| Objective:To evaluate the correlation between the left ventricular hypertrophy(LVH) and the severity degree and distribution of cerebral microbleeds(CMBs) in patients who diagnosed as ischemic cerebrovascular diseases without hypertension(ICDWH).Methods: 177 patients diagnosed as ICDWH were admitted in the department of neurology in our hospital from August 2014 to January 2016. According to the absence of LVH, they were divided into LVH group and non LVH group. The general clinical information including basic information, biochemical markers, heart ultrasound, lacunar cerebral infarction, white matter lesion and hemorrhagic infarction were compared between these two groups. Based on the gradient of T2*-weighted echo MRI, CMBs were counted and divided into 4 grades: nothing, mild group, 1 to 2 CMBs, moderate group,3 to 10 CMBs, severe group, more than 10 CMBs. On the foundation of the locations of CMBs which classified as subcortical white matter, basal ganglia, thalamus, infratentorial and mixed group, the severity degree and distribution of CMBs were re-evaluated between these two groups. The risk factors of arteriosclerosis including male, smoking, diabetes, hyper-fibrinogenemia, age and LDL-C were compared between the subcortical white matter and basal ganglia/thalamus group. The incidences of arrhythmia and CMBs were compared between the normal geometric, concentric remodeling, concentric hypertrophy and eccentric hypertrophy group.Results : The incidence of LVH in ICDWH was 36.2%( 64/177). No significant difference was observed in age, gender, the type of ischemic cerebrovascular disease,smoking history,the past history of stroke,the history of taking warfarin or antiplatelet drugs,the indexes of blood viscosity, coagulation function, lipid levels and serum uric acid between the LVH and non-LVH group. Even though the incidence of atrial fibrillation in LVH group was slightly higher than non-LVH group(25.00% vs 14.16%, p>0.05), while the incidence of arrhythmia including atrial fibrillation in LVH group was obviously higher than non-LVH group(53.13% vs 36.28%,P=0.029). 2.The left ventricular end diastolic diameter( 49.52±6.03 mm vs 45.26±3.82 mm, p=0.000) and the left atrial diameter(35.37±6.92 mm vs 32.16±5.22 mm,p=0.001)in LVH group were higher than non-LVH group.3.No significant difference was detected in CMBs risk factors including lacunar cerebral infarction and white matter lesion between LVH and non- LVH group(p>0.05). The total incidence of CMBs in this study was 23.73%.The LVH group tended to have more opportunities for CMBs compared to the non-LVH group(34.38% vs 17.70%, p=0.012).However, there was no significant difference in hemorrhagic infarction between groups(p =0.670). 4. More CMBs occurred in basal ganglia/thalamus in the LVH group(40.91%), while in the non-LVH group, more CMBs in subcortical(40.00%). 5. LVH group had higher proportions of moderate and severe CMBs, while the non-LVH group was more accompanied with none and mild CMBs. There was a significant difference in severity degree of CMBs between groups(p=0.006). 6. Subcortical white matter group had higher incidences in male, smoking, diabetes and hyperfibrinogenemia, whereas, basal ganglia/thalamus group occupied higher incidences in advanced age and high LDL-C, no significant difference was observed. 7. Ventricular structure could not affect the occurrence of arrhythmia(p=0.062) and CMBs(p=0.105), even though concentric hypertrophy group had the highest incidence of arrhythmia(66.67%) and CMBs(38.89%).Conclusion: 1.The LVH group had a higher incidence of CMBs in the whole brain, especially in the central gray matter. 2.While the LVH group had more basal ganglia/thalamus microbleeds, the non-LVH group had more subcortical microbleeds. The distribution might been linked to atherosclerosis.3.LVH group had a higher incidence in moderate and severe CMBs and LVH might affect the severity degree of CMBs. |
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