Stroke: Is cardiovascular remodeling actually related to white matter lesions?

The increase in Left ventricular (LV) mass index is an imaging biomarker that reflects the subclinical remodeling of the cardiac ventricular wall
.

The increase in left ventricular mass index is related to cognitive decline, large white matter structure damage, and white matter microstructure damage, even without left ventricular hypertrophy (LVH)

However, the correlation mechanism between the increase in left ventricular mass and the changes in white matter remains unclear

Although the association between left ventricular mass index and white matter microstructure may be due to common potential risk factors, such as differences in cell tissue, there are many ways to explain the association between left ventricular mass index and white matter damage
.

Increased left ventricular mass index is associated with cerebral small vessel disease, increased risk of stroke, and high blood pressure
.

These conditions can lead to a state of neuroinflammation, which can lead to white matter damage in the elderly

Blood vessel

In addition to cerebral small vessel disease, the increase in left ventricular mass index is also related to the decrease in gray matter volume
.

Neurodegeneration can destroy neighboring white matter through Wallerian degeneration, which may be another way in which the LV mass index affects the white matter of the brain

Neurodegeneration can destroy neighboring white matter through Wallerian degeneration, which may be another way in which the LV mass index affects the white matter of the brain

This study first examined the relationship between left ventricular mass index and Aβ accumulation in CSF, microglial activation (sTREM2), axonal injury (NFL) and age-related neurodegeneration (total-tau) markers, and then To assess whether CSF biomarkers partially mediate the previously reported link between the left ventricular mass index and the white matter microstructure of the elderly
.

CSF Aβ, sTREM2, NFL and total-tau19 are all related to white matter microstructure damage.

Therefore, Elizabeth E.

Moore of Vanderbilt Memory and Alzheimer's Center et al.

diagnosis

They included participants of the Vanderbilt Memory and Aging Project (n=142, 72±6 years old, 37% with mild cognitive impairment) who underwent cardiac magnetic resonance, lumbar puncture, and diffusion tensor imaging [ MCI], 32% APOE-ε4 positive, LV mass index 51.
4±8.
1 g/m2, NFL 1070±588 pg/ml)
.

Linear regression and voxel analysis respectively correlate the left ventricular mass index with each biomarker and diffusion tensor imaging index

In all participants, the left ventricular mass index was not related to CSF ​​biomarkers (P>0.
33)
.

The left ventricular mass index interacts with MCI (P=0.

NFL partially mediates the 13% effect of increased left ventricular mass index on white matter damage
.

The important significance of this study lies in the discovery that in patients with MCI and APOE-ɛ4, subclinical cardiovascular remodeling as measured by the increase in left ventricular mass index is associated with neuronal degeneration
.

Axonal degeneration partly reflects the association between a higher left ventricular mass index and white matter damage

Cardiovascular

The findings emphasize that axon degeneration, rather than amyloidosis or microglia, may be more related to the path between cardiovascular remodeling and white matter damage
.

Axon degeneration, rather than amyloidosis or microglia, may be more related to the path between cardiovascular remodeling and white matter damage

Original source:
Moore EE, Khan OA, Shashikumar N, et al.
Axonal Injury Partially Mediates Associations Between Increased Left Ventricular Mass Index and White Matter Damage .
Stroke.
Published online October 27, 2021:STROKEAHA.
121.
034349.
doi:10.
1161/STROKEAHA.
121.
034349

Axonal Injury Partially Mediates Associations Between Increased Left Ventricular Mass Index and White Matter Damage

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