Risk Factors Analysis Of Intracranial Aneurysm Formation And Rupture And Correlation Between Left Ventricular Hypertrophy And Intracranial Aneurysm

ObjectiveThis study involved the risk factors of intracranial aneurysm formation and rupture and the effect of left ventricular hypertrophy on the formation and rupture of intracranial aneurysm,with the purpose of high-risk population screening for intracranial aneurysm.Methods and materialsWe retrospectively enrolled the patients hospitalized in Neurosurgery Center or Department of Cerebrovascular Disease of Zhujiang Hospital from June 2012 to November 2021.199 patients diagnosed with intracranial aneurysm by DSA were included in the aneurysm group.A total of 166 patients with no aneurysms detected by DSA,CTA or MRA were used as the control group.The basic information and parameters related to left ventricular hypertrophy of the two groups were analyzed.The factors affecting the formation and rupture of intracranial aneurysm were analyzed by univariate analysis and multivariate Logistics regression analysis.ROC curves of each independent influencing factor were drawn,and a clinical prediction model including left ventricular hypertrophy was constructed to evaluate the reliability of the model by Delong test.Results(1)Univariate analysis indicated that there were no statistically significant differences in smoking,fasting blood glucose,serum triglyceride and serum total cholesterol between aneurysm group and healthy group(P>0.05).There were statistically significant differences in age(t=4.405,P<0.001),gender(χ2=6.549,P=0.010),hypertension(χ2=25.830,P<0.001)and left ventricular hypertrophy(χ2=15.085,P<0.001)between the two groups.There were statistically significant differences between the aneurysm group and the control group at different age stages(<50 years old,50-70 years old,>70 years old)(P<0.001).(2)The results of Logistics regression analysis showed that gender(OR:1.855,95%CI:1.169～3.396,P=0.009),age(P=0.046),history of hypertension(OR:2.687,95%CI:1.639～2.943,P<0.001)and left ventricular hypertrophy(OR:2.072,95%CI:1.197～3.586,P=0.009)were risk factors for intracranial aneurysm formation.Age<50years(OR:0.402,95%CI:0.178～0.908,P=0.028)was a protective factor for intracranial aneurysm formation.(3)The closer the age was to 59.50 years,and the closer the left ventricular mass index was to 108.28 g/m2(male)and 92.49 g/m2(female),the greater the risk of intracranial aneurysu formation.(4)The clinical prediction model constructed by left ventricular mass index combined with age,sex,hypertension and total cholesterol had higher predictive value(AUC=0.725,95%CI:0.673-0.777,P<0.001).(5)There was no significant correlation between left ventricular hypertrophy and location distribution(P=0.508),size(P=0.468)and rupture(P=0.789)of intracranial aneurysm.(6)Age(t=-2.145,P=0.033),abnormal fasting blood glucose(χ2=22.508,P<0.001),hypertriglyceridemia(χ2=4.049,P=0.044)and location of intracranial aneurysm(χ2=31.581,P<0.001)were statistically associated with risk of aneurysmal rupture between ruptured aneurysm group and unruptured aneurysm group.There were no statistically significant differences in gender(χ2=0.142,P=0.707),smoking(x2=0.763,P=0.382),serum total cholesterol(χ2=3.090,P=0.079),hypertension(χ2=0.362,P=0.548),aneurysm size(χ2=5.245,P=0.073)and left ventricular hypertrophy(χ2=0.072,P=0.789)between two groups.(7)The variables that may affect intracranial aneurysmal rupture were included in Logistics regression analysis,and the results showed that the risk of aneurysmal rupture was higher in patients with abnormal fasting blood glucose,with statistical significance(OR:7.375,95%CI:2.664～20.416,P<0.001).Compared with internal carotid artery aneurysms,middle cerebral artery aneurysms(OR:7.346,95%CI:2.541～21.235,P<0.001),posterior circulation artery aneurysms(OR:4.358,95%CI:1.230～14.446,P=0.023),anterior communicating artery aneurysms(OR:6.740,95%CI:1.859～24.434,P=0.004),posterior communicating artery aneurysm(OR:13.216,95%CI:3.53749.386,P<0.001)had a higher risk of rupture.Age was an obstacle factor of intracranial aneurysm rupture,suggesting that the risk of intracranial aneurysm rupture decreased with increasing age,with statistical significance(OR:0.955,95%CI:0.920～0.991,P=0.014).Hypertriglyceridemia was a protective factor for ruptured intracranial aneurysm,and the difference was statistically significant(OR:0.265,95%CI:0.082～0.856,P=0.026).ConclusionFemale,hypertension and left ventricular hypertrophy are risk factors for intracranial aneurysm formation.Left ventricular mass index combined with clinical models of age,sex,hypertension,and total cholesterol had better predictive reliability in assessing the risk of intracranial aneurysm formation.Abnormal fasting glucose and location of aneurysm were independent risk factors for rupture of intracranial aneurysm.Left ventricular hypertrophy is not an independent risk factor for ruptured intracranial aneurysm.There was no correlation between left ventricular hypertrophy and the size and location of intracranial aneurysm.