Lee S-H, Park J-M, Kwon S-J, Kim H, Kim Y-H, Roh J-K, Yoon B-W
Department of Neurology, School of Public Health, SNUMRC and Clinical Research Institute, Seoul National University Hospital, Republic of Korea.
Neurology. 2004 Jul 13;63(1):16-21. doi: 10.1212/01.wnl.0000132525.36804.a1.
Cerebral microbleeds (CMBs) are indicative of hemorrhage-prone microangiopathy and known to be closely associated with chronic hypertension. However, no studies have been undertaken on the association between left ventricular (LV) hypertrophy and the severity of CMB.
One hundred two consecutive stroke patients with hypertension were examined. CMBs were counted using T2*-weighted gradient echo MRI data. With use of ordinal logistic regression analysis, the associations between LV mass index and other vascular risk factors and CMBs were analyzed.
Hypertensive patients with CMBs showed a higher LV mass index than patients without. The grades of LV mass index were significantly correlated with the grades of CMB in the whole brain (p = 0.02), in the central gray matter (p < 0.01), and in the infratentorial area (p < 0.01), but not with those in the subcortical white matter. Ordinal regression analysis revealed that the LV mass index was independently associated with increased CMB severity (p = 0.01), regionally in the central gray matter (p < 0.01) and in the infratentorial area (p < 0.01), but not in the subcortical white matter (p = 0.63). After excluding patients with cerebral amyloid angiopathy, the association between the LV mass index and the CMB severity in the subcortical white matter became significant (p < 0.01).
There is a close relationship between CMBs and LV hypertrophy in hypertensive patients with stroke. Thus, CMBs should be understood as one type of cerebral target organ damage by chronic hypertension.
脑微出血（CMB）提示易出血的微血管病变，且已知与慢性高血压密切相关。然而，尚未有关于左心室（LV）肥厚与CMB严重程度之间关联的研究。
对102例连续的高血压性卒中患者进行检查。使用T2*加权梯度回波MRI数据对CMB进行计数。采用有序逻辑回归分析，分析LV质量指数与其他血管危险因素和CMB之间的关联。
有CMB的高血压患者的LV质量指数高于无CMB的患者。LV质量指数分级与全脑（p = 0.02）、中央灰质（p < 0.01）和幕下区域（p < 0.01）的CMB分级显著相关，但与皮质下白质的CMB分级无关。有序回归分析显示，LV质量指数与CMB严重程度增加独立相关（p = 0.01），在区域上与中央灰质（p < 0.01）和幕下区域（p < 0.01）相关，但与皮质下白质无关（p = 0.63）。排除脑淀粉样血管病患者后，LV质量指数与皮质下白质CMB严重程度之间的关联变得显著（p < 0.01）。
高血压性卒中患者的CMB与LV肥厚之间存在密切关系。因此，CMB应被理解为慢性高血压所致的一种脑靶器官损害。
