Transcript Liquid-based Cytology for Thyroid Fine

The Relationship between Leukoaraiosis &
Heart Function
Hyung Suk Seo1, Young Hen Lee1, Sung Hwan Kim2
Korea Univ., Ansan Hosp., Dept. of Radiology1
Dept. of Cardiology2
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
Aa
Ea
Purpose
• To evaluate the correlation between leukoaraiosis on brain
MRI and heart function on advanced echocardiography
Materials
• Retrospective study
• Jan. 2008 – Apr. 2009
• undergone brain MRI & echocardiography within one
month
• no large intracranial lesion
• Demographics
• Total 508 patients
• mean age: 59.6±15.0 years, range: 16-95 years
• M:F=277:231
Methods
• Leukoaraiosis Pointing System
• a 4-point scale following European Task Force
White matter
Basal ganglia
0
No
No
1
focal
1 focal (≥5mm)
2
beginning confluent
>1 focal
3
diffuse
confluent
(Stroke. 2001;32:1318-1322)
• 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
Methods
1 point
2 point
3 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)
γ-value
p-value
EF
-0.07
0.11
E/A ratio
-0.22
< .01
Ea
-0.48
< .01
E/Ea ratio
0.16
< .01
Aa
-0.05
0.24
• significant good correlation with leukoraiosis
E/A ratio
Ea
E/Ea ratio
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.