Association of Nocturnal Heart Rate with White Matter Hyperintensity Burden in Cerebral Small Vessel Disease Patients

Background: Age and hypertension are widely considered to be the main risk factors for white matter hyperintensity (WMH), but they do not account for all the pathophysiological mechanisms of WMH. Therefore, identifying novel risk factors is significant for improving our understanding of the etiology and consequences of WMH. Objective: This study aimed to examine the association of heart rate (HR) and common vascular risk factors with WMH burden in patients hospitalized for cerebral small vessel disease (CSVD) Methods: The study consisted of 778 patients who underwent 24-hour ambulatory blood pressure and HR monitoring and brain magnetic resonance imaging (MRI). The relationship of HR measures and vascular risk factors with the presence of log WMHV4 was analyzed. Univariable and multivariable analysis was carried out to investigate the relationship of incidence of severe WMH (4th quartile, >= 19.64 ml) and HR measures and common vascular risk factors. Results: Multivariate analysis showed that WMHV was independently predicted by night-time HR (OR (95 % CI): 1.041 (1.02 similar to 1.062), P < 0.001), homocysteine (OR (95 % CI): 1.019 (1.005 similar to 1.033), P = 0.009), and cerebral infarction (OR (95 % CI): 0.463 (0.31 similar to 0.691), P < 0.001). No similar association was observed for daytime HR, HR variability, and other vascular risk factors Conclusion: As night-time HR, Hcy increased, log WMHV increased accordingly; furthermore, patients with cerebral infarction were more likely to have higher levels of WMHV. Night-time HR, Hcy cerebral infarction was associated with WMHV, suggesting their independent roles in WMHV. The influence of HRV on WMHV needs to be addressed by further studies.