Abstract W MP58: The Relationship Between Carotid Stiffness, Diastolic Diameter, and White Matter Hyperintensity Volume: The Northern Manhattan Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Matthew S Markert ◽  
Chuanhui Dong ◽  
David Della-Morte ◽  
Eugene Roberts ◽  
Susanne Bartels ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
Small Vessel Disease ◽  
Vascular Risk Factors ◽  
Small Vessel ◽  
White Matter Hyperintensity ◽  
Large Artery ◽  
Vascular Risk ◽  
Vessel Disease ◽  
Carotid Stiffness

Background: Changes in the extracranial vasculature may be associated with small vessel disease in the brain. We sought to examine the association of carotid stiffness and carotid diastolic diameter with white matter hyperintensity volume (WMHV), a magnetic resonance imaging (MRI) measure for cerebral small vessel disease, in a multi-ethnic community-based cohort. Methods: We evaluated 1140 stroke-free participants in the Northern Manhattan study who underwent brain MRIs and high-resolution carotid ultrasounds. We used linear regression to examine carotid stiffness and diastolic diameter with WMHV after adjusting for sociodemographics, lifestyle behaviors, and traditional vascular risk factors. Results: Among 1140 participants (mean age: 70.6±9.0 years; 61% women; 15% White, 16% Black, 59% Hispanics), the mean carotid stiffness was 8.19 ± 5.39, mean carotid diastolic diameter was 6.16 ± 0.93 mm, and mean WMHV 0.68 ± 0.84. In a fully adjusted model, diastolic diameter was associated with log-WMHV (β=0.10, p=0.001). In a stratified multivariable linear model, greater carotid arterial stiffness and diastolic diameter were associated with log-WMHV among Hispanics (β=0.15, p=0.005 and β=0.13, p<0.001, respectively), but not among blacks or whites. Conclusion: Greater carotid stiffness and diastolic diameter were associated with greater WMHV independent of demographics and traditional vascular risk factors, especially among Hispanics. Further studies are needed to understand how these large artery characteristics relate to WMH formation and lesion load. Carotid ultrasound may be a useful tool to assess the risk of increased brain white matter disease in a pre-clinical stage.

scholarly journals Associations of Vascular Risk Factors and APOE Genotype With Perivascular Spaces Among Community‐Dwelling Older Adults

2020 ◽  
Vol 9 (16) ◽  
Author(s):  
Anna Laveskog ◽  
Rui Wang ◽  
Davide L. Vetrano ◽  
Lena Bronge ◽  
Lars‐Olof Wahlund ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
White Matter ◽  
Magnetic Resonance ◽  
Orthostatic Hypotension ◽  
Small Vessel Disease ◽  
Vascular Risk Factors ◽  
Perivascular Spaces ◽  
Vascular Risk ◽  
Vessel Disease

Background Evidence suggests that enlarged perivascular spaces (PVSs) may represent a marker for cerebral small‐vessel disease. We investigated whether vascular risk factors are correlated with visible PVS in older adults. Methods and Results This population‐based study included 530 participants (age ≥60 years) who were free from dementia and functional dependence, derived from the Swedish National study on Aging and Care in Kungsholmen (2001–2003). We collected data on demographics, vascular risk factors, and health conditions through interviews, clinical examinations, laboratory tests, and patient registers. Cerebral PVSs and white matter hyperintensities on magnetic resonance images were visually assessed with semiquantitative visual rating scales. Data were analyzed using the general linear regression models. After controlling for demographics and cardiovascular disease, very high blood pressure (≥160/100 mm Hg) was significantly associated with global PVS score (β‐coefficient, 1.30; 95% CI, 0.06–2.53) and orthostatic hypotension was associated with PVS score in the basal ganglia (β‐coefficient 0.37; 0.03–0.70), but the associations became non‐significant when adjusting for white matter hyperintensity load. Orthostatic hypotension was significantly associated with global and lobar PVS scores in carriers but not in noncarriers of the APOE ε4 allele. Global or regional PVS score was not significantly associated with other traditional vascular risk factors such as smoking, diabetes mellitus, physical inactivity, and overweight or obesity. Conclusions This study provides limited evidence supporting a correlation of magnetic resonance imaging–visible PVS with traditional vascular risk factors in older adults. The association of orthostatic hypotension with lobar PVS among APOE ε4 carriers suggests that lobar PVS may be a marker for amyloid‐associated small‐vessel disease.

