Effects of left heart function changes on cerebral small vessel diseases and its cognitive impairment

Objective To explore the correlation of left heart function changes with cognitive impairment in patients with cerebral small vessel diseases (CSVD). Methods From February 2012 to June 2018, 199 CSVD patients admitted to the Department of Neurology of the First Affiliated Hospital of Anhui Medical University were enrolled as CSVD group. A total of 103 healthy elderly persons without cognition disorders were included as normal control group (NC group). According to the diagnostic criteria, CSVD patients were divided into 112 CSVD patients with vascular cognitive impairment (CSVD-VCI group) and 87 CSVD patients without cognitive impairment (CSVD-NCI group). Neuroimaging markers of CSVD (including lacunar infarction and white matter hyperintensity) were assessed through brain MRI. Cognitive function was evaluated by The Mini-Mental State Examination (MMSE), the Cambridge Cognitive Examination-Chinese Version (CAMCOG-C), etc. Routine echocardiography was performed to evaluate left ventricular ejection fraction (LVEF), left atrial diameter (LAD) and other parameters. Results Compared with NC group, the LVEF level was significantly decreased in CSVD group [(65±5)% and (63±6)%, respectively] (P=0.007), while LAD level was significantly increased in CSVD group (P=0.024). The LVEF level of CSVD-VCI group [(62±6)%] was significantly lower than that of CSVD-NCI group [(64±5)%] (P=0.02). Correlation analysis revealed MMSE and CAMCOG-C scores in CSVD group were positively correlated with LVEF level (r=0.210, P=0.003; r=0.238, P=0.001). Logistic regression analysis revealed that declined LVEF was an independent risk factor associated with CSVD (OR=0.937, 95%CI 0.890-0.986) and CSVD-VCI (OR=0.900, 95%CI 0.829-0.977). Conclusions Left heart function changes play important roles in the occurrence of CSVD and severity of its cognitive impairment. The declined LVEF may represent an independent risk factor for CSVD and its cognitive impairment. Key words: Cerebral small vessel diseases; Cognition disorders; Left heart function; Left ventricular ejection fraction