The Relationship Of Asymptomatic Left Ventricular Diastolic Dysfunction And Leukoaraiosis In Patients With First-ever Ischemic Stroke

Objective: This paper evaluates the relationship of asymptomatic left ventricular diastolic dysfunction,age or hypertension and the severity degree of leukoaraiosis among the patients who diagnosed as first-ever ischemic stroke with quantifiy the index of left ventricular function by Echocardiography.Methods: 1.317 patients who diagnosed as first-ever ischemic stroke were admitted in department of neurology in our hospital(FU JIANG UNION HOSPITAL)continuously from January 2016 to January 2017.And gathering their clinical information such as general information,biochemical markers,brain MRI data and Echocardiography data.2.According to the absence of LA,the patients were divided into non-LA group and LA group.The clinical information including general information,biochemical makers and index of Echocardiography etc,were compared between these two groups,finally analyze independent relevant factors of LA.The date was analyzed by using univariate analysis and logistic repression analysis.3.According to the distribution of LA,the patients can be divided into the simple lateral ventricle LA group and mixed area LA group,and analyze the independent relevant factors of the mixed area LA.4.According to the distribution of LA,the patients were divided into lateral venricle group and deep white matter group.According to the Fazekas classification,the each group can be divided into mild group(level 1)and moderate-severe group(level 2~3).5.According to the result of LA analysis,compare the difference of severity degree of the lateral ventricle LA group by logistic repression analysis.Finally analyze the independent relevant factors of the moderate-severe group of the lateral ventricle LA.6.According to the result of LA analysis,compare the difference of severity degree of the deep white matter LA group by logistic repression analysis.And analyze the independent relevant factors of moderate-severe group of the deep white matter LA.Result: 1.Univariate analysis showed that there were significant difference in age,Hcy,hypertension disease and diabetes between non-LA group and LA group(P=0.002,0.001,0.001,0.024).And no significant difference was observed in sex,drinking,smoking,Uric acid,Scr,total cholesterol,triglyceride,Homocysteine,HDL-C and LDL-C between the two groups.2.Univariate analysis showed that there were significant difference in LAD,E/A and E/E’ between non-LA group and LA group(P=0.024,0.0370.005).And no significant difference was observed in LVEDD and LVESD between the two groups.3.Logistic-regression analysis showed that compared to the non-LA group,age,Hcy,hypertension and E/E’ were Statistically associated with LA(P=0.041,0.011.014,0.026),except diabetes.4.The logistic regression analysis of the simple lateral ventricle LA deep white matter LA showed that: In addition to homocysteine(P = 0.169),age,hypertension and E / E ’were statistically significant with the mixed area LA(P=0.006,0.013,0.048).5.The logistic statistical analysis of the different severity of the lateral ventricle LA patients showed that: compared to the mild group,age,hypertension and E/E’ were independently associated with moderate-severe group(P=0.04,0.006,0.004).6.The logistic statistical analysis of the different severity of the deep white LA patients showed that: compared to the mild group,age and hypertension were independently associated with moderate-severe group(P=0.016,0.025),except E/E’ and Hcy.Conclusion: 1.In patients with first-ever ischemic stroke,age,Hcy,hypertension and asymptomatic left ventricular diastolic dysfunction are independent risk factor of LA.Diabetes,hyperlipidemia,uric acid,creatinine,smoking,and alcohol consumption are not independent risk factor for LA.2.In patients with first ischemic stroke,homocysteine,age,hypertension,and ALVDD play a role in the development of lateral ventricle LA.3.In patients with first-ever ischemic stroke,compared to the deep white matter LA group,ALVDD may affect the development of LA in the lateral ventricle compared with deep white matter LA.4.ALVDD may lead to the development of LA mainly by reducing the mechanism of cerebral blood flow perfusion.