systhiperСистемные гипертензииSystemic Hypertension2075-082X2542-2189LLC «ИнтерМедсервис»systhiper-528Research ArticleСТАТЬИARTICLESМаркеры раннего поражения головного мозга как органа-мишени артериальной гипертензии: поиск продолжается. Возможности диффузионно-тензорной магнитно-резонансной томографии головного мозгаMarkers of early target-organ brain damage in essential arterial hypertension: the search continues. Possibilities of diffusion tensor magnetic resonance imagingПарфеновВ. А.ParfenovV. A.Vladimirparfenov@mail.ruОстроумоваТ. М.OstroumovaT. M.noemail@neicon.ruОстроумоваО. Д.OstroumovaO. D.noemail@neicon.ruПерепеловаЕ. М.PerepelovaE. M.noemail@neicon.ruПерепеловВ. А.PerepelovV. A.vsevolod.perepelov@gmail.comФГАОУ ВО «Первый МГМУ им. И.М.Сеченова»РоссияI.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian FederationRussian FederationФГАОУ ВО «Первый МГМУ им. И.М.Сеченова»; ФГБОУ ВО «МГМСУ им. А.И.Евдокимова»РоссияI.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation; A.I.Evdokimov Moscow State Medical and Dental University of the Ministry of Health of the Russian FederationRussian Federation2017231220221444449Copyright © Парфенов В.А., Остроумова Т.М., Остроумова О.Д., Перепелова Е.М., Перепелов В.А., 20222022Парфенов В.А., Остроумова Т.М., Остроумова О.Д., Перепелова Е.М., Перепелов В.А.Parfenov V.A., Ostroumova T.M., Ostroumova O.D., Perepelova E.M., Perepelov V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.syst-hypertension.ru/jour/article/view/528

Статья посвящена поражению головного мозга как органа-мишени артериальной гипертензии (АГ). Изложено современное состояние вопроса о возможностях и перспективах диффузионно-тензорной магнитно-резонансной томографии для ранней диагностики поражения белого вещества головного мозга при АГ. Представлены литературные данные о снижении фракционной анизотропии при наличии АГ и взаимосвязи данного показателя с уровнями артериального давления.

The article touches upon the issue of brain as an end-organ target of essential arterial hypertension (AH). The article gives current information about the possibilities and potential clinical application of diffusion-tensor magnetic resonance imaging for the earliest assessment of white matter damage in patients with essential AH. Dataare presented upon the reduction of fractional anisotropy in hypertensive patients and its correlation with blood pressure level.

артериальная гипертензияартериальное давлениедиффузионно-тензорная магнитно-резонансная томографиябелое вещество головного мозгафракционная анизотропияarterial hypertensionblood pressurediffusion tensor imagingwhite matterfractional anisotropyReferencesMancia G, Fagard R, Narkiewicz K. et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertension 2013; 31: 1281-357.Mancia G, Fagard R, Narkiewicz K. et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertension 2013; 31: 1281-357.Диагностика и лечение артериальной гипертонии: клинические рекомендации. Кардиол. вестн. 2015; 1: 3-30.Диагностика и лечение артериальной гипертонии: клинические рекомендации. Кардиол. вестн. 2015; 1: 3-30.Бойцов С.А., Баланова Ю.А., Шальнова С.А. и др. Артериальная гипертония среди лиц 25-64 лет: распространенность, осведомленность, лечение и контроль. По материалам исследования ЭССЕ. Кардиоваск. терапия и профилактика. 2014; 13 (4): 4-14.Бойцов С.А., Баланова Ю.А., Шальнова С.А. и др. Артериальная гипертония среди лиц 25-64 лет: распространенность, осведомленность, лечение и контроль. По материалам исследования ЭССЕ. Кардиоваск. терапия и профилактика. 