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1/2021
vol. 86 Cardiovascular radiology
abstract:
Original paper
Magnetic resonance imaging assessment of cerebral small vessel disease intensification in patients with severe aortic valve stenosis
Jakub Chrostowski
1
,
Marcin Majos
2
,
Andrzej Walczak
3
,
Mariusz Wachowski
1
,
Agata Majos
1
1.
Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Poland
2.
Department of Radiology and Diagnostic Imaging, Medical University of Lodz, Poland
3.
Department of Cardiac Surgery, Medical University of Lodz, Poland
Pol J Radiol 2021; 86: e564-573
Online publish date: 2021/09/27
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Introduction
To assess the prevalence of the neuroradiological indices of cerebral small vessel disease (CSVD) in patients with severe aortic valve stenosis (AS) in magnetic resonance imaging (MRI). Material and methods 34 patients (age 60-90 years, 17 women and 17 men) with severe AS and 50 healthy controls (age 61-85 years, 29 women and 21 men) underwent MRI brain examinations, which were analysed for the neuroradiological indices of CSVD: hyperintensities in periventricular white matter (PVWM) and deep white matter (DWM), enlarged perivascular spaces (ePVS), lacunar strokes, and cerebral microbleeds (CMBs). Results PVWM hyperintensities were found in 46% of volunteers and was significantly lower (p = 0.027), corresponding to AS patients (80%), the density of lesions was higher in the AS group than in controls (p = 0.019). DWM hyperintensities were found more often in AS patients (76%) than in controls (66%) (p = 0.303), but the densities were similar in both groups. Lacunar strokes were found in 35% of AS patients and 16% of controls (p = 0.042). The average number of lacunar strokes per person was 0.9 in the AS group and 0.3 in the controls (p = 0.035). The AS group showed higher variance in the number of strokes: SD = 1.96 vs. SD = 1.06 in controls. Both prevalence and density of the ePVS and CMBs did not differ significantly between the groups. Conclusions Neuroradiological indices of the vascular disease do not provide an unequivocal clue to the pathogenesis of CSVD in patients with severe AS. Most observations imply that CSVD is primarily a consequence of cerebral hypoperfusion caused by AS. keywords:
aortic stenosis, cerebral small vessel disease, lacunar stroke, perivascular spaces, cerebral microbleed, white matter hyperintensities |