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Background  Global longitudinal strain ( GLS ), reflecting total shortening of the myocardium during the cardiac cycle, has emerged as a more precise myocardial function measure than left ventricular ejection fraction ( LVEF ). Longitudinal strain may be selectively affected in subclinical heart disease, even in the presence of normal  LVEF . This study examines subclinical cardiac dysfunction, assessed by  GLS  and  LVEF , and cognition among older adults.    Methods and Results  Vanderbilt Memory and Aging Project participants who were free of clinical dementia, stroke, and heart failure (n=318, 73±7 years, 58% male) completed neuropsychological assessment and cardiac magnetic resonance to quantify  GLS  and  LVEF . Linear regression models related  GLS  and  LVEF  to neuropsychological performances, adjusting for age, sex, race/ethnicity, education, Framingham Stroke Risk Profile, cognitive diagnosis, and   APOE  *ε4 status. Models were repeated with a cardiac×cognitive diagnosis interaction term. Compromised  GLS  (reflected by higher values) related to worse naming (β=−0.07,  P =0.04), visuospatial immediate recall (β=−0.83,  P =0.03), visuospatial delayed recall (β=−0.22,  P =0.03), and verbal delayed recall (β=−0.11,  P =0.007).  LVEF  did not relate to worse performance on any measure ( P >0.18). No diagnostic interactions were observed.    Conclusions  Our study results are among the first to suggest that compromised  GLS  relates to worse episodic memory and language performance among older adults who are free of clinical dementia, stroke, and heart failure. Subclinical cardiac dysfunction may correlate with cognitive health in late life, even when  LVEF  remains normal. The results add to growing evidence that  GLS  may be a more sensitive and preferred method for quantifying subclinical changes in cardiac function.

Subclinical Compromise in Cardiac Strain Relates to Lower Cognitive Performances in Older Adults