Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008;4(2):463-9.
doi: 10.2147/vhrm.s2166.

Silent cerebral infarction in chronic heart failure: ischemic and nonischemic dilated cardiomyopathy

Guliz Kozdag  1 , Ercument Ciftci, Dilek Ural, Tayfun Sahin, Macit Selekler, Aysen Agacdiken, Ali Demirci, Sezer Komsuoglu, Baki Komsuoglu
Affiliations

Silent cerebral infarction in chronic heart failure: ischemic and nonischemic dilated cardiomyopathy

Guliz Kozdag et al. Vasc Health Risk Manag. 2008.

Abstract

Objectives: Patients with dilated cardiomyopathy (DCM) may have a high incidence of clinically asymptomatic silent cerebral infarction (SCI). Prevalence of SCI and its risk factors may differ between ischemic and nonischemic DCM. The purpose of this study was to evaluate prevalence and related parameters of silent cerebral infarction in patients with ischemic and nonischemic DCM.

Methods: Patients with ischemic and nonischemic DCM (53 male, 19 female, aged 62 +/- 12 years) were included in the study. Etiology of DCM was ischemic in 46 and nonischemic in 26 patients. Fifty-six age- and gender-matched healthy volunteers served as a control group for comparison of SCI prevalence.

Results: Prevalence of SCI was 39%, 27%, and 3.6% in ischemic, nonischemic DCM, and control group, respectively (ischemic DCM vs control group, p < 0.001, nonischemic DCM vs control group, p = 002). In patients with nonischemic DCM, the mean age of the subjects with SCI was significantly higher than that of subjects without lesions (67 +/- 5 years vs 53 +/- 13, p < 0.001), whereas in ischemic DCM NHYA Functional Class was statistically higher in patients with SCI than without SCI (p = 0.03). In both groups, patients with SCI had lower systolic functions than patients with normal MRI findings. In multivariable logistic regression analysis, restrictive type of diastolic filling pattern was found as an independent factor for SCI occurrence on the whole patient population (OR: 16.5, 95% CI: 4.4-61.8, p < 0.001).

Conclusion: SCI is common in patients with both ischemic and nonischemic DCM. In univariate analysis, both groups have similar systolic and diastolic characteristics in the occurrence of SCI. Logistic regression analysis revealed that restrictive diastolic filling pattern is an independent risk factor in the occurrence of SCI for the whole patient population.

PubMed Disclaimer

Conflict of interest statement

Disclosure The authors have no conflicts of interest to disclose.

References

    1. Bryan RN, Cai J, Burke G, et al. Prevalence and anatomic characteristics of infarct-like lesions on MR images of middle-aged adults: the atherosclerosis risk in communities study. AJNR Am J Neuroradiol. 1999;20:1273–80. - PMC - PubMed
    1. Büsing KA, Schulte-Sasse C, Flüchter S, et al. Cerebral infarction: incidence and risk factors after diagnostic and interventional cardiac catheterization – prospective evaluation at diffusion-weighted MR imaging. Radiology. 2005;235:177–83. - PubMed
    1. Cleland JG. Anticoagulant and antiplatelet therapy in heart failure. Curr Opin Cardiol. 1997;12:276–87. - PubMed
    1. Douglas LM. Heart Failure. In: Bozkurt B, Mann DL, editors. Heart Failure as a Consequence of Dilated Cardiomyopathy. Philedelphia: Elsevier; 2004. pp. 363–89.
    1. Dries DL, Rosenberg YD, Waclawiw MA, et al. Ejection fraction and risk of thromboembolic events in patients with systolic dysfunction and sinus rhythm: evidence for gender differences in the studies of left ventricular dysfunction trials. J Am Coll Cardiol. 1997;29:1074–80. - PubMed

MeSH terms