The Relationship between Leukoaraiosis & Heart Function Hyung Suk Seo 1, Young Hen Lee 1, Sung Hwan Kim 2 Korea Univ., Ansan Hosp., Dept. of Radiology 1 Dept. of Cardiology 2 Dept. of Cardiology 2
Introduction Leukoaraiosis (ARWMC) high signal intensites on T2WI, low attenuation area on CT mechanism chronic ischemic change or infarction degeneration of myelin or axons with increased water gliosis enlarged perivascular (Virchow-Robin) space clinical significance related to cerebrovascular risk factors : age, HTn related to cognitive impairment
Introduction Heart Function Ejection fraction (EF) conventional indication of LV function E/A ratio diastolic function estimated by doppler echocardiography early (E) to late (A) ventricular filling velocity ratio Tissue doppler imaging (TDI) tissue spectral trace by high-pass filter elemination in doppler sensitive measurement of LV function early detection of LV function change
Introduction Tissue doppler imaging (TDI) systolic myocardial velocity (Sa) early (Ea) and late (Aa) diastolic tissue velocities E/Ea ratio Sa Ea Sa Aa
Purpose To evaluate the correlation between leukoaraiosis on brain MRI and heart function on advanced echocardiography
Materials Retrospective study Jan – Apr undergone brain MRI & echocardiography within one month no large intracranial lesion Demographics Total 508 patients mean age: 59.6±15.0 years, range: years M:F=277:231
Methods Leukoaraiosis Pointing System a 4-point scale following European Task Force Adding up points of 5 regions in Rt. & Lt. hemispheres (0-30 points) ① frontal ② parieto-occipital ③ temporal ④ infratentorial ⑤ basal ganglia White matterBasal ganglia 0No 1focal 1 focal ( ≥5mm) 2beginning confluent>1 focal 3diffuseconfluent (Stroke. 2001;32: )
Methods 1 point2 point3 point
Methods Hear Function EF E/A ratio Tissue doppler imaging (TDI) Sa : systolic function Ea & Aa: diastolic function E/Ea ratio
Results Leukoaraiosis vs. Heart function (Pearson’s correlation test) significant good correlation with leukoraiosis E/A ratio Ea E/Ea ratio γ-value p-value EF E/A ratio-0.22<.01 Ea-0.48<.01 E/Ea ratio0.16<.01 Aa
Conclusion The severity of leukoaraiosis scales is correlated with heart or left ventricular functions. Especially, sensitive tissues doppler imaging is well correlated. Decreased heart function may be the cause of leukoaraiosis or chronic ischemic change in brain.