The association between transthoracic echocardiogram parameters and white matter hyperintensities

Area of Science:

• Cardiology
• Neurology
• Radiology

Background:

• Cerebral small vessel disease (CSVD) is a significant cause of stroke and cognitive impairment.
• Transthoracic echocardiogram (TTE) assesses cardiac structure and function, which may be linked to neurological conditions.
• White matter hyperintensities (WMH) on brain MRI are a key indicator of CSVD.

Purpose of the Study:

• To determine if cardiac chamber size and hemodynamic parameters on TTE can predict the progression of CSVD, indicated by WMH on brain MRI.
• To investigate the association between specific TTE measurements and the severity of WMH.

Main Methods:

• A retrospective review of adult patients with both brain MRI and TTE data was conducted.
• The Fazekas score, measuring white matter hyperintensities (WMH), was the primary outcome.
• Multivariate ordinal logistic regression models were used to analyze the association between TTE parameters and WMH, adjusting for confounders.

Main Results:

• While cardiac functional markers were not significant predictors, cardiac structural markers showed associations.
• Normal values for right ventricular internal diameter (RVID) and left atrial area (LAA) were associated with increased WMH (p=0.020 and p=0.041, respectively).
• No association was found between cardiac structure/function and isolated deep or periventricular white matter hyperintensities.

Conclusions:

• Normal left atrial area (LAA) and right ventricular internal diameter (RVID) on TTE may be associated with a higher degree of white matter hyperintensities (WMH) on brain MRI.
• This finding could indicate an earlier stage of WMH detection prior to observable cardiac changes.
• Further prospective studies are needed to validate these associations and explore quantitative comparisons.