic pressure(r = -0.048,p = 0.0417), aortic flow(r = 0.060,p = 0.0101), aortic power(r = -0.080,p = 0.006), carotid flow(r = -0.085,p = 0.003), and carotid power(r = -0.097,p < 0.0001) were all significantly associated with cognitive function, independent of age, sex, and education. Carotid power PI was significantly better than other PIs in the association with cognitive function. In the multivariable model, MoCA score was positively and negatively associated with carotid mean power (beta = 0.005,p < .0001) and carotid pulsatile power(beta = -0.048,p < .0001), respectively. With increasing aortic characteristic impedance and transmitting coefficient, and decreasing reflection coefficient, there was a significantly increased transmitting aortic power into carotid arteries(all p value < 0.0001). Conclusions: Among all ascending aorta and carotid hemodynamics, carotid power PI was the hemodynamic parameter with the best correlation with cognitive function. Increased proximal aortic stiffness, and increased transmission and decreased reflection of the aortic power at the aorta-carotid interface were closely associated with increased carotid pulsatile power.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".