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Left ventricular diastolic dysfunction is associated with cerebral white matter lesions (leukoaraiosis) in elderly
Atsuya Shimizu1, Takashi Sakurai, Toko Mitsui
1Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan; Department of Cardiology, Nagoya University, Nagoya, Japan.
Insights
Increased left ventricular (LV) diastolic dysfunction, indicated by E/E
Area of Science:
- Cardiology
- Neurology
- Geriatrics
Background:
- Aging is associated with increased cerebral white matter lesions (WML) and left ventricular (LV) diastolic dysfunction.
- The relationship between WML and LV diastolic dysfunction, despite shared aging risk factors, remains unclear.
- E/E' ratio, derived from tissue Doppler echocardiography, quantifies LV diastolic dysfunction severity by reflecting stiffness and filling pressures.
Purpose of the Study:
- To investigate the association between cerebral white matter lesions (WML) and left ventricular (LV) diastolic dysfunction.
- To clarify the relationship using the E/E' ratio as an indicator of LV diastolic dysfunction.
Main Methods:
- Seventy-five patients (65-75 years) with normal LV contraction and no history of cardiovascular or neurological disease were studied.
- Brain MRI quantified white matter lesion (WML) volume.
- Echocardiography measured the E/E' ratio to assess LV diastolic dysfunction severity.
Main Results:
- Patients were grouped by E/E' ratio: Low (≤8), Middle (8-15), and High (≥15).
- White matter lesion (WML) volume significantly increased with higher E/E' ratios (Low: 3.6±3.0 mL; Middle: 5.4±6.5 mL; High: 12.0±11.0 mL).
- A significant positive association was found between WML volume and the E/E' ratio (r=0.377, P=0.0009).
Conclusions:
- A significant association exists between left ventricular (LV) diastolic dysfunction and white matter lesions (WML).
- Further research is needed to determine if a direct causal link underlies this observed association.
Aim:
Cerebral white matter lesions (WML) are known to increase with age, as is left ventricular (LV) diastolic dysfunction with normal contraction. Although aging is a common risk factor, the link between these diseases is not fully understood. The aim was to clarify this relationship, using the ratio between early diastolic mitral inflow and early diastolic mitral annular tissue velocity (E/E'). E/E' measured by tissue Doppler echocardiography offers an indicator of the severity of LV diastolic dysfunction, reflecting both diastolic LV stiffness and diastolic LV filling pressure.
Methods:
Participants comprised 75 patients aged between 65 and 75 years with normal LV contraction and no signs or history of symptomatic heart failure, ischemic heart diseases, atrial fibrillation, stroke, or cognitive dysfunction. The volume of WML was quantified on brain magnetic resonance imaging.
Results:
The participants were classified into three groups: Low E/E', E/E' ≤ 8; Middle E/E', 8 < E/E' < 15; and High E/E', E/E' ≥ 15. WML volume was 3.6 ± 3.0 mL in Low E/E', 5.4 ± 6.5 mL in Middle E/E' and 12.0 ± 11.0 mL in High E/E', increasing significantly with increased diastolic LV stiffness (Low vs High, P = 0.034; Middle vs High, P = 0.016). Linear regression analysis showed the positive association between the volume of WML and E/E' ratio (r = 0.377, P = 0.0009).
Conclusions:
This investigation identified an association between LV diastolic dysfunction and WML. Further investigations are required to clarify whether there is a direct association between the two diseases.
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