Interrelation between cardiac and brain small-vessel disease: a pilot quantitative PET and MRI study

Area of Science:

• Cardiovascular Imaging and Neurology
• Systemic Vascular Disease Research

Background:

• Small-vessel disease (SVD) is implicated in cardiac and brain ischemia, but its interrelation remains unclear.
• Investigating the connection between cardiac and cerebral SVD is crucial for understanding systemic vascular health.

Purpose of the Study:

• To assess the interrelation between cardiac and cerebral small-vessel disease (SVD).
• To evaluate cardiac SVD markers using quantitative 82Rb cardiac PET/CT and brain SVD markers using brain MRI in 370 patients.

Main Methods:

• Retrospective analysis of 370 patients undergoing 82Rb cardiac PET/CT and brain MRI.
• Quantification of left-ventricle myocardial blood flow (LV-MBF) and flow reserve (LV-MFR) via PET/CT.
• Assessment of brain SVD markers including Fazekas score, white matter lesion (WMab) volume, deep gray matter lesion (GMab) volume, and brain morphometry using MRI.

Main Results:

• Patients with cardiac SVD exhibited reduced stress LV-MBF and MFR compared to those with normal perfusion.
• Cardiac SVD was associated with specific alterations in deep gray matter, including lower z-scores for left-putamen, right-thalamus, and right-pallidum.
• Lower stress LV-MBF and LV-MFR correlated with decreased left-caudate z-scores and increased right-thalamus GMab volume.

Conclusions:

• Significant interrelations were identified between cardiac and cerebral SVD markers.
• Deep gray matter alterations are particularly linked to cardiac SVD, supporting the hypothesis of SVD as a systemic disease.