title: Cardiac diastolic dysfunction is associated with cerebral white matter lesions in elderly patients with risk factors for atherosclerosis.
abstract: Cerebral white matter lesions on magnetic resonance imaging (MRI) are considered to be the result of brain ischemic injury and a risk factor for clinical stroke. The purpose of this study was to elucidate the relationship between the cardiac diastolic function and cerebral white matter lesions in elderly patients with risk factors for atherosclerosis. The study subjects were 55 patients (75 +/- 7 years) with risk factors for atherosclerosis including hypertension, diabetes mellitus, and dyslipidemia. Patients with symptomatic cerebrovascular events were excluded from the study. Cerebral white matter lesions, which were defined as exhibiting high intensity regions on brain MRI, were evaluated with the degrees of periventricular hyperintensity (PVH) according to the Japanese Brain Dock Guidelines of 2003. Peak early diastolic mitral annular velocity (E' velocity) was measured by tissue Doppler echocardiography, and was used as a parameter of cardiac diastolic function. The mean value of E' velocity was decreased due to the cardiac diastolic dysfunction (5.2 +/- 1.4 cm/s). In addition, the E' velocity was inversely correlated with the degree of PVH (rho = -0.701, p < 0.001). Stepwise regression analysis showed that the decrease in the E' velocity (beta coefficient = -0.42, p < 0.001) and the presence of hypertension (beta coefficient = 0.31, p = 0.001) were independent determinants of the degree of PVH. Thus, cardiac diastolic dysfunction is correlated to the severity of cerebral white matter lesions, suggesting the cardio-cerebral connection in elderly patients with risk factors for atherosclerosis.
authors.affiliation: Department of Integrated Medicine, Kagawa University, Kagawa, Japan. masugata@med.kagawa-u.ac.jp
authors.forename: Hisashi
authors.initials: H
authors.lastname: Masugata
authors.forename: Shoichi
authors.initials: S
authors.lastname: Senda
authors.forename: Fuminori
authors.initials: F
authors.lastname: Goda
authors.forename: Ayumu
authors.initials: A
authors.lastname: Yamagami
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okuyama
authors.forename: Takeaki
authors.initials: T
authors.lastname: Kohno
authors.forename: Naohisa
authors.initials: N
authors.lastname: Hosomi
authors.forename: Masanobu
authors.initials: M
authors.lastname: Imai
authors.forename: Kazushi
authors.initials: K
authors.lastname: Yukiiri
authors.forename: Takahisa
authors.initials: T
authors.lastname: Noma
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kohno
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001927:Brain Diseases / Q000150:complications* / Q000503:physiopathology*; D003971:Diastole / Q000502:physiology*; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008954:Models, Biological; D012044:Regression Analysis; D012307:Risk Factors; D014463:Ultrasonography