2014; 13 (4): 4-14.O’Donnell M.J, Xavier D, Liu L. et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet 2010; 376 (9735): 112-23.O’Donnell M.J, Xavier D, Liu L. et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet 2010; 376 (9735): 112-23.Brown D.W, Giles W.H, Greenlund K.J. Blood pressure parameters and risk of fatal stroke, NHANES II mortality study. Am J Hypertens 2007; 20: 338-41.Brown D.W, Giles W.H, Greenlund K.J. Blood pressure parameters and risk of fatal stroke, NHANES II mortality study. Am J Hypertens 2007; 20: 338-41.Bushnell C, McCullough L.D, Awad I.A et al. American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; Council for High Blood Pressure Research. Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45 (5): 1545-88.Bushnell C, McCullough L.D, Awad I.A et al. American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; Council for High Blood Pressure Research. Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45 (5): 1545-88.Skoog I, Lernfelt B, Landahl S. et al. 15-year longitudinal study of blood pressure and dementia. Lancet 1996; 347: 1141-5.Skoog I, Lernfelt B, Landahl S. et al. 15-year longitudinal study of blood pressure and dementia. Lancet 1996; 347: 1141-5.Kilander L, Nyman H, Boberg M. et al. Hypertension is related to cognitive impairment: a 20-year follow-up of 999 men. Hypertension 1998; 31: 780-6.Kilander L, Nyman H, Boberg M. et al. Hypertension is related to cognitive impairment: a 20-year follow-up of 999 men. Hypertension 1998; 31: 780-6.Muela H.C.S, Costa-Hong V.A, Yassuda M.S. et al. Hypertension severity is associated with impaired cognitive performance. J Am Heart Assoc 2017; 6 (1): e004579.Muela H.C.S, Costa-Hong V.A, Yassuda M.S. et al. Hypertension severity is associated with impaired cognitive performance. J Am Heart Assoc 2017; 6 (1): e004579.Perrotta M, Lembo G, Carnevale D. Hypertension and dementia: epidemiological and experimental evidence revealing adetrimental relationship. Int J Mol Sci 2016; 17: 347-58.Perrotta M, Lembo G, Carnevale D. Hypertension and dementia: epidemiological and experimental evidence revealing adetrimental relationship. Int J Mol Sci 2016; 17: 347-58.Iadecola C, Yaffe K, Biller J. et al. Impact of hypertension on cognitive function. A scientific statement from the American Heart Association. Hypertension 2016; 68 (6): e67-e94.Iadecola C, Yaffe K, Biller J. et al. Impact of hypertension on cognitive function. A scientific statement from the American Heart Association. Hypertension 2016; 68 (6): e67-e94.De Leeuw F.E, de Groot J.C, Oudkerk M. et al. Hypertension and cerebral white matter lesions in a prospective cohort study. Brain 2002; 125: 765-72.De Leeuw F.E, de Groot J.C, Oudkerk M. et al. Hypertension and cerebral white matter lesions in a prospective cohort study. Brain 2002; 125: 765-72.Longstreth W.T, Manolio T.A, Arnold A.et al. Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people. The Cardiovascular Health Study. Stroke 1996; 27: 1274-82.Longstreth W.T, Manolio T.A, Arnold A.et al. Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people. The Cardiovascular Health Study. Stroke 1996; 27: 1274-82.Vermeer S.E, Longstreth W.T Jr, Koudstaal P.J. Silent brain infarcts: a systematic review. Lancet Neurology 2007; 6: 611-9.Vermeer S.E, Longstreth W.T Jr, Koudstaal P.J. Silent brain infarcts: a systematic review. Lancet Neurology 2007; 6: 611-9.Wong T.Y, Klein R, Sharrett A.R. et al. Cerebral white matter lesions, retinopathy and incident clinical stroke. JAMA 2002; 288: 67-74.Wong T.Y, Klein R, Sharrett A.R. et al. Cerebral white matter lesions, retinopathy and incident clinical stroke. JAMA 2002; 288: 67-74.Buyck J.F, Dufouil C, Mazoyer B. et al. Cerebral white matter lesions are associated with the risk of stroke but not with other vascular events: the 3-City Dijon Study. Stroke 2009; 40: 2327-31.Buyck J.F, Dufouil C, Mazoyer B. et al. Cerebral white matter lesions are associated with the risk of stroke but not with other vascular events: the 3-City Dijon Study. Stroke 2009; 40: 2327-31.Kearney-Schwartz A, Rossignol P, Bracard S.et al. Vascular structure and function is correlated to cognitive performance and white matter hyperintensities in older hypertensive patients with subjective memory complaints. Stroke 2009; 40: 1229-36.Kearney-Schwartz A, Rossignol P, Bracard S.et al. Vascular structure and function is correlated to cognitive performance and white matter hyperintensities in older hypertensive patients with subjective memory complaints. Stroke 2009; 40: 1229-36.Le Bihan D, van Zijl P. From the diffusion coefficient to the diffusion tensor. NMR Biomed 2002; 15: 431-4.Le Bihan D, van Zijl P. From the diffusion coefficient to the diffusion tensor. NMR Biomed 2002; 15: 431-4.Horsfield M.A, Larsson H.B, Jones D.K, Gass A. Diffusion magnetic resonance imaging in multiple sclerosis. J Neurol Neurosurg Psychiatry 1998; 64 (Suppl. 1): S80-4.Horsfield M.A, Larsson H.B, Jones D.K, Gass A. Diffusion magnetic resonance imaging in multiple sclerosis. J Neurol Neurosurg Psychiatry 1998; 64 (Suppl. 1): S80-4.Lövblad K.O, Baird A.E, Schlaug G et al. Ischemic lesion volumes in acute stroke by diffusion-weighted magnetic resonance imaging correlate with clinical outcome. Ann Neurol 1997; 42: 164-70.Lövblad K.O, Baird A.E, Schlaug G et al. Ischemic lesion volumes in acute stroke by diffusion-weighted magnetic resonance imaging correlate with clinical outcome. Ann Neurol 1997; 42: 164-70.Eriksson S.H, Rugg-Gunn F.J, Symms M.R et al. Diffusion tensor imaging in patients with epilepsy and malformations of cortical development. Brain 2001; 124: 617-26.Eriksson S.H, Rugg-Gunn F.J, Symms M.R et al. Diffusion tensor imaging in patients with epilepsy and malformations of cortical development. Brain 2001; 124: 617-26.Potgieser A.R, Wagemakers M, van Hulzen A.L. et al. The role of diffusion tensor imaging in brain tumor surgery: a review of the literature. Clin Neurol Neurosurg 2014; 124: 51-8.Potgieser A.R, Wagemakers M, van Hulzen A.L. et al. The role of diffusion tensor imaging in brain tumor surgery: a review of the literature. Clin Neurol Neurosurg 2014; 124: 51-8.Rose S.E, Chen E, Chalk J.B. et al. Loss of connectivity in Alzheimer’s disease: an evaluation of white matter tract integrity with color-coded MR diffusion tensor imaging. Neurol Neurosurg Psychiatry 2000; 69: 528-30.Rose S.E, Chen E, Chalk J.B. et al. Loss of connectivity in Alzheimer’s disease: an evaluation of white matter tract integrity with color-coded MR diffusion tensor imaging. Neurol Neurosurg Psychiatry 2000; 69: 528-30.Lenfeldt N, Hansson W, Larsson A. et al. Diffusion tensor imaging and correlations to Parkinson rating scales. J Neurol 2013; 260 (11): 2823-30.Lenfeldt N, Hansson W, Larsson A. et al. Diffusion tensor imaging and correlations to Parkinson rating scales. J Neurol 2013; 260 (11): 2823-30.Левашкина И.М., Серебрякова С.В., Ефимцев А.Ю. Диффузионно-тензорная МРТ - современный метод оценки микроструктурных изменений вещества головного мозга (обзор литературы). Вестник СПбГУ. 2016; 4: 39-54.Левашкина И.М., Серебрякова С.