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Silent cerebral infarction in chronic heart failure: ischemic and nonischemic dilated cardiomyopathy

Guliz Kozdag1, Ercument Ciftci, Dilek Ural

  • 1Kocaeli University Medical Faculty Department of Cardiology, Kocaeli, Turkey. gkozdag@superonline.com

Vascular Health and Risk Management
|June 20, 2008
PubMed

Insights

Silent cerebral infarction (SCI) is common in patients with dilated cardiomyopathy (DCM). A restrictive diastolic filling pattern is an independent risk factor for SCI in both ischemic and nonischemic DCM patients.

Area of Science:

  • Cardiology
  • Neurology
  • Radiology

Background:

  • Dilated cardiomyopathy (DCM) is associated with a high incidence of silent cerebral infarction (SCI).
  • Prevalence and risk factors for SCI may differ between ischemic and nonischemic DCM.
  • Understanding these differences is crucial for patient management and stroke prevention.

Purpose of the Study:

  • To evaluate the prevalence of SCI in patients with ischemic and nonischemic DCM.
  • To identify parameters and risk factors associated with SCI in these patient populations.
  • To compare SCI prevalence between ischemic DCM, nonischemic DCM, and healthy controls.

Main Methods:

  • Included patients with ischemic (n=46) and nonischemic DCM (n=26).
  • Utilized a control group of 56 age- and gender-matched healthy volunteers.
  • Analyzed prevalence, clinical characteristics, and MRI findings, including systolic function and diastolic filling patterns.

Main Results:

  • SCI prevalence was significantly higher in ischemic DCM (39%) and nonischemic DCM (27%) compared to controls (3.6%).
  • In nonischemic DCM, SCI patients were older; in ischemic DCM, they had a higher NYHA Functional Class.
  • Lower systolic function was observed in SCI patients in both groups. A restrictive diastolic filling pattern was an independent risk factor for SCI (OR: 16.5).

Conclusions:

  • Silent cerebral infarction is a common finding in both ischemic and nonischemic dilated cardiomyopathy.
  • While univariate analysis showed similar characteristics, multivariable analysis identified a restrictive diastolic filling pattern as a key independent risk factor for SCI.
  • These findings highlight the importance of assessing diastolic function in DCM patients to predict SCI risk.
Abstract

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