카다실 환자에서 고혈압과 뇌미세출혈의 연관성 = The Association Between Hypertension and Cerebral Microbleeds in Patients With CADASIL

다국어 초록 (Multilingual Abstract)

Background: Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL)is an inherited microangiopathy that is caused by mutations in the Notch3 gene. Typical findings from magneticresonance imaging (MRI) include multiple subcortical lacunae, extensive white-matter change, and multiple cerebralmicrobleeds (CMBs). CMBs are indicative of bleeding-prone microangiopathy. The rate of intracerebral hemorrhage inCADASIL is higher in Asian patients than in Caucasian patients. However, CMBs have not been thoroughly evaluated inAsian patients. We performed a detailed analysis of the frequency and distribution pattern of CMBs and assessedwhether vascular risk factors exert an independent effect on CMBs in Asian CADASIL patients.
Methods: The study population comprised 60 patients who underwent brain MRI, including T2*-weighted gradient-echosequences. Demographic factors, vascular risk factors, and MRI findings were compared between CADASIL patientswith and without CMBs. The impact of vascular risk factors on CMBs, lacunae, and white-matter hyperintensities(WMHs) was assessed by logistic regression analysis.
Results: CMBs, which were detected in 34 (56.7%) patients, exhibited a significant predilection for the thalamus (46.7%),subcortical-cortical region (35.0%), and basal ganglia (31.7%). Hypertension, lacunae, and white-matter lesions weremore common in patients with CMBs. Hypertension was an independent risk factor for CMBs, lacunae, and WMHs inpatients with CADASIL.
Conclusions: This study found that CMBs tended to occur in hypertensive patients with CADASIL. Further studiesshould focus on elucidating the association between reduced blood pressure and the number of CMBs.

참고문헌 (Reference)

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