Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou,Henan, China.
Curr Neurovasc Res. 2021;18(5):565-571. doi: 10.2174/1567202619666211231092630.
Age and hypertension are widely considered to be the main risk factors for white matter hyperintensity (WMH), but they do not account for all the pathophysiological mechanisms of WMH.Therefore, identifying novel risk factors is significant to improve our understanding of the etiology and consequences of WMH.
To examine the association of heart rate(HR) and common vascular risk factors with WMH burden in patients hospitalized for Cerebral Small Vessel Disease(CSVD).
The study consisted of 778 patients who underwent 24-hour ambulatory blood pressure and HR monitoring and brain magnetic resonance imaging(MRI). The relationship of HR measures and vascular risk factors with the presence of log WMHV4 was analyzed.Univariable and multivariable analysis was carried out to investigate the relationship of incidence of severe WMH (4th quartile, ≥19.64 ml) and HR measures and common vascular risk factors.
Multivariate analysis showed that WMHV was independently predicted by nighttime HR ( OR (95% CI): 1.041（1.021.062）, P<0.001),Homocysteine ( OR (95% CI): 1.019（1.0051.033）, P=0.009), and cerebral infarction ( OR (95% CI): 0.463（0.31~0.691）, P<0.001), No similar association was observed for daytime HR、HR variability and other vascular risk factors.
As nighttime HR、Hcy increased, log WMHV increased accordingly; furthermore, patients with cerebral infarction were more likely to have higher levels of WMHV. nighttime HR 、Hcy、cerebral infarction was associated with WMHV, suggesting independent roles of their in WMHV. The influence of HRV on WMHV needs to be addressed by further studies.
年龄和高血压被广泛认为是脑白质高信号（WMH）的主要危险因素，但它们不能解释 WMH 的所有病理生理机制。因此，确定新的危险因素对于提高我们对 WMH 的病因和后果的理解具有重要意义。
探讨心率（HR）和常见血管危险因素与因脑小血管病（CSVD）住院患者的 WMH 负荷之间的关系。
本研究纳入 778 例患者，他们接受了 24 小时动态血压和 HR 监测以及脑部磁共振成像（MRI）检查。分析了 HR 指标和血管危险因素与 logWMHV4 存在的关系。进行单变量和多变量分析，以研究 HR 指标和常见血管危险因素与严重 WMH（第 4 四分位数，≥19.64ml）发生率之间的关系。
多变量分析显示，夜间 HR（优势比（95%置信区间）：1.041（1.021.062），P<0.001）、同型半胱氨酸（优势比（95%置信区间）：1.019（1.0051.033），P=0.009）和脑梗死（优势比（95%置信区间）：0.463（0.31~0.691），P<0.001）可独立预测 WMHV。未观察到日间 HR、HR 变异性和其他血管危险因素与 WMHV 有类似的关联。
夜间 HR 升高、Hcy 升高，logWMHV 随之升高；此外，脑梗死患者更有可能出现更高水平的 WMHV。夜间 HR、Hcy 和脑梗死与 WMHV 相关，提示它们在 WMHV 中具有独立作用。HRV 对 WMHV 的影响需要进一步研究。
