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Review
. 2018 May 14:19:63-69.
doi: 10.1016/j.ijcha.2018.04.006. eCollection 2018 Jun.

Cardiovascular disease and brain health: Focus on white matter hyperintensities

Francesco Moroni  1 , Enrico Ammirati  1   2 , Maria A Rocca  3 , Massimo Filippi  3 , Marco Magnoni  1 , Paolo G Camici  1
Affiliations
Review

Cardiovascular disease and brain health: Focus on white matter hyperintensities

Francesco Moroni et al. Int J Cardiol Heart Vasc. .

Abstract

Diseases affecting the brain contribute to a substantial proportion of morbidity and mortality in the general population. Conditions such as stroke, dementia and cognitive impairment have a prominent impact on global public health. Despite the heterogeneous clinical manifestations of these conditions and their diverse prognostic implications, current evidence supports a role for cardiovascular disease as a common pathophysiological ground. Brain white matter hyperintensities (WMH) are patchy white matter signal hyperintensity on T2-weighted magnetic resonance imaging sequences commonly found in elderly individuals. WMH appear to have a vascular pathogenesis and have been shown to confer an increased risk of stroke and cognitive decline. Indeed, they were proposed as a marker for central nervous system frailty. Cardiovascular diseases seem to play a key role in the etiology of WMH. Carotid atherosclerosis and atrial fibrillation were shown to be associated with higher WMH burden, while adequate blood pressure control has been reported reducing WMH progression. Aim of the present work is to review the available evidence linking WMH to cardiovascular disease, highlighting the complex interplay between cerebral and cardiovascular health.

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Figures

Fig. 1
Fig. 1
White matters hyperintensities in a representative subject. Panels A–D show fluid attenuated inversion recovery (FLAIR) sequence scans of the same patient at different levels. White matter hyperintensities are outlined in red.
Fig. 2
Fig. 2
Summary of possible causative elements in white matter hyperintensities and possible mechanism of action.
See this image and copyright information in PMC

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