Vascular risk factors as independent predictors of neurocognitive impairments in patients with late-onset epilepsy who have small-vessel disease

2020 ◽  
Vol 104 ◽  
pp. 106443 ◽  
Author(s):  
Marc Turon ◽  
Laura Abraira ◽  
Sonia Cazorla ◽  
Elena Fonseca ◽  
Manuel Quintana ◽  
...  
Keyword(s):  
Risk Factors ◽  
Small Vessel Disease ◽  
Late Onset ◽  
Vascular Risk Factors ◽  
Small Vessel ◽  
Vascular Risk ◽  
Vessel Disease ◽  
Neurocognitive Impairments

Peripheral lipid oxidative stress markers are related to vascular risk factors and subcortical small vessel disease

2017 ◽  
Vol 59 ◽  
pp. 91-97 ◽  
Author(s):  
Walter Swardfager ◽  
Di Yu ◽  
Gustavo Scola ◽  
Hugo Cogo-Moreira ◽  
Parco Chan ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Risk Factors ◽  
Small Vessel Disease ◽  
Vascular Risk Factors ◽  
Small Vessel ◽  
Oxidative Stress Markers ◽  
Vascular Risk ◽  
Vessel Disease ◽  
Stress Markers

scholarly journals A Case of Sporadic Cerebral Small Vessel Disease in an Identical Twin

2020 ◽  
Vol 12 (3) ◽  
pp. 416-421
Author(s):  
Hilde van den Brink ◽  
Nick A. Weaver ◽  
Geert Jan Biessels
Keyword(s):  
Risk Factors ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Vascular Risk Factors ◽  
Small Vessel ◽  
Vascular Risk ◽  
Vessel Disease ◽  
Causative Factors ◽  
Potential Risk Factors ◽  
Clinical Consequences

Sporadic cerebral small vessel disease (cSVD) is primarily attributed to heritability and vascular risk factors. Still, our understanding of the causative factors in cSVD lesion burden in the brain is far from complete. This is exemplified by this case of identical twins with remarkably similar vascular risk profiles, where one twin had developed severe cSVD on neuroimaging with cognitive deficits, while the other twin had no cSVD. This case highlights the need to search for further causes of cSVD, also beyond genetic and conventional vascular risk factors. Identification of other potential risk factors or disease mechanisms should be a priority for cSVD research to improve our understanding, prevention and treatment of this common cause of vascular brain injury with major clinical consequences.

scholarly journals Stroke subtype, vascular risk factors, and total MRI brain small-vessel disease burden

Neurology ◽  
2014 ◽  
Vol 83 (14) ◽  
pp. 1228-1234 ◽  
Author(s):  
J. Staals ◽  
S. D. J. Makin ◽  
F. N. Doubal ◽  
M. S. Dennis ◽  
J. M. Wardlaw
Keyword(s):  
Risk Factors ◽  
Disease Burden ◽  
Small Vessel Disease ◽  
Vascular Risk Factors ◽  
Small Vessel ◽  
Vascular Risk ◽  
Stroke Subtype ◽  
Vessel Disease ◽  
Mri Brain

scholarly journals Carotid artery wall stiffness is increased in patients with small vessel disease: A case-control study

2016 ◽  
Vol 144 (1-2) ◽  
pp. 6-9 ◽  
Author(s):  
Denisa Salihovic-Hajdarevic ◽  
Aleksandra Pavlovic ◽  
Dzevdet Smajlovic ◽  
Ana Podgorac ◽  
Zagorka Jovanovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Arterial Stiffness ◽  
Small Vessel Disease ◽  
Vascular Risk Factors ◽  
Small Vessel ◽  
Vascular Risk ◽  
Vessel Disease ◽  
Increased Risk ◽  
Atheromatous Plaques

Introduction. Cerebral ischemic small-vessel disease (SVD), causing lacunar infarcts and white matter hyperintensities on brain magnetic resonance imaging (MRI), is a progressive disease associated with an increased risk of stroke, dementia and death. Increased arterial stiffness has been associated with ischemic stroke and cerebral SVD independently of common vascular risk factors. Objective. The aim of the study was to analyze arterial stiffness in our patients with symptomatic SVD. Methods. In a cross-sectional study design we included 30 patients with clinical and MRI evidence of cerebral SVD and 30 age-, gender- and risk factor-matched control subjects with no neurological diseases. Patients were evaluated at the Ultrasound Laboratory at the Neurology Clinic, Clinical Center of Serbia in Belgrade, during a three-month period (from September 1st to December 1st 2012). Baseline demographic and vascular risk factors were recorded. All patients underwent standard carotid ultrasound scans with measuring of intima-media thickness (IMT) and analysis of atheromatous plaques. Internal carotid artery stiffness was evaluated with the use of e-tracking option as beta stiffness index (BSI) value. Results. There were no differences between study groups in regard to degree of carotid stenosis and type of carotid plaques (p>0.05). Patients in SVD group had significantly higher mean IMT (p=0.0093) and mean BSI (p<0.0001) than subjects in the control group. No significant correlation was detected between IMT and BSI in SVD group (r=0.168; p=0.376). Brain lesions severity correlated with BSI (r=0.733; p<0.0001). Conclusion. Arterial stiffness is increased in symptomatic patients with SVD, independently of vascular risk factors and IMT.

