Abstract P369: Cerebral Small Vessel Disease and Enlarged Cardiac Ventricles

Autor:	Adam de Havenon, Eric D. Goldstein, Kayla S. Navarro, Ka-Ho Wong, Majd Ibrahim
Rok vydání:	2021
Předmět:	Advanced and Specialized Nursing medicine.medical_specialty business.industry Hemodynamics Cardiac Ventricle Disease medicine.disease Hyperintensity Internal medicine cardiovascular system Cardiology Medicine Neurology (clinical) Small vessel Cardiology and Cardiovascular Medicine business Stroke
Zdroj:	Stroke. 52
ISSN:	1524-4628 0039-2499
Popis:	Introduction: White matter hyperintensities (WMH) are a radiographic marker for cerebral small vessel disease (CSVD). Conditions altering cerebral venous outflow such as elevated central venous pressure and right atrial pressure in individuals with cardiac valvular disease have been implicated in the development of WMH. Hypothesis: We hypothesize that increased right-heart chamber size in individuals without significant cardiac valvular disease is associated with worse WMH. Methods: A retrospective chart review of adults with a brain MRI and a 2-dimensional transthoracic echocardiogram (TTE) was performed. Worst burden of WMH by way of Fazekas score, either periventricular or deep white matter, served as the primary outcome. Statistical analysis was performed using a multivariate ordinal logistic regression model. Results: A total of 132 individuals were included. Right atrial area (OR 0.93, 95% CI 0.87 to 1.00, p = 0.0041), right ventricular internal diameter (OR 0.48, 95%CI 0.27 to 0.83, p = 0.008) and left atrial area (OR 0.93, 95%CI 0.88 to 0.98, p = 0.007) was identified as being significant. Cardiac functional markers were not significant, including tricuspid annular plane systolic excursion (OR 0.99, 95%CI 0.93 to 1.05, p = 0.670), right ventricular ejection fraction (OR 0.99, 95%CI 0.96 to 1.02, p = 0.670) and left ventricular ejection fraction (OR 0.99, 95%CI 0.96 to 1.02, p = 0.567). Analysis of isolated DWM or PVWM Fazekas scores did not find significant predictors in relation to cardiac structure or function. Conclusions: Through non-invasive cardiac imaging, we identified that cardiac structural abnormalities as opposed to functional abnormalities were associated with worse WMH. Mechanistically this may result from altered intracerebral arteriovenous coupling or a shared pathophysiologic pathway between WMH and coronary microvascular disease.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::1fa26cd0f4d4ddf948a28e4ddb9232bc https://doi.org/10.1161/str.52.suppl_1.p369 Zobrazit plný text záznamu