Neuroimaging biomarkers of small vessel disease in cerebral amyloid angiopathy‐related intracerebral hemorrhage. (5th February 2023)

• Record Type: Journal Article
• Authors: Zhang, Mengke; Che, Ruiwen; Zhao, Wenbo; Sun, Hailiang; Ren, Changhong; Ma, Jin; Hu, Wenbo; Jia, Milan; Wu, Chuanjie; Liu, Xin; Ji, Xunming
• Is Part Of: CNS neuroscience & therapeutics. Volume 29:Number 5(2023)
• Page Start: 1222
• Page End: 1228
• Publication Date: 2023-02-05
• Subjects: cerebral amyloid angiopathy -- cerebral hemorrhage -- cerebral small vessel diseases -- neuroimaging; Neuropharmacology -- Periodicals; Central nervous system -- Diseases -- Effect of drugs on -- Periodicals; 612.8
• DOI: 10.1111/cns.14098
• Languages: English
• ISSNs: 1755-5930

Abstract

Abstract: Aims: The significance of the correlation of computed tomography (CT)–based cerebral small vessel disease (SVD) markers with the clinical outcomes in patients with cerebral amyloid angiopathy (CAA)‐related intracerebral hemorrhage (ICH) remains uncertain. Thus, this study aimed to explore the relationship between SVD markers and short‐term outcomes of CAA‐ICH. Methods: A total of 183 patients with CAA‐ICH admitted to the Xuanwu Hospital, and Beijing Fengtai You'anmen Hospital, from 2014 to 2021 were included. The multivariate logistic regression analysis was performed to identify the correlation between SVD markers based on CT and clinical outcomes at 7‐day and 90‐day. Results: Of the 183 included patients, 66 (36%) were identified with severe SVD burden. The multivariate analysis showed that the total SVD burden, white matter lesion (WML) grade, and brain atrophy indicator were independent risk factors for unfavorable outcomes at 90‐day. The brain atrophy indicator was independently associated with mortality at 90‐day. Severe cortical atrophy was significantly associated with early neurological deterioration. Conclusions: The neuroimaging profiles of SVD based on CT in patients with CAA‐ICH might predict the short‐term outcome more effectively. Further studies are required to validate these findings and identify modifiable factors for preventing CAA‐ICH development. Abstract : The significance of the correlation of computed tomography–based cerebral small vessel disease (SVD) markers with the clinical outcomes in patients with cerebral amyloid angiopathy (CAA)‐related intracerebral hemorrhage (ICH) remains uncertain. In our study, of the 183 included patients [with average age, 71 years; and male participants, 98 (54%)], 66 (36%) were identified with severe SVD burden. The multivariate analysis showed that the total SVD burden ( p < 0.001, OR, 2.74; 95% CI, 1.61–4.67), white matter lesion (WML) grade ( p < 0.001, OR, 8.93; 95% CI, 2.63–30.38), and brain atrophy indicator ( p = 0.009, OR, 0.76; 95% CI, 0.61–0.93) were independent risk factors for unfavorable outcomes at 90‐day. The brain atrophy indicator ( p = 0.027, OR, 0.78; 95% CI, 0.63–0.97) was independently associated with mortality at 90‐day. Severe cortical atrophy ( p = 0.031, OR, 2.98; 95% CI, 1.10–8.04) was significantly associated with early neurological deterioration within 7 days. Thus, considering cerebral SVD on baseline CT when determining prognosis in patients in the acute phase with CAA‐ICH is promising.