Department of Neurology, Seoul National University Hospital, Seoul, South Korea.
Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea.
PLoS One. 2020 Jul 27;15(7):e0236473. doi: 10.1371/journal.pone.0236473. eCollection 2020.
Cerebral white-matter hyperintensities (WMHs) on MRI is associated with reduced compliance of the cerebral arterioles. We hypothesized that an echocardiography index for left ventricular (LV) diastolic function, E/e', might reflect the cerebral arteriolar compliance and evaluated the association between E/e' and long-term progression rate of the cerebral WMH volume. This retrospective study included individuals who were ≥ 50 years of age, with a preserved LV ejection fraction (≥ 50%) and neurological function status (modified Rankin scale score ≤1), and underwent initial and follow-up MRI evaluations within intervals of 34-45 months. Baseline clinical, laboratory, and echocardiography markers such as ejection fraction, LV mass index, and E/e' were obtained. WMH volume progression rate between the baseline and follow-up MRIs was designated as the outcome factor. 392 individuals (57.1% men; mean age: 66.7±8.4 years) were followed-up for 38.2±3.4 months. The mean WMH volume progression rate was 1.35±2.65 mL/year. The log-transformed value of WMH volume progression rate was linearly associated with the log-transformed E/e' (B coefficient = 0.365; 95% confidence interval [CI] 0.180-0.551; P = 0.001), along with the log-transformed values of baseline WMH volume (B = 0.142; 95% CI 0.106-0.179; P<0.001) and glomerular filtration rate (B = -0.182; 95% CI -0.321-0.044; P = 0.010). Additionally, a subgroup with an E/e' ≥15 exhibited a significantly higher WMH progression rate compared to the subgroups with lower E/e' values (P<0.001), especially in the lower quartiles (quartiles 1 and 2) of the baseline WMH volume. We concluded that echocardiographic marker E/e' is associated with the long-term progression rate of cerebral WMHs in population with preserved LV systolic function.
脑白质高信号（WMHs）与脑小动脉顺应性降低有关。我们假设左心室（LV）舒张功能的超声心动图指标 E/e'可能反映脑小动脉顺应性，并评估 E/e'与脑 WMH 体积长期进展率之间的关系。这项回顾性研究纳入了年龄≥50 岁、LV 射血分数（≥50%）和神经功能状态（改良 Rankin 量表评分≤1）正常的个体，且在 34-45 个月的时间间隔内行初始和随访 MRI 评估。获取了基线临床、实验室和超声心动图标志物，如射血分数、LV 质量指数和 E/e'。将基线和随访 MRI 之间的 WMH 体积进展率指定为结局因素。392 名个体（57.1%为男性；平均年龄：66.7±8.4 岁）随访 38.2±3.4 个月。WMH 体积进展率的平均值为 1.35±2.65mL/年。WMH 体积进展率的对数值与 E/e'的对数值呈线性相关（B 系数=0.365；95%置信区间[CI]0.180-0.551；P=0.001），与基线 WMH 体积的对数值（B=0.142；95%CI0.106-0.179；P<0.001）和肾小球滤过率的对数值（B=-0.182；95%CI-0.321-0.044；P=0.010）也呈线性相关。此外，E/e'≥15 的亚组与 E/e'值较低的亚组相比，WMH 进展率显著更高（P<0.001），尤其是在基线 WMH 体积的较低四分位数（四分位数 1 和 2）中。我们得出结论，在左心室收缩功能正常的人群中，超声心动图标志物 E/e'与脑 WMH 长期进展率相关。
