Left ventricular hypertrophy is associated with cerebral microbleeds in hypertensive patients
Left ventricular hypertrophy is associated with cerebral microbleeds in hypertensive patients
复制标题
DOI：
10.1212/01.wnl.0000132525.36804.a1
复制
发表时间：
2004-07-13
期刊：
影响因子：
9.9
通讯作者：
Yoon, BW
中科院分区：
文献类型：
--
作者：
Lee, SH;Park, JM;Yoon, BW
背景资料：脑微出血（CMB）是易发生脑血管病的指标，已知与慢性高血压密切相关。然而，尚未进行关于左心室（LV）肥大与CMB严重程度之间关系的研究。方法：对102例脑卒中合并高血压患者进行检查。使用T2* 加权梯度回波MRI数据计数CMB。采用有序Logistic回归分析左室质量指数与其他血管危险因素及心肌梗死的关系。结果：高血压合并CMB患者的左室质量指数高于无CMB患者。LV质量指数分级与全脑（p = 0.02）、中央灰质（p < 0.01）和幕下区（p <0.01）的CMB分级显著相关，但与皮质下白色物质的CMB分级无关。有序回归分析显示LV质量指数与CMB严重程度的增加独立相关（p = 0.01），在中央灰质（p < 0.01）和幕下区域（p < 0.01），但在皮质下白色物质（p = 0.63）中不相关。排除脑淀粉样血管病患者后，左室质量指数与皮质下白色物质中CMB严重程度之间的相关性变得显著（p < 0.01）。结论：高血压合并脑卒中患者心肌微循环与左室肥厚密切相关。因此，CMB应被理解为慢性高血压引起的脑靶器官损害的一种类型。
Background: Cerebral microbleeds (CMBs) are indicative of hemorrhage-prone microangiopathy and known to be closely associated with chronic hypertension. However, no studies have been undertaken on the association between left ventricular (LV) hypertrophy and the severity of CMB. Methods: One hundred two consecutive stroke patients with hypertension were examined. CMBs were counted using T2*-weighted gradient echo MRI data. With use of ordinal logistic regression analysis, the associations between LV mass index and other vascular risk factors and CMBs were analyzed. Results: Hypertensive patients with CMBs showed a higher LV mass index than patients without. The grades of LV mass index were significantly correlated with the grades of CMB in the whole brain (p = 0.02), in the central gray matter (p < 0.01), and in the infratentorial area (p < 0.01), but not with those in the subcortical white matter. Ordinal regression analysis revealed that the LV mass index was independently associated with increased CMB severity (p = 0.01), regionally in the central gray matter (p < 0.01) and in the infratentorial area (p < 0.01), but not in the subcortical white matter (p = 0.63). After excluding patients with cerebral amyloid angiopathy, the association between the LV mass index and the CMB severity in the subcortical white matter became significant (p < 0.01). Conclusions: There is a close relationship between CMBs and LV hypertrophy in hypertensive patients with stroke. Thus, CMBs should be understood as one type of cerebral target organ damage by chronic hypertension.