{
  "abstract": "Background\n\nWe investigated if ambient air pollution and neighbourhood walkability associate with presence and progression of cerebral small vessel disease (CSVD) in patients with cardiovascular disorders along the heart-brain axis.Methods\n\nData from patients with heart failure, carotid occlusive disease, or vascular cognitive impairment (30% women; mean age 69.0 years) of the Heart-Brain Connection study were used. Brain parenchymal fraction (BPF), white matter hyperintensity fraction (WMH), cerebral blood flow (CBF), and incident vascular lesions were assessed with 3T brain MRI at baseline (n = 300) and at two years follow-up (n = 181). Incident clinical cerebrovascular events were assessed with questionnaires and telephone interviews up to five years. Annual residential nitrogen dioxide (NO₂; µg/m³) concentration was linked to participants at baseline. Neighbourhood walkability was measured using the Dutch walkability index within a 500-m Euclidean buffer around each residential-area centroid (range 0-100). Associations were analyzed using age- and sex-adjusted logistic regression and repeated-measures linear mixed models.Results\n\nAt baseline, no association was found between NO₂ or walkability and BPF, WMH, CBF, infarcts or microbleeds. Walkability (per 10 units) was associated with lower odds for having infarcts at baseline (OR 0.82, 95%CI 0.96-0.99) and attenuated age-related WMH increases by 0.01 SD (95%CI 0.00-0.02) per year. In longitudinal analyses, no associations between NO₂ or walkability and progression of vascular brain lesions, cerebrovascular events, or mortality were found.Conclusion\n\nAlthough air pollution and neighbourhood walkability were not strongly associated with CSVD progression, stroke, or mortality, higher walkability appeared to modestly attenuate age-related increases in WMH.",
  "abstract_shown": true,
  "affiliations": [
    "Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.",
    "Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.",
    "Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands.",
    "Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands.",
    "Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands.",
    "Department of Internal Medicine, Section Geriatrics, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands.",
    "Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands.",
    "Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ina Rissanen"
    },
    {
      "affs": [
        0
      ],
      "name": "Erik J Timmermans"
    },
    {
      "affs": [
        1
      ],
      "name": "Jeroen de Bresser",
      "orcid": "0000-0003-0759-8407"
    },
    {
      "affs": [
        2
      ],
      "name": "Esther E Bron"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Anna E Leeuwis"
    },
    {
      "affs": [
        3,
        5
      ],
      "name": "Majon Muller"
    },
    {
      "affs": [
        1
      ],
      "name": "Matthias J P van Osch"
    },
    {
      "affs": [
        3,
        6
      ],
      "name": "Betty M Tijms"
    },
    {
      "affs": [
        7
      ],
      "name": "Geert Jan Biessels"
    },
    {
      "affs": [
        0
      ],
      "name": "Ilonca Vaartjes"
    },
    {
      "name": "Heart-Brain Connection Consortium"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5jcak4dsfzctt.bib",
  "cited_by": 0,
  "doi": "10.1016/j.cccb.2026.100565",
  "fulltext_url": "https://europepmc.org/articles/PMC13677411",
  "id": "5jcak4dsfzctt",
  "issns": [
    "2666-2450"
  ],
  "landing_url": "https://europepmc.org/article/MED/42898191",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2307|Air Quality and Health Impacts"
    ]
  ],
  "openalex": "W7218967178",
  "pdf_url": "https://europepmc.org/articles/PMC13677411?pdf=render",
  "pmcid": "PMC13677411",
  "pmid": "42898191",
  "published": "2026-10-03",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/5jcak4dsfzctt.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:37Z",
      "native_id": "MED:42898191",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42898191"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2307|Air Quality and Health Impacts",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "Air pollution, neighbourhood walkability and cerebrovascular small vessel disease in patients with cardiovascular disorders along the heart-brain axis.",
  "title_text": "Air pollution, neighbourhood walkability and cerebrovascular small vessel disease in patients with cardiovascular disorders along the heart-brain axis.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:37Z",
  "url": "https://research.draconitic.com/paper/5jcak4dsfzctt",
  "venue": "Cerebral circulation - cognition and behavior",
  "versions": []
}