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Left Ventricular Ejection Fraction is Associated with Small Vessel Disease in Ischemic Stroke Patients.

Research paper by Ki-Woong KW Nam, Hyung-Min HM Kwon, Hack-Lyoung HL Kim, Yong-Seok YS Lee

Indexed on: 20 Dec '18Published on: 20 Dec '18Published in: European Journal of Neurology



Abstract

To evaluate the association between the left ventricular ejection fraction (LVEF) and cerebral small vessel disease (cSVD) in ischemic stroke patients METHODS: We included consecutive first-ever ischemic stroke patients between 2010 and 2013. White matter hyperintensity (WMH) volumes were rated using both the Fazekas score and quantitative methods on FLAIR images. As spectra of cSVD, lacunes, cerebral microbleeds (CMB), and enlarged perivascular spaces (EPVS) were also evaluated. To assess the dose-response relationship between LVEF and cSVD, the burdens of each radiological marker and the total cSVD score were rated. A total of 841 patients were included (median WMH volume: 2.98 [1.22-10.50] mL; the frequencies of lacunes, CMBs and moderate-to-severe EPVS were 38%, 31%, and 35%, respectively). In the multivariable analysis about predictors of WMH volumes, LVEF [B = -0.052, P < 0.001] remained significant after adjusting for confounders. LVEF was also a predictor of lacune [adjusted odds ratio (aOR) = 0.978, P = 0.012], CMB (aOR = 0.96, P < 0.001), and moderate-to-severe EPVS (aOR = 0.94, P < 0.001) after adjusting for their confounders. The LVEF values were negatively correlated with the burdens of lacunes (P = 0.026), CMBs (P < 0.001) and EPVS (P = 0.002). The total cSVD score also showed a negative association with LVEF in a dose-response manner (P < 0.001). The burden of cSVD is negatively correlated with the LVEF in a dose-response manner. Our results suggest clues for further studies about determining the pathophysiology of cSVD. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.