title: Left ventricular diastolic dysfunction is associated with cerebral white matter lesions (leukoaraiosis) in elderly patients without ischemic heart disease and stroke.
abstract: OBJECTIVE
  Cerebral white matter lesions (WML) are known to increase with age, as is left ventricular (LV) diastolic dysfunction with normal contraction. Although aging is a common risk factor, the link between these diseases is not fully understood. The aim was to clarify this relationship, using the ratio between early diastolic mitral inflow and early diastolic mitral annular tissue velocity (E/E'). E/E' measured by tissue Doppler echocardiography offers an indicator of the severity of LV diastolic dysfunction, reflecting both diastolic LV stiffness and diastolic LV filling pressure.
  
  
  METHODS
  Participants comprised 75 patients aged between 65 and 75 years with normal LV contraction and no signs or history of symptomatic heart failure, ischemic heart diseases, atrial fibrillation, stroke, or cognitive dysfunction. The volume of WML was quantified on brain magnetic resonance imaging.
  
  
  RESULTS
  The participants were classified into three groups: Low E/E', E/E' ≤ 8; Middle E/E', 8 < E/E' < 15; and High E/E', E/E' ≥ 15. WML volume was 3.6 ± 3.0 mL in Low E/E', 5.4 ± 6.5 mL in Middle E/E' and 12.0 ± 11.0 mL in High E/E', increasing significantly with increased diastolic LV stiffness (Low vs High, P = 0.034; Middle vs High, P = 0.016). Linear regression analysis showed the positive association between the volume of WML and E/E' ratio (r = 0.377, P = 0.0009).
  
  
  CONCLUSIONS
  This investigation identified an association between LV diastolic dysfunction and WML. Further investigations are required to clarify whether there is a direct association between the two diseases.
authors.affiliation: Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan; Department of Cardiology, Nagoya University, Nagoya, Japan.
authors.forename: Atsuya
authors.initials: A
authors.lastname: Shimizu
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakurai
authors.forename: Toko
authors.initials: T
authors.lastname: Mitsui
authors.forename: Motohiro
authors.initials: M
authors.lastname: Miyagi
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Nomoto
authors.forename: Manabu
authors.initials: M
authors.lastname: Kokubo
authors.forename: Yasuko K
authors.initials: YK
authors.lastname: Bando
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
authors.forename: Kenji
authors.initials: K
authors.lastname: Toba
mesh_terms: D000368:Aged; D003971:Diastole; D004452:Echocardiography; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049292:Leukoaraiosis / Q000150:complications* / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D009200:Myocardial Contraction / Q000502:physiology*; D017202:Myocardial Ischemia; D011379:Prognosis; D012189:Retrospective Studies; D020521:Stroke; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D066127:White Matter / Q000473:pathology*
keywords: cerebral white matter lesions; left ventricular diastolic dysfunction; ratio of early diastolic mitral inflow to early diastolic mitral annular tissue velocity