Long-Term Prognostic Perspectives of Cardiovascular Disease: Myocardium to Mind
With the improved treatment of acute cardiovascular events and an aging population, the global landscape of cardiovascular care is increasingly shifting toward managing chronic cardiovascular disease. This transition is ongoing, as more patients live longer with the long-term consequences of cardiovascular disease. In addition, cardiovascular disease may contribute to the development of cognitive impairment, another major public health concern. These chronic complications profoundly impact quality of life and independence in daily life, while also placing a growing burden on healthcare systems, healthcare costs and society. This thesis addresses two challenges in the current age of cardiovascular care: (1) acute myocardial infarction (AMI) and its long-term complications, and (2) mechanisms through which cardiovascular disease may lead to abnormal brain aging and cognitive impairment. Using insights from cardiovascular magnetic resonance (CMR), this work aims to explore the underlying pathophysiological processes in depth. The first part of this thesis focuses on identifying high-risk subgroups among patients with acute myocardial infarction to improve secondary prevention strategies. The second part examines the role of cardiovascular disease in the pathophysiology of cognitive impairment, with the aim of better understanding the complex interplay of cardiac dysfunction, arterial stiffness, and vascular risk factors in their contribution to abnormal brain aging.
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