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Covert Cerebrovascular Changes in People With Heart Disease: A Systematic Review and Meta-Analysis.
Zhou, Zien; You, Shoujiang; Sakamoto, Yuki; Xu, Ying; Ding, Song; Xu, Wenyi; Li, Wenjie; Yu, Jie; Wang, Yanan; Harris, Katie; Delcourt, Candice; Reeves, Mathew J; Lindley, Richard I; Parsons, Mark W; Woodward, Mark; Anderson, Craig; Du, Xin; Pu, Jun; Wardlaw, Joanna M; Carcel, Cheryl.
Affiliation
  • Zhou Z; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • You S; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Sakamoto Y; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Xu Y; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Ding S; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Xu W; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Li W; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Yu J; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Wang Y; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Harris K; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Delcourt C; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Reeves MJ; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Lindley RI; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Parsons MW; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Woodward M; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Anderson C; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Du X; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Pu J; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Wardlaw JM; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
  • Carcel C; From the The George Institute for Global Health (Z.Z., S.Y., Y.S., Y.X., J.Y., Y.W., K.H., C.D., M.W., C.A., C.C.), Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurology and Clinical Research Center of Neurological Disease (S.Y.), The Second Affiliated Hospit
Neurology ; 102(8): e209204, 2024 Apr 23.
Article in En | MEDLINE | ID: mdl-38531010
ABSTRACT
BACKGROUND AND

OBJECTIVES:

To determine the prevalence of silent brain infarction (SBI) and cerebral small vessel disease (CSVD) in adults with atrial fibrillation (AF), coronary artery disease, heart failure or cardiomyopathy, heart valve disease, and patent foramen ovale (PFO), with comparisons between those with and without recent stroke and an exploration of associations between heart disease and SBI/CSVD.

METHODS:

Medline, Embase, and Cochrane Library were systematically searched for hospital-based or community-based studies reporting SBI/CSVD in people with heart disease. Data were extracted from eligible studies. Outcomes were SBI (primary) and individual CSVD subtypes. Summary prevalence (95% confidence intervals [CIs]) were obtained using random-effects meta-analysis. Pooled prevalence ratios (PRs) (95% CI) were calculated to compare those with heart disease with available control participants without heart disease from studies.

RESULTS:

A total of 221 observational studies were included. In those with AF, the prevalence was 36% (31%-41%) for SBI (70 studies, N = 13,589), 25% (19%-31%) for lacune (26 studies, N = 7,172), 62% (49%-74%) for white matter hyperintensity/hypoattenuation (WMH) (34 studies, N = 7,229), and 27% (24%-30%) for microbleed (44 studies, N = 13,654). Stratification by studies where participants with recent stroke were recruited identified no differences in the prevalence of SBI across subgroups (phomogeneity = 0.495). Results were comparable across participants with different heart diseases except for those with PFO, in whom there was a lower prevalence of SBI [21% (13%-30%), 11 studies, N = 1,053] and CSVD. Meta-regressions after pooling those with any heart disease identified associations of increased (study level) age and hypertensives with more SBIs and WMH (pregression <0.05). There was no evidence of a difference in the prevalence of microbleed between those with and without heart disease (PR [95% CI] 1.1 [0.7-1.7]), but a difference was seen in the prevalence of SBI and WMH (PR [95% CI] 2.3 [1.6-3.1] and 1.7 [1.1-2.6], respectively).

DISCUSSION:

People with heart disease have a high prevalence of SBI (and CSVD), which is similar in those with vs without recent stroke. More research is required to assess causal links and implications for management. TRIAL REGISTRATION INFORMATION PROSPERO CRD42022378272 (crd.york.ac.uk/PROSPERO/).
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cerebral Small Vessel Diseases / Heart Diseases Limits: Humans Language: En Journal: Neurology Year: 2024 Document type: Article
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cerebral Small Vessel Diseases / Heart Diseases Limits: Humans Language: En Journal: Neurology Year: 2024 Document type: Article