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

Figures & data

Table 1 Demographic, clinical, and echocardiographic characteristics of patients with ischemic and nonischemic DCM

	Ischemic DCM (n = 46)	Nonischemic DCM (n = 26)	P
Prevalence of SCI	18 (39%)	7 (%27)	NS
Gender (male/female)	37/9	16/10	NS
Age (years)	64 ± 10	57 ± 13	0.012
NHYA functional classification	3.0 ± 0.8	3.0 ± 0.8	NS
Previous hypertension	29 (%63)	11 (%42)	NS
Diabetes mellitus	19 (%41)	3 (%1)	0.008
Dyslipidemia	9 (%20)	9 (%35)	NS
Body mass index (kg/m^2)	26 ± 4	26 ± 3	NS
Drug use (%)			NS
Digitalis	19 (%41)	11 (%42)	NS
ACEI/ARB	31 (%67)	17 (%65)	NS
Diuretics	26 (%57)	16 (%62)	NS
Spiranolactone	5 (%10)	2 (%1)	NS
Beta-blockers	5 (%10)	7 (%27)	NS
Aspirin	39 (%85)	17 (%65)	0.057
LVDD (mm)	65 ± 7	69 ± 10	0.055
LVSD (mm)	54 ± 7	57 ± 10	NS
Ejection fraction (%)	32 ± 9	31 ± 10	NS
Left atrial diameter (mm)	45 ± 5	44 ± 6	NS
Right ventricular diameter (mm)	28 ± 4	28 ± 7	NS

Abbreviations: SCI, silent cerebral infarction; NYHA, New York Heart Association; ACE-I/ARB, ACE-inhibitors/angiotensin II receptor antagonists; LVDD, Left ventricular end-diastolic diameter; LVSD, Left ventricular end-systolic diameter; NS, Nonsignificant.

Table 2 Demographic, clinical, hematological, and biochemical parameters of ischemic DCM patients with and without SCI

	SCI (+) (n = 18)	SCI (−) (n = 28)	P
Gender (male/female)	6/12	3/25	0.059
Age (years)	65 ± 12	64 ± 8	NS
NHYA functional classification	3.3 ± 0.8	2.8 ± 0.8	0.03
Body mass index (kg/m^2)	26 ± 5	25 ± 3	NS
Hematocrit (volume fraction)	0.37 ± 0.04	0.40 ± 0.05	0.054
Sedimentation rate (mm/hour)	21 ± 16	23 ± 25	NS
Fasting glucose level (mmol/L)	6.9 ± 2.8	6.6 ± 2.3	NS
Cholesterol (mmol/L)	4.3 ± 1.0	4.2 ± 0.8	NS
HDL-C (mmol/L)	0.9 ± 0.2	0.9 ± 0.3	NS
LDL-C (mmol/L)	2.8 ± 0.8	3.0 ± 0.8	NS
Tryglyceride (mmol/L)	1.2 ± 0.5	1.0 ± 0.4	NS
Creatinine (μmol/L)	122 ± 35	96 ± 27	0.017
Fibrinogen (g/L)	4.58 ± 0.61	4.36 ± 0.98	NS
CRP (mg/L)	9.8 ± 15	13 ± 23	NS

Abbreviations: SCI (+), patients with silent cerebral infarction; SCI (−), patients without silent cerebral infarction; CRP, C-reactive protein; NS, not significant.

Table 3 Echocardiographic parameters of ischemic DCM patients with and without SCI

	SCI (+) (n = 18)	SCI (−) (n = 28)	P
LVDD (mm)	65 ± 7	64 ± 6	NS
LVSD (mm)	55 ± 7	53 ± 7	NS
Ejection fraction (%)	29 ± 7	34 ± 9	0.03
Fractional shortening (%)	15 ± 4	17 ± 5	NS
LA (mm)	46 ± 6	45 ± 4	NS
Left atrial total emptying fraction (%)	39 ± 16	42 ± 12	NS
CI (L/min/m^2)	2.4 ± 0.7	2.0 ± 0.4	0.01
LVSEC (n, %)	8 (44%)	8 (29%)	NS
Restrictive filling pattern (n, %)	12 (67%)	3 (11%)	<0.001

Abbreviations: SCI (+), patients with silent cerebral infarction; SCI (-), patients without silent cerebral infarction; LVDD, left ventricular end-diastolic diameter; LVSD, left ventricular systolic diameter; LA, left atrium diameter; EF, ejection fraction; CI, cardiac index; LVSEC, left ventricular spontaneous echo contrast; NS, not significant.

Table 4 Echocardiographic parameters of nonischemic DCM patients with and without SCI

	SCI (+) (n = 7)	SCI (−) (n = 19)	P
LVDD (mm)	70 ± 11	69 ± 10	NS
LVSD (mm)	59 ± 12	57 ± 10	NS
Ejection fraction (%)	24 ± 8	33 ± 10	0.05
Fractional shortening (%)	12 ± 4	17 ± 5	0.02
LA (mm)	43 ± 7	44 ± 6	NS
Left atrial total emptying fraction (%)	38 ± 4	40 ± 12	NS
CI (L/min/m^2)	2.2 ± 0.9	2.5 ± 0.8	NS
LVSEC (n, %)	4 (57%)	7 (37%)	NS
Restrictive filling pattern (n, %)	5 (71%)	4 (21%)	0.017

Abbreviations: SCI (+), patients with silent cerebral infarction; SCI (−), patients without silent cerebral infarction; LVDD, left ventricular end-diastolic diameter; LVSD, left ventricular systolic diameter; LA, left atrium diameter; EF, ejection fraction; CI, cardiac index; LVSEC, left ventricular spontaneous echo contrast; NS, not significant.