В., Ефимцев А.Ю. Диффузионно-тензорная МРТ - современный метод оценки микроструктурных изменений вещества головного мозга (обзор литературы). Вестник СПбГУ. 2016; 4: 39-54.Le Bihan D, Breton E, Lallemand D et al. MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders. Radiology 1986; 161 (2): 401-7.Le Bihan D, Breton E, Lallemand D et al. MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders. Radiology 1986; 161 (2): 401-7.Launer L.J, Lewis C.E, Schreiner P.J. et al. Vascular factors and multiple measures of early brain health: CARDIA brain MRI study. PLoS One 2015; 10 (3): e0122138.Launer L.J, Lewis C.E, Schreiner P.J. et al. Vascular factors and multiple measures of early brain health: CARDIA brain MRI study. PLoS One 2015; 10 (3): e0122138.Lawrence A.J, Patel B, Morris R.J et al. Mechanisms of cognitive impairment in cerebral small vessel disease: multimodal MRI results from the St George's cognition and neuroimaging in stroke (SCANS) study. PLoS One 2013; 8 (4): e61014.Lawrence A.J, Patel B, Morris R.J et al. Mechanisms of cognitive impairment in cerebral small vessel disease: multimodal MRI results from the St George's cognition and neuroimaging in stroke (SCANS) study. PLoS One 2013; 8 (4): e61014.Gons R.A, de Laat K.F, van Norden A.G.W. Hypertension and cerebral diffusion tensor imaging in small vessel disease. Stroke 2010; 41: 2801-6.Gons R.A, de Laat K.F, van Norden A.G.W. Hypertension and cerebral diffusion tensor imaging in small vessel disease. Stroke 2010; 41: 2801-6.Heye A.K, Thrippleton M.J, Chappell F.M. et al. Blood pressure and sodium: Association with MRI markers in cerebral small vessel disease. J Cereb Blood Flow Metab 2016; 36 (1): 264-74.Heye A.K, Thrippleton M.J, Chappell F.M. et al. Blood pressure and sodium: Association with MRI markers in cerebral small vessel disease. J Cereb Blood Flow Metab 2016; 36 (1): 264-74.Power M.C, Tingle J.V, Reid R.I et al. Midlife and late-life vascular risk factors and white matter microstructural integrity: the atherosclerosis risk in communities neurocognitive study. JAHA 2017; 6: e005608.Power M.C, Tingle J.V, Reid R.I et al. Midlife and late-life vascular risk factors and white matter microstructural integrity: the atherosclerosis risk in communities neurocognitive study. JAHA 2017; 6: e005608.Rosano C, Abebe K.Z, Aizenstein H.J et al. Longitudinal systolic blood pressure characteristics and integrity of white matter tracts in a cohort of very old black and white adults. Am J Hypertens 2015; 28 (3): 326-34.Rosano C, Abebe K.Z, Aizenstein H.J et al. Longitudinal systolic blood pressure characteristics and integrity of white matter tracts in a cohort of very old black and white adults. Am J Hypertens 2015; 28 (3): 326-34.Salat D.H, Williams V.J, Leritz E.C et al. Interindividual variation in blood pressure is associated with regional white matter integrity in generally healthy older adults. Neuroimage 2012; 59 (1): 181-92.Salat D.H, Williams V.J, Leritz E.C et al. Interindividual variation in blood pressure is associated with regional white matter integrity in generally healthy older adults. Neuroimage 2012; 59 (1): 181-92.Maillard P, Seshadri S, Beiser A.et al. Effects of systolic blood pressure on white-matter integrity in young adults in the Framingham Heart Study: a cross-sectional study. Lancet Neurol 2012; 11 (12): 1039-47.Maillard P, Seshadri S, Beiser A.et al. Effects of systolic blood pressure on white-matter integrity in young adults in the Framingham Heart Study: a cross-sectional study. Lancet Neurol 2012; 11 (12): 