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Cerebral white matter hyperintensity predicts cardiovascular events in haemodialysis patients

Toshihide Naganuma1, Yoshiaki Takemoto, Tetsuo Shoji

  • 1Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan.

Nephrology (Carlton, Vic.)
|June 21, 2013
PubMed

Insights

White matter hyperintensities (WMHs) predict cardiovascular events in hemodialysis patients. Periventricular hyperintensity (PVH) is a stronger predictor than deep and subcortical WMH (DSWMH).

Area of Science:

  • Nephrology
  • Neurology
  • Cardiovascular Medicine

Background:

  • White matter hyperintensities (WMHs) are linked to stroke, cognitive decline, and dementia in the general population.
  • Longitudinal studies on WMHs' clinical significance in hemodialysis (HD) patients are lacking.
  • This study investigates WMHs as predictors of cardiovascular disease in HD patients.

Purpose of the Study:

  • To determine if cerebral white matter hyperintensities (WMHs) predict future cardiovascular events in hemodialysis (HD) patients.
  • To compare the predictive value of periventricular hyperintensity (PVH) and deep and subcortical white matter hyperintensity (DSWMH) for cardiovascular events.

Main Methods:

  • Cranial MRI was used to assess WMHs in 179 HD patients without prior stroke.
  • Patients were prospectively followed for cardiovascular events.
  • Kaplan-Meier and Cox proportional hazards analyses were employed to investigate the influence of WMHs on cardiovascular events.

Main Results:

  • Patients with advanced PVH and DSWMH showed significantly higher cardiovascular morbidity.
  • Advanced PVH and DSWMH independently increased the risk of cardiovascular events.
  • PVH emerged as a stronger predictor of cardiovascular events than DSWMH.

Conclusions:

  • Cerebral white matter hyperintensities (WMHs) are a novel predictor of cardiovascular events in hemodialysis patients.
  • Periventricular hyperintensity (PVH) is more strongly associated with incident cardiovascular disease in this population.
Abstract

Keywords:
cardiovascular diseasedialysislongitudinal studyperiventricular hyperintensitystrokesubcortical white matter hyperintensitywhite matter hyperintensities

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