Correlation Of Left Ventricular Hypertrophy And Geometry With The Risk Of Cerebral Microbleeds In Patients With Cerebral Vascular Disease

Objective:The aim of the present study was to find out the risk factors of ischemic cerebral vascular disease in patients with hypertension and investigate the association and severity between left ventricular hypertrophy(LVH)or left ventricular(LV)geometry and cerebral microbleeds(CMBs).Method:According the inclusion and exclusion criteria,a total of 172 consecutive hypertensive ischemic cerebral vascular disease patients who were hospitalized at the Department of Neurology,in the First Hospital of Dalian university from 2014 August to 2015 December were enrolled.There were 89 patients with CMBs confirmed by magnetic resonance imaging(MRI)susceptibility weighted imaging(SWI),recording the number and location of CMBs,the other 83 patients who had no CMBs.Their ages ranged from 49 to 93 years(mean 67.97±10.15 years).Of them,32 patients had strictly deep CMBs,20 patients had strictly lobar CMBs and 37 patients had both deep and lobar CMBs by the different regions.The patients who had CMBs were divided into three groups in terms of the number of CMBs on MRI:a slight group(1 to 5 CMBs),a moderate group(6 to 15 CMBs)and a severe group(>15 CMBs)?All people were assessed for leukoaraiosis(LA)by Fazecas Score Criteria and counted the number of lacuna infarction(LI)on MRI.The left ventricular internal dimensions(LVID),interventricular septum thickness(IVST),and posterior wall thickness(PWT)were measured by echocardiography,and left ventricular mass index(LVMI)was estimated using the formula.The basic information and biochemistry items were registered for all patients.Data were analyzed with the Statistical Package for Social Sciences for Windows software(version 20.0,SPSS).A 2-tailed value of P<0.05 was considered significant.Result:1.Patients with CMBs exhibited significantly higher LVMI,RWT,the proportion of concentration hypertrophy(CH),LA score,No.of LI,age,hypertensive duration,systolic blood pressure(SBP),diastolic blood pressure(DBP)when compared with those patients without CMBs by univariate analysis(P=0.000,0.003,0.009,0.000,0.000,0.015,0.044,0.024,0.006,separately).In Binary logistic regression analysis,CMBs were independent and significantly associated with LVMI(OR=1.031,P=0.007)?hypertensive duration(OR=1.041,P=0.040)?concentration hypertrophy(CH)(OR=2.558,P=0.029).2.Patients showed significantly higher LVMI and the proportion of CH in strictly lobar CMBs than that observed in those without(P=0.016,0.039,separately).Binary logistic regression analysis showed LVMI(OR=1.027,P=0.044)and CH(OR=3.304,P=0.026)were independent risk for strictly lobar CMBs.In addition,patients with strictly deep CMBs had significant higher hypertensive duration,DBP,LA score,no.of LI,LVMI,RWT,and the proportion of patients using antithrombotic drugs than those without(P=0.042,0.001,0.002,0.000,0.005,0.005).By binary logistic regression analysis indicated LVMI,DBP,hypertensive duration and a history of antithrombotic drugs were independently significant with strictly deep CMBs,and the statistics were(OR=1.029,P=0.023),(OR=1.055,P=0.020),(OR=1.061,P=0.027),(OR=3.321,P=0.038),separately.3.Spearman rank correlation test revealed that the severity of CMBs were positively correlated with LVMI(r=0.288,P=0.006),no.of LI(r=0.433,P=0.000),LA score(r=0.324,P=0.002).Ordinal logistic regression analysis demonstrated that LVMI(OR=1.008,P=0.006)and no.of LI(OR=1.204,P=0.015)were independently correlated with the severity of CMBs.Conclusion:1.The common relative risk factors of ischemic cerebral vascular disease in patients with hypertension:(1)Hypertensive duration were independent risk factors for CMBs.(2)Hypertensive duration,DBP,and a history of antithrombotic drugs were independent risk factors associated with strictly deep CMBs.(3)The number of LI were independently correlated with the severity of CMBs.2.The LVH and LV geometry of echocardiography in ischemic cerebral vascular disease of patients with hypertension:(1)LVMI and concentration hypertrophy(CH)were independent risk factors for CMBs.(2)LVMI and CH were independent risk factors for CMBs for strictly lobar CMBs.LVMI were independent risk factors associated with strictly deep CMBs.(3)LVMI and no.of LI were independently correlated with the severity of CMBs.