Katulska K, Wykrętowicz M, Minczykowski A, Krauze T, Milewska A, Piskorski J, Marciniak R, Stajgis M, Wysocki H, Guzik P, Wykrętowicz A
Department of Radiology, Poznan University School of Medicine, 49 Przybyszewskiego, 60-355 Poznan, Poland.
Department of Cardiology-Intensive Therapy, Poznan University School of Medicine, 49 Przybyszewskiego, 60-355 Poznan, Poland.
J Neurol Sci. 2014 Aug 15;343(1-2):100-4. doi: 10.1016/j.jns.2014.05.044. Epub 2014 May 29.
Hemodynamic disturbances are associated with aging as well as the chronic process of left ventricular and arterial stiffening. This process can influence gray matter volume and thereby contribute to brain atrophy. We performed a comprehensive assessment of left ventricular and arterial function as well as central hemodynamics. These data were correlated with gray matter volume (GMV) as evaluated by magnetic resonance imaging (MRI).
GMV and aortic stiffness were estimated using MRI. Left ventricular end-systolic elastance or stiffness (Ees), arterial elastance (Ea) and total arterial compliance (TAC) were determined by echocardiography. Central hemodynamics were assessed using pulse wave analysis.
Seventy-five healthy subjects (42 women, 33 men, mean age of 58 years) were recruited. The clinical analyses showed that GMV correlates significantly and inversely with age (r=-0.37, P=0.001), end-systolic LV stiffness (r=-0.39, P=0.0009), augmentation pressure (r=-0.48, P<0.0001), arterial elastance (r=-0.27, P=0.02) and aortic stiffness (r=-0.23, P=0.04), as determined by aortic pulse wave velocity (aPWV). GMV correlated significantly with total arterial compliance (r=0.23, P=0.04). Stepwise forward multiple regression analysis revealed that 35% of variance (P<0.0001) in GMV is attributed to aPWV, Ees and AP.
Left ventricular end-systolic stiffness, augmentation of central arterial pressure and aortic stiffness are associated independently and negatively with GMV. These associations suggested that brain atrophy is influenced by hemodynamic factors.
血流动力学紊乱与衰老以及左心室和动脉僵硬度的慢性过程相关。这一过程会影响灰质体积,进而导致脑萎缩。我们对左心室和动脉功能以及中心血流动力学进行了全面评估。这些数据与通过磁共振成像(MRI)评估的灰质体积(GMV)相关。
使用MRI估计GMV和主动脉僵硬度。通过超声心动图测定左心室收缩末期弹性或僵硬度(Ees)、动脉弹性(Ea)和总动脉顺应性(TAC)。使用脉搏波分析评估中心血流动力学。
招募了75名健康受试者(42名女性,33名男性,平均年龄58岁)。临床分析表明,GMV与年龄(r = -0.37,P = 0.001)、收缩末期左心室僵硬度(r = -0.39,P = 0.0009)、增压(r = -0.48,P < 0.0001)、动脉弹性(r = -0.27,P = 0.02)和主动脉僵硬度(通过主动脉脉搏波速度(aPWV)测定,r = -0.23,P = 0.04)显著负相关。GMV与总动脉顺应性显著相关(r = 0.23,P = 0.04)。逐步向前多元回归分析显示,GMV中35%的方差(P < 0.0001)可归因于aPWV、Ees和AP。
左心室收缩末期僵硬度、中心动脉压升高和主动脉僵硬度与GMV独立且呈负相关。这些关联表明脑萎缩受血流动力学因素影响。