Excessive brain atrophy in patients with severe aortic stenosis

Purpose:
To assess the prevalence of the neuroradiological indices of brain atrophy in patients with severe aortic valve stenosis (AS) in magnetic resonance imaging (MRI) with particular emphasis on the assessment of atrophy areas typical of cerebral small vessel disease (CSVD).

Material and methods:
The group of 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 brain atrophy.

Results:
A slight but statistically significant age difference was found between the study and control groups – about 3 years on average (p = 0.040). Differences between total brain volumes in both the groups did not show statistical significance. In a comparative analysis of the main brain compartments, a statistically significant difference was found only in the volumetry of cerebral hemispheres for both the groups: mean volume of cerebral hemispheres in patients with severe AS was 884.46 cm³, while it was 17 cm³ bigger in the volunteer group, reaching 901.80 cm³ on average (p = 0.043). Comparison of the volumetry of the other major and minor regions and structures according to the clinical and anatomical division revealed statistically non-significant differences. No statistically significant relationships were observed concerning structures correlated with CSVD.

Conclusions:
Neuroradiological indices of the brain atrophy do not provide an unequivocal distinction in patients with severe AS. Most observations imply that brain atrophy in patients with severe AS is primarily a consequence of physiological ageing of the brain.