Cerebral small vessel disease markers and long-term prognosis in spontaneous intracerebral hemorrhage: the HAGAKURE-ICH study.

Autor: Ikeda S; Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.; Department of Neurology, Kansai Medical University, Hirakata, Japan., Yakushiji Y; Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan. yakushiy@hirakata.kmu.ac.jp.; Department of Neurology, Kansai Medical University, Hirakata, Japan. yakushiy@hirakata.kmu.ac.jp., Tanaka J; Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan., Nishihara M; Department of Radiology, Faculty of Medicine, Saga University, Saga, Japan., Ogata A; Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan., Eriguchi M; Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan., Ono S; Department of Neurology, Kansai Medical University, Hirakata, Japan., Kosugi M; Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan., Suzuyama K; Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan., Mizoguchi M; Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan., Shichijo C; Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan., Ide T; Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan., Nagaishi Y; Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan., Ono N; Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan., Yoshikawa M; Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan., Katsuki Y; Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan., Irie H; Department of Radiology, Faculty of Medicine, Saga University, Saga, Japan., Abe T; Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan., Koike H; Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan., Hara H; Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
Jazyk: angličtina
Zdroj: Hypertension research : official journal of the Japanese Society of Hypertension [Hypertens Res] 2024 Sep 19. Date of Electronic Publication: 2024 Sep 19.
DOI: 10.1038/s41440-024-01906-1
Abstrakt: We investigated the effects of individual and cumulative cerebral small vessel disease (SVD) markers on long-term clinical outcomes in spontaneous intracerebral hemorrhage (sICH) patients. This prospective, single-center cohort study was conducted from 2012 to 2019. SVD markers, including lacunae, cerebral microbleeds, white matter hyperintensity (WMH), and perivascular spaces in the basal ganglia, were assessed to calculate a summary SVD score. Patients were categorized into severe (score ≥3) and non-severe (score 0-2) SVD burden groups. Functional prognosis was defined as recovery, no change, or decline based on modified Rankin Scale changes at 2 years after discharge, excluding death. Associations of SVD burden and individual SVD markers with outcomes were evaluated using Cox proportional hazards modeling for recurrent stroke and all-cause mortality, and using ordinal logistic regression for functional prognosis. Among 155 sICH patients who underwent MRI, 98 showed severe SVD burden. Recurrent stroke and all-cause mortality rates were 2.2 and 8.3 per 100 patient-years, respectively, over a median 2.1-year follow-up. In terms of functional prognosis, 57 patients (51.8%) recovered, 32 (29.1%) showed no change, and 21 (19.1%) declined. A significant association was apparent between severe SVD burden and poorer functional prognosis (odds ratio [OR] 2.48, 95% confidence interval [CI] 1.04-6.04; p = 0.042), particularly with moderate-to-severe WMH (OR 2.54, 95%CI 1.02-6.54; p = 0.048). The cumulative effects of SVD markers inhibited long-term functional recovery in sICH patients. Severe SVD burden, as well as moderate-to-severe WMH, can be indicators of long-term prognosis after sICH.
(© 2024. The Author(s), under exclusive licence to The Japanese Society of Hypertension.)
Databáze: MEDLINE
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