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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Increased prevalence of cerebral microbleeds in patients with low left ventricular systolic function
Tomohiko Watanabe1, Yumiko Kanzaki2, Yohei Yamauchi1
1Department of Cardiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, 569-8686, Japan.
Abstract:
Gradient-echo T2-star (T2*)-weighted magnetic resonance imaging (MRI) is a sensitive method to detect cerebral microbleeds (CMBs). The presence of CMBs was reported to be a marker of future cardiovascular mortality and is associated with various cardiovascular risk factors, use of antithrombotic drugs, and cognitive dysfunction. However, the relationship between cardiac function and CMBs remains unclear. We investigated the association between cardiac function and presence of CMBs in patients with cardiovascular diseases. This single-center retrospective study included a total of 424 participants (mean age 70 ± 12 years; men 286 (67%); mean left ventricular ejection fraction (LVEF) 61% ± 12%] who underwent echocardiography and brain T2*-weighted MRI within 1 month without neurologic abnormality. CMBs were found in 118 (28%) patients. There was no significant relationship between CMBs and anticoagulant or antiplatelet therapy. LVEF was significantly lower in patients with CMBs than in those without CMBs (59% ± 13% vs. 62% ± 11%, P < 0.05). On multivariate logistic analysis, lower LVEF [odds ratio (OR) 0.98, 95% confidence interval (CI) 0.96-1.00; P < 0.05] and age (OR 1.02, 95% CI 1.00-1.05; P < 0.05) were significantly associated with CMBs. The presence of CMBs was frequently observed in the patients with cardiovascular disease and was significantly associated with age and LVEF.
Insights
Cerebral microbleeds (CMBs) are common in cardiovascular disease patients. Lower left ventricular ejection fraction (LVEF) and older age are linked to increased CMB presence.
Area of Science:
- Cardiology
- Neurology
- Radiology
Background:
- Cerebral microbleeds (CMBs) detected by T2*-weighted MRI are linked to cardiovascular mortality and cognitive issues.
- The association between cardiac function and CMBs in cardiovascular disease (CVD) patients is not well understood.
Purpose of the Study:
- To investigate the relationship between cardiac function, specifically left ventricular ejection fraction (LVEF), and the presence of CMBs in patients with cardiovascular diseases.
Main Methods:
- A retrospective study of 424 cardiovascular disease patients who underwent echocardiography and brain T2*-weighted MRI.
- Analysis included assessment of CMB presence, LVEF, age, and antithrombotic therapy.
Main Results:
- CMBs were detected in 28% of participants.
- Patients with CMBs had significantly lower LVEF compared to those without CMBs.
- Lower LVEF and older age were independently associated with the presence of CMBs.
Conclusions:
- The presence of CMBs is common in patients with cardiovascular disease.
- Reduced left ventricular ejection fraction and advanced age are significant predictors of CMBs in this population.
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