Association of Left Ventricular Function With Cerebral Small Vessel Disease in a Community-Based Population

IF 5 1区医学 Q1 NEUROSCIENCES

CNS Neuroscience & Therapeutics Pub Date : 2025-02-20 DOI:10.1111/cns.70226

Yingying Yang, Xueli Cai, Mengyuan Zhou, Yiyi Chen, Jingtao Pi, Mengxi Zhao, Yulu Shi, Jing Jing, Weiqi Chen, Hongyi Yan, Xia Meng, Yongjun Wang, Yuesong Pan, Yilong Wang

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引用次数: 0

Abstract

Background and Objectives

The relationship of cardiac function with cerebral small vessel disease (CSVD) remains unknown. The study aimed to investigate the association between left ventricular (LV) function and CSVD in a community-based population.

Methods

Community-dwelling residents in China from the cross sectional survey of the PRECISE (PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events) cohort were included. LV ejection fraction (LVEF) and LV fractional shortening (LVFS) were measured for LV systolic function, and mitral E/A ratio (the ratio of the peak trans-mitral filling velocity during early diastole and late diastole) was evaluated for LV diastolic function by transthoracic echocardiogram (TTE). Total CSVD score and CSVD imaging makers including white matter hyperintensity (WMH), lacunes, cerebral microbleeds (CMB), and enlarged perivascular spaces (EPVS) were assessed. The associations of cardiac function with CSVD were analyzed using ordinal or binary logistic regression models. Restricted cubic spline models fitted for logistic regression models were used.

Results

A total of 3063 participants with available TTE and brain MRI data were included in the study. In the multivariable logistic regression analysis, LVEF and LVFS were not associated with total CSVD score or markers of CSVD. E/A ratio showed a negative correlation with total CSVD score (cOR, 0.89, 95% CI: 0.80–0.98, p = 0.01). Participants with E/A ≤ 0.8 or ≥ 2 had a higher total CSVD score than those with 0.8 < E/A < 2 (cOR 1.20, 95% CI: 1.00–1.43, p = 0.046). E/A ratio was also correlated with lacunes, moderate to severe EPVS, and periventricular WMH. Logistic regression analyses with restricted cubic spline further demonstrated that a lower E/A ratio were associated with a higher total CSVD score.

Conclusion

Our study showed that mitral E/A ratio was associated with nonhemorrhagic CSVD. LV diastolic dysfunction assessed by TTE provides clues for the early warning of high CSVD burden.

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社区人群左心室功能与脑血管疾病的关系

背景与目的心功能与脑血管病（CSVD）的关系尚不清楚。该研究旨在调查社区人群中左心室（LV）功能与CSVD的关系。方法采用PRECISE （PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events）横断面调查的中国社区居民为研究对象。测量左室射血分数（LVEF）和左室缩短分数（LVFS）判断左室收缩功能，通过经胸超声心动图（TTE）评价二尖瓣E/A比（舒张早期和舒张晚期二尖瓣充盈速度峰值之比）判断左室舒张功能。评估总CSVD评分和CSVD影像学指标，包括白质高信号（WMH）、脑凹、脑微出血（CMB）和血管周围间隙扩大（EPVS）。使用有序或二元logistic回归模型分析心功能与CSVD的关系。采用拟合逻辑回归模型的限制三次样条模型。结果本研究共纳入3063名具有TTE和脑MRI数据的受试者。在多变量logistic回归分析中，LVEF和LVFS与总CSVD评分或CSVD标志物无关。E/A比值与总CSVD评分呈负相关（cOR, 0.89, 95% CI: 0.80 ~ 0.98, p = 0.01）。E/A≤0.8或≥2的受试者的CSVD总评分高于E/A≤0.8的受试者（cOR = 1.20, 95% CI: 1.00-1.43, p = 0.046）。E/A比值也与腔隙、中重度EPVS和室周WMH相关。限制三次样条Logistic回归分析进一步表明，较低的E/ a比率与较高的CSVD总评分相关。结论我们的研究表明二尖瓣E/A比值与非出血性CSVD有关。TTE评估左室舒张功能障碍为高心血管疾病负担的早期预警提供线索。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.