Research Abstract: Advanced Trainee - Poster Presentation Only Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2023

Aims.

White Matter Hyperintensities (WMHs) are associated with cerebral vascular disease. Increased WMH volumes are associated with increasing age, but less clearly with cardiovascular parameters such as Left Ventricular Hypertrophy, Left Atrial Volume and Left Ventricular Ejection Fraction.  It is unclear whether these relationships exist when WMHs are adjusted for age using WMH percentiles. We correlated both WMH volumes and age-adjusted WMH percentiles with echocardiographic parameters in patients referred to a Transient Ischaemic Attack (TIA) clinic.

Methods.

We conducted a retrospective cohort correlation study of patients without other significant brain lesions who were referred to a TIA clinic with a contemporaneous brain MRI and echocardiogram. WMH volumes were assessed with an AI-based computer vision tool. (Figure 1) WMH percentiles were simultaneously derived from a normative reference database that was adjusted for age, sex and intracranial volume. (Figure 2)

Results.

Of 136 patients (39 to 92 years old), 63 had WMH volumes greater than 6mL and 43 had WMH percentiles greater than the 85th percentile. Left ventricular hypertrophy and increased left atrial volume appeared to be associated with increased WMH volumes, but not WMH percentiles (r = 0.01, p = 0.91 and r = -0.01, p = 0.91 respectively). Increased Left Ventricular Ejection Fraction appeared to have a stronger association with WMH percentiles (r = 0.09, p = 0.31).

Conclusions.

The only echocardiographic finding that appeared to be associated with higher WMH percentiles was increased Left Ventricular Ejection Fraction, although this failed to reach statistical significance.