Silent Brain Infarct, Cerebral Small Vessel Disease Prevalent in Heart Disease

MONDAY, April 15, 2024 (HealthDay News) — The prevalence of silent brain infarction (SBI) and cerebral small vessel disease (CSVD) is high among individuals with heart disease and is similar with and without recent stroke, according to a review published in the April 23 issue of Neurology.

Zien Zhou, M.D., Ph.D., from The George Institute for Global Health at the University of New South Wales in Sydney, and colleagues conducted a systematic review to examine the prevalence of SBI and CSVD among adults with atrial fibrillation, coronary artery disease, heart failure or cardiomyopathy, heart valve disease, and patent foramen ovale (PFO). Data were extracted from 221 observational studies.

The researchers found that the prevalence was 36, 25, 62, and 27 percent for SBI, lacune, white matter hyperintensity/hypoattenuation (WMH), and microbleed, respectively. No differences were seen in the prevalence of SBI across subgroups on stratification by studies that recruited participants with recent stroke. Participants with different heart diseases had comparable results, apart from those with PFO, who had a lower prevalence of SBI (21 percent) and CSVD. Associations of increased age and hypertensives with more SBIs and WMH were seen in meta-regressions. The prevalence of microbleeds did not differ for those with and without heart disease, but differences were seen in the prevalence of SBI and WMH (prevalence ratio, 2.3 and 1.7, respectively).

“In summary, people with heart disease have a high prevalence of covert cerebrovascular changes, which is generally comparable across those with and without recent stroke,” the authors write.

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