Altered Hemodynamics May Influence White Matter Hyperintensity Development

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There was a linear link between white matter hyperintensity volume and RA pressure in chronic valvular heart disease.
There was a linear link between white matter hyperintensity volume and RA pressure in chronic valvular heart disease.

HealthDay News — For patients with chronic valvular heart disease, white matter hyperintensity (WMH) volume is associated with mean right atrial (RA) pressure, according to a study published online Nov. 6 in JAMA Neurology.

Woo-Jin Lee, MD, from Seoul National University Hospital in South Korea, and colleagues examined the correlation between chronically altered cardiac hemodynamics and severity of cerebral WMH in 303 patients diagnosed with severe chronic valvular heart disease. Two hundred thirty-two patients were included in the final analyses.

The researchers found that 63.4% of patients were classified as having a disease involving the mitral valve; 40.1%, the aortic valve; 15.9%, the tricuspid valve; and 1.7%, the pulmonary valve. WMH volume was linearly associated with mean RA pressure (B coefficient, 0.702; 95% confidence interval, 0.373 to 1.031; P =.001) along with age (B coefficient, 0.145; 95% confidence interval, 0.029 to 0.261; P =.01) and mean aortic pressure (B coefficient, 0.112; 95% confidence interval, 0.034 to 0.19; P =.005) after adjustment for the type and mechanism of valve disease and clinical, echocardiographic, and/or other catheterization parameters.

"Mean RA pressure was independently associated with the WMH volume in chronic valvular heart disease," the authors wrote.

Reference

Lee W-J, Jung K-H, Ryu YJ, et al. Association of cardiac hemodynamic factors with severity of white matter hyperintensities in chronic valvular heart disease [published online November 6, 2017]. JAMA. doi:10.1001/jamaneurol.2017.2853

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