1039-47.Friedman G.D, Cutter G.R, Donahue R.P et al. CARDIA: study design, recruitment, and some characteristics of the examined subjects. J Clin Epidemiol 1988; 41 (11): 1105-16.Friedman G.D, Cutter G.R, Donahue R.P et al. CARDIA: study design, recruitment, and some characteristics of the examined subjects. J Clin Epidemiol 1988; 41 (11): 1105-16.Burgmans S, van Boxtel M.P.J, Gronenschild E.H et al. Multiple indicators of age-related differences in cerebral white matter and the modifying effects of hypertension. Neuroimage 2010; 49 (3): 2083.Burgmans S, van Boxtel M.P.J, Gronenschild E.H et al. Multiple indicators of age-related differences in cerebral white matter and the modifying effects of hypertension. Neuroimage 2010; 49 (3): 2083.Kennedya K.M, Raz N. Pattern of normal age-related regional differences in white matter microstructure is modified by vascular risk. Brain Res 2009; 1297: 41-56.Kennedya K.M, Raz N. Pattern of normal age-related regional differences in white matter microstructure is modified by vascular risk. Brain Res 2009; 1297: 41-56.Kochunov P, Thompson P.M, Lancaster J.L. et al. Relationship between white matter fractional anisotropy and other indices of cerebral health in normal aging: tract-based spatial statistics study of aging. Neuroimage 2007; 35: 478-87.Kochunov P, Thompson P.M, Lancaster J.L. et al. Relationship between white matter fractional anisotropy and other indices of cerebral health in normal aging: tract-based spatial statistics study of aging. Neuroimage 2007; 35: 478-87.Stadlbauer A, Salomonowitz E, Strunk G. et al. Age-related degradation in the central nervous system: assessment with diffusion-tensor imaging and quantitative fiber tracking. Radiology 2008; 247: 179-88.Stadlbauer A, Salomonowitz E, Strunk G. et al. Age-related degradation in the central nervous system: assessment with diffusion-tensor imaging and quantitative fiber tracking. Radiology 2008; 247: 179-88.Jones D, Lythgoe D, Horsfield M. et al. Characterization of white matter damage in ischaemicleukoaraiosis with diffusion tensor MRI. Stroke 1999; 30: 393-7.Jones D, Lythgoe D, Horsfield M. et al. Characterization of white matter damage in ischaemicleukoaraiosis with diffusion tensor MRI. Stroke 1999; 30: 393-7.Chabriat H, Pappata S, Poupon C et al. Clinical severity in CADASIL related to ultrastructural damage in white matter: in vivo study with diffusion tensor MRI. Stroke 1999; 30: 2637-43.Chabriat H, Pappata S, Poupon C et al. Clinical severity in CADASIL related to ultrastructural damage in white matter: in vivo study with diffusion tensor MRI. Stroke 1999; 30: 2637-43.Nitkunan A, Charlton R.A, McIntyre D.J. et al. Diffusion tensor imaging and MR spectroscopy in hypertension and presumed cerebral small vessel disease. Magn Reson Med 2008; 59 (3): 528-34.Nitkunan A, Charlton R.A, McIntyre D.J. et al. Diffusion tensor imaging and MR spectroscopy in hypertension and presumed cerebral small vessel disease. Magn Reson Med 2008; 59 (3): 528-34.Benjamin P, Zeestraten E, Lambert Ch et al. Progression of MRI markers in cerebral small vessel disease: Sample size considerations for clinical trials. Journal of Cerebral Blood Flow & Metabolism 2016; 36(1): 228-240. DOI: 10.1038/jcbfm.2015.113Benjamin P, Zeestraten E, Lambert Ch et al. Progression of MRI markers in cerebral small vessel disease: Sample size considerations for clinical trials. Journal of Cerebral Blood Flow & Metabolism 2016; 36(1): 228-240. DOI: 10.1038/jcbfm.2015.113

The authors declare that there are no conflicts of interest present.