Left ventricular diastolic dysfunction is associated with cerebral white matter lesions (leukoaraiosis) in elderly patients without ischemic heart disease and stroke

Abstract

Aim: 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. Geriatr Gerontol Int 2014; 14 (Suppl. 2): 71-76.Keywords: cerebral white matter lesions, left ventricular diastolic dysfunction, ratio of early diastolic mitral inflow to early diastolic mitral annular tissue velocity.

Severity of white matter hyperintensities in older adults aged in their mid 80s and its relationship with hemodynamic and cardiac parameters

“…Some studies have reported the existence of correlations between cardiac dysfunction and brain abnormalities, between LV diastolic function and the severity of WMH, between the left ventricular ejection fraction and the severity of WMH, between the left ventricular ejection fraction and cognitive function, between systolic blood pressure and the severity of the WMH, and between diastolic blood pressure (or pulse pressure) and the severity of WMH . These present and previous data show the importance of increased pulse pressure as a risk factor for the presence of severe WMH.…”

Impact of night‐time blood pressure on cerebral white matter hyperintensity in elderly hypertensive patients

“…Populations with hypertension, diabetes, metabolic syndrome, chronic kidney disease, high serum total homocysteine levels, a history of smoking and vitamin D deficiency have been reported as high‐risk groups for WMH developing and becoming severe . Furthermore, our group has clarified that left ventricular diastolic dysfunction is associated with WMH in elderly patients without ischemic heart disease and stroke . Of the aforementioned risk factors, hypertension is considered the greatest risk factor for the progression of WMH.…”

Left ventricular diastolic dysfunction is directly associated with cerebral white matter lesions in elderly patients

“…3 We previously reported that the severity of left ventricular (LV) diastolic dysfunction is associated with the volume of cerebral WML. 4 However, the analysis could not be carried out by removing the effect of the common or specific risk factors that are known to be involved in the progression of LV diastolic dysfunction and/or cerebral WML, such as age, hypertension, diabetes mellitus, hyperlipidemia, smoking, obesity and so on. Consequently, whether LV diastolic dysfunction is directly associated with cerebral WML remained unclear.…”