Tohoku J. Exp. Med., 2008, 216(2)

Cardiac Diastolic Dysfunction Is Associated with Cerebral White Matter Lesions in Elderly Patients with Risk Factors for Atherosclerosis

HISASHI MASUGATA,¹ SHOICHI SENDA,¹ FUMINORI GODA,¹ AYUMU YAMAGAMI,¹ HIROYUKI OKUYAMA,¹ TAKEAKI KOHNO,¹ NAOHISA HOSOMI,² MASANOBU IMAI,³ KAZUSHI YUKIIRI,² TAKAHISA NOMA² and MASAKAZU KOHNO²

¹Department of Integrated Medicine, Kagawa University, Kagawa, Japan
²Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University, Kagawa, Japan
³Kagawa General Rehabilitation Center, Kagawa, Japan

Cerebral white matter lesions on magnetic resonance imaging (MRI) are considered to be the result of brain ischemic injury and a risk factor for clinical stroke. The purpose of this study was to elucidate the relationship between the cardiac diastolic function and cerebral white matter lesions in elderly patients with risk factors for atherosclerosis. The study subjects were 55 patients (75 ± 7 years) with risk factors for atherosclerosis including hypertension, diabetes mellitus, and dyslipidemia. Patients with symptomatic cerebrovascular events were excluded from the study. Cerebral white matter lesions, which were defined as exhibiting high intensity regions on brain MRI, were evaluated with the degrees of periventricular hyperintensity (PVH) according to the Japanese Brain Dock Guidelines of 2003. Peak early diastolic mitral annular velocity (E' velocity) was measured by tissue Doppler echocardiography, and was used as a parameter of cardiac diastolic function. The mean value of E' velocity was decreased due to the cardiac diastolic dysfunction (5.2 ± 1.4 cm/s). In addition, the E' velocity was inversely correlated with the degree of PVH (ρ = −0.701, p < 0.001). Stepwise regression analysis showed that the decrease in the E' velocity (β coefficient = −0.42, p < 0.001) and the presence of hypertension (β coefficient = 0.31, p = 0.001) were independent determinants of the degree of PVH. Thus, cardiac diastolic dysfunction is correlated to the severity of cerebral white matter lesions, suggesting the cardio-cerebral connection in elderly patients with risk factors for atherosclerosis.

keywords —— Cardiac diastolic function; cerebral white matter lesions; echocardiography.

© 2008 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2008, 216, 99-108

Correspondence: Hisashi Masugata, M.D., Ph.D., Department of Integrated Medicine, Faculty of Medicine, Kagawa University, 1750-1, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.

e-mail: masugata@med.kagawa-u.ac.jp