Abstract T P412: Cerebral Microbleeds and Cognition: The Framingham Heart Study

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Jose R Romero ◽  
Sarah R Preis ◽  
Alexa Beiser ◽  
Ashkan Shoamanesh ◽  
Rhoda Au ◽  
...  
Keyword(s):  
Risk Factors ◽  
Executive Function ◽  
Cognitive Performance ◽  
Small Vessel Disease ◽  
Vascular Risk Factors ◽  
Cerebral Microbleeds ◽  
Small Vessel ◽  
Vascular Risk ◽  
Community Based ◽  
Vessel Disease

Objective: To study the association of cerebral microbleeds (CMB) on MRI and performance on a comprehensive neuropsychological test battery in a community based cohort free of stroke and dementia. Background: CMB represent hemorrhage-prone cerebral small vessel disease (SVD) and have been related to increased risk of dementia. In non-demented individuals, CMB may negatively affect cognition and the pattern of impaired cognitive performance may differ according to lesion topography. Methods: We evaluated 1744 Framingham Offspring Study participants (mean age 64.6 years, 54% women) attending a baseline examination (1998-2008), who had brain MRI allowing for CMB detection and underwent concurrent NP testing. Using multivariable linear regression we related CMB presence overall and stratified by brain location (lobar, deep or mixed) to performance on NP tests representing cognitive domains including memory, executive function, abstraction, language and visuospatial function. Results: CMB were observed in 7.7% of subjects (66% lobar, 20% deep, 14% mixed). After adjustment for sex, age, level of education and MRI markers of ischemic small vessel disease, presence of any CMB was associated with impaired performance on tests of abstraction (β -0.71, p=0.02) and language (β -0.13, p=0.04). The associations were attenuated after adjustment for vascular risk factors (hypertension, diabetes, smoking, prevalent cardiovascular disease). Lobar CMB showed similar marginal associations (p=0.05), also attenuated after adjustment for vascular risk factors. Mixed location CMB were associated with tests of executive function, an association that remained significant after adjustment for MRI markers of ischemic SVD and vascular risk factors (β-0.12, p= 0.02). CMB in only deep location did not show any significant association with NP test performance. Conclusions: CMB were associated with lower cognitive performance in a community-based sample of middle-aged adults. Our findings are limited given the cross sectional study design and small sample in subgroups of deep and mixed CMB, but concur with studies suggesting a negative impact of CMB on cognition, and expand prior studies by showing that the relations are independent of ischemic cerebral SVD.

White Matter Hyperintensity Burden in Cerebral Small Vessel Disease Patients Is Associated with Nocturnal Heart Rate

2021 ◽  
Vol 19 ◽  
Author(s):  
Lulu Yu ◽  
Yusheng Li ◽  
Yunchao Wang ◽  
Yuan Gao ◽  
Shanshan Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cerebral Infarction ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Vascular Risk Factors ◽  
White Matter Hyperintensity ◽  
Vascular Risk ◽  
Vessel Disease ◽  
Relationship Of ◽  
The Relationship

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 to improve our understanding of the etiology and consequences of WMH. Objective: 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) Method: 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 nighttime HR ( OR (95% CI): 1.041（1.02~1.062）, P<0.001),Homocysteine ( OR (95% CI): 1.019（1.005~1.033）, P=0.009), and cerebral infarction ( OR (95% CI): 0.463（0.31~0.691）, P<0.001), No similar association was observed for daytime HR、HR variability and other vascular risk factors . Conclusion: As nighttime HR、Hcy increased, log WMHV increased accordingly; furthermore, patients with cerebral infarction were more likely to have higher levels of WMHV. nighttime HR 、Hcy、cerebral infarction was associated with WMHV, suggesting independent roles of their in WMHV. The influence of HRV on WMHV needs to be addressed by further studies.

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