サブクリニックの左心室機能障害と静かな脳血管疾患:心臓血管異常と脳損傷 (CABL) 研究
Cesare Russo1, Zhezhen Jin, Shunichi Homma
1Department of Medicine, Columbia University, New York, NY 10032, USA.
Circulation
|August 2, 2013
まとめ
全球縦線ストレイン (GLS) は,一般人群において,静かな脳梗塞を含むサブ臨床的脳疾患を検出します. この心臓測定は,従来の左心室射出分数 (LVEF) 評価を超えて,脳血管リスクの洞察を提供します.
科学分野:
- 心臓病学 心臓病学
- 神経学 神経学とは
- メディカルイマージング (医学イメージング)
背景:
- 静かな脳梗塞 (SBI) や白質の過濃度などのサブ臨床的脳血管損傷は,脳卒中と認知機能低下に関連しています.
- 左心室射出分数 (LVEF) は,心不全における脳卒中を予測しますが,一般人における亜臨床的脳疾患との関連は不明です.
- 左心室全長ストレイン (GLS) は,正常なLVEFであっても,早期の心臓機能不全を特定することができます.
研究 の 目的:
- コミュニティベースのコホートにおけるLVEF,GLS,およびサブクリニカル脳疾患の関連性を調査する.
- GLSが,LVEFと比較して,脳血管疾患のリスクに関する追加の情報を提供しているかどうかを判断する.
主な方法:
- エコーカルディオグラフィー (2Dとスペックル・トラッキング) は,前回の脳卒中や心臓病のない439人の参加者において,LVEFとGLSを評価した.
- 脳のMRIは,SBIと白質の超強度性を評価しました.
- 多変量分析は,心臓の測定値と脳損傷の関係を調べた.
主要な成果:
- GLSの低下は,LVEFではないが,SBIの存在と有意に関連していた.
- 減少したGLSは独立してSBIを予測した (OR 1.18単位減少,P<0.01).
- GLSの低下は,より大きな白質の超強度容量と相関していたが,LVEFはそうではなかった.
結論:
- Lower GLSは,一般コミュニティのコホートにおけるサブクリニカル脳疾患と独立して関連しています.
- GLSは,LVEFを超える脳血管リスクに関する貴重な情報を提供します.
- GLSは,脳血管疾患のリスクのある個人を特定するための新しいバイオマーカーとして役立つ可能性があります.
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