The following is a summary of “Hidden Cerebrovascular Changes in People with Heart Disease: A Systematic Review and Meta-Analysis.” neurology According to Zhou et al.

Researchers have investigated the effects of subclinical cerebral infarction (SBI)/cerebral small vessel disease (CSVD) in adults with various heart diseases, including atrial fibrillation (AF), coronary artery disease (CAD), and heart failure (HF). The prevalence was investigated retrospectively in comparison with stroke. History and association of heart disease and SBI/CSVD.

They systematically searched Medline, Embase, and the Cochrane Library for studies conducted in hospitals or in the community that reported SBI/CSVD in cardiac patients. Eligible studies were extracted and outcomes including SBI (primary) and individual CSVD subtypes were analyzed. Summary prevalence with 95% CI was determined using random effects meta-analysis. Pooled PRs with 95% CIs were calculated to compare individuals with heart disease to control participants without heart disease from included studies.

The results showed that 221 observational studies were included. In AF patients, the prevalence of SBI was 36% (31%-41%), the prevalence of lacunae was 25% (19%-31%), and the prevalence of WMH was 62% (49%-74%). ), the prevalence of microbleeds was 27% (from 24%). 30%). There was no difference in the prevalence of SBI when stratified by recent stroke (homogeneity = 0.495). Prevalence was similar for different heart diseases, except for PFO, in which he had a lower SBI of 21% (13% to 30%). Meta-regression revealed an association between older age and hypertension with increased SBI and WMH. The prevalence of microbleeds did not differ between those with and without heart disease (PR [95% CI] 1.1 [0.7–1.7]), but differences were observed in the prevalence of SBI and WMH (PR [95% CI] 2.3 [1.6–3.1] and 1.7 [1.1–2.6]Each).

The researchers concluded that the prevalence of SBI and CSVD was higher in heart disease patients regardless of recent stroke, but further research is needed to explore causal relationships and implications for treatment.

sauce: neurology.org/doi/10.1212/WNL.0000000000209204