Impact of Systolic Blood Viscosity on Deep White Matter Hyperintensities in Patients With Acute Ischemic Stroke

• Published in: Journal of the American Heart Association Vol. 13; no. 15; p. e034162
• Main Authors: Lee, Minwoo, Park, Soo‐Hyun, Kim, Yeo Jin, Bae, Jong Seok, Lee, Ju‐Hun, Lee, Sang‐Hwa, Kim, Chulho, Lee, Kijeong, Kim, Yerim
• Format: Journal Article
• Language: English
• Published: England John Wiley and Sons Inc 06.08.2024; Wiley
• Subjects: Aged; Aged, 80 and over; Blood Viscosity; Female; Humans; Ischemic Attack, Transient - blood; Ischemic Attack, Transient - physiopathology; ischemic stroke; Ischemic Stroke - blood; Ischemic Stroke - diagnostic imaging; Ischemic Stroke - physiopathology; Leukoencephalopathies - blood; Leukoencephalopathies - diagnostic imaging; Leukoencephalopathies - etiology; Leukoencephalopathies - physiopathology; Magnetic Resonance Imaging; Male; Middle Aged; Original Research; rheology; Risk Factors; stroke; Systole; white matter; White Matter - diagnostic imaging; White Matter - pathology; white matter; rheology; stroke; blood viscosity; ischemic stroke
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.123.034162

Elevated blood viscosity (BV), a critical determinant in blood rheology, is a contributing factor in cerebrovascular diseases. The specific influence of BV on small vessel disease burden remains unexplored. This study aims to examine the relationship between BV and regional white matter hyperintensity (WMH) volume in patients with acute ischemic stroke. We enrolled a cohort of 302 patients with acute ischemic stroke or transient ischemic attack who were admitted to a hospital within 7 days of symptom onset in this study. We measured whole BV using a scanning capillary-tube viscometer and categorized systolic blood viscosity into 3 groups based on established references. We quantified and normalized WMH volumes using automated localization and segmentation software by NEUROPHET Inc. We performed multivariable logistic regression analysis to assess the correlation between systolic BV and WMH. The mean subject age was 66.7±13.4 years, and 38.7% (n=117) of the participants were female. Among a total of 302 patients, patients with higher deep WMH volume (T3) were typically older and had an atrial fibrillation, strokes of cardioembolic or undetermined cause, elevated levels of C-reactive protein, diastolic blood viscosity and systolic BV. A multivariable adjustment revealed a significant association between high systolic BV and increased deep-WMH volume (odds ratio [OR], 2.636 [95% CI, 1.225-5.673]). Elevated systolic BV is more likely to be associated with deep WMH volume in patients with acute ischemic stroke or transient ischemic attack. These findings reveal novel therapeutic strategies focusing on blood rheology to enhance cerebral microcirculation in stroke management.