Related Experiment Video
Updated: May 9, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Association between echocardiographic parameters and white matter hyperintensities in patients with ischemic
Yajie Zhang1, Yun Wang2, Shoujiang You3
1Department of Neurology, Huai'an Hospital Affiliated to Yangzhou University, Huai'an Fifth People's Hospital, Huai'an, Jiangsu, China; Department of Neurology and Clinical Research Centre of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Insights
Preserved left ventricular ejection fraction (LVEF) is linked to reduced white matter hyperintensities (WMHs), a marker of brain aging and stroke risk. Echocardiography may aid in assessing WMH risk in patients with cerebrovascular disease.
Area of Science:
- Neurology
- Cardiology
- Radiology
Background:
- White matter hyperintensities (WMHs) are linked to stroke, cognitive decline, and mortality.
- The association between cardiac function (LVEF, FS) and WMH burden requires further clarification.
- This study investigates left ventricular systolic function's role in WMH development in ischemic cerebrovascular disease patients.
Purpose of the Study:
- To explore the association between left ventricular systolic function and white matter hyperintensity burden.
- To determine if echocardiographic parameters can predict WMH severity in patients with ischemic cerebrovascular disease.
Main Methods:
- Retrospective analysis of 1,049 patients with ischemic cerebrovascular disease.
- Transthoracic echocardiography (TTE) assessed cardiac structure and systolic function (LVEF, FS).
- Magnetic resonance imaging (MRI) evaluated WMH severity using the Fazekas scale; logistic regression analyzed associations.
Main Results:
- Higher WMH burden correlated with atrial fibrillation, smoking history, and lower FS and LVEF.
- Decreased LVEF (OR=0.77) and atrial fibrillation (OR=6.48) were independently associated with moderate-severe WMHs (P < 0.001).
- The association between LVEF and WMHs was stronger in younger patients and females.
Conclusions:
- Preserved LVEF is associated with a lower risk of WMHs.
- The association between fractional shortening (FS) and WMHs was not statistically significant after adjustment.
- Echocardiographic assessment of LVEF may aid in early risk stratification for WMHs.
Background:
White matter hyperintensities (WMHs) are associated with an increased risk of stroke, cognitive decline, and all-cause mortality. However, the relationship between cardiac function, particularly left ventricular ejection fraction (LVEF) and fractional shortening (FS), and WMH burden has not been fully elucidated. This study aimed to explore the association between left ventricular systolic function and WMHs in patients with ischemic cerebrovascular disease.
Methods:
This retrospective study included 1,049 patients hospitalized at Huai'an Hospital affiliated with Yangzhou University between January 2023 and December 2024. Cardiac structure and systolic function were assessed using transthoracic echocardiography (TTE), and the severity of WMHs was evaluated by magnetic resonance imaging (MRI) using the Fazekas scale. The associations between echocardiographic parameters and WMH burden were examined using univariate and multivariate logistic regression analyses.
Results:
Of the 1,049 patients, 723 (68.9%) had none-mild WMHs (Fazekas score 0-2), and 326 (31.1%) had moderate-severe WMHs (Fazekas score 3-6). Patients with a higher WMH burden were more likely to have atrial fibrillation, and smoking history, and showed significantly lower FS and LVEF values. In multivariate logistic regression, atrial fibrillation (OR = 6.48, 95% CI: 3.85-10.88) and decreased LVEF (OR = 0.77, 95% CI: 0.72-0.83) were independently associated with moderate-severe WMHs (both P < 0.001). When FS was analyzed as a continuous variable, each 1% increase was associated with a 16% lower odd of WMHs (OR = 0.84, 95% CI: 0.73-0.89, P < 0.001); however, after categorization into quartiles, the dose-response trend was attenuated and no longer significant (P-trend = 0.245). Subgroup analyses showed significant interactions for LVEF with age, sex (P-interaction < 0.001, < 0.001 respectively), indicating that the inverse association between LVEF and WMHs was more pronounced in younger patients, females. No significant effect modification was observed for FS.
Conclusion:
Preserved LVEF was associated with a lower risk of WMHs, whereas the association for FS was attenuated and did not reach statistical significance after full adjustment. These findings highlight the potential contribution of cardiac function to the pathophysiology of WMHs and suggest that echocardiographic assessment may offer clinical insights for early risk stratification.
More Related Videos
15:263D Modeling of the Lateral Ventricles and Histological Characterization of Periventricular Tissue in Humans and Mouse
Published on: May 19, 2015
09:36A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
Published on: August 12, 2025
Related Concept Videos
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:15Ischemic Stroke ll: Pathophysiology
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and narrowing...