scholarly journals Association of Carotid Atherosclerosis With White Matter Hyperintensity in an Asymptomatic Japanese Population: A Cross-Sectional Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Li Zhang ◽  
Quan Zhou ◽  
Li Hua Shao ◽  
Jun Wen ◽  
Jun Xia
Keyword(s):  
White Matter ◽  
Carotid Artery ◽  
Japanese Population ◽  
Carotid Atherosclerosis ◽  
Smoking Status ◽  
White Matter Hyperintensity ◽  
Large Artery ◽  
Cross Sectional ◽  
Carotid Artery Plaque ◽  
Plaque Score

Objective: A limited number of scholars concentrated on the relationship between carotid atherosclerosis (CAS) and white matter hyperintensity (WMH) (i.e., CAS-WMH relationship). The current research aimed to clarify the CAS-WMH relationship in Japanese population.Methods: All participants underwent MRI of head and ultrasonography of the carotid artery. WMH was diagnosed from MRI results. The carotid ultrasound findings, carotid artery plaque score (PS), and plaque number (PN) could be achieved to indicate the severity of CAS. We also employed multivariate logistic regression models to estimate the CAS-WMH relationship. Interaction and stratified analyses were undertaken on the basis of a number of factors (e.g., gender, age, smoking status, drinking habit, and history of chronic diseases).Results: A total of 1,904 Japanese subjects were included, and the prevalence of WMH was 54.8% (1,044/1,904). It was unveiled that frequency of CAS was greater in cases with WMH. In a fully adjusted model, high PS was associated with the frequency of WMH, followed by high PN. Further analyses revealed a dose-response relationship between PS and incidence of WMH.Conclusion: PS and PN exhibited the greatest influences on determining the frequency of WMH, highlighting the potentially important pathophysiological role of large artery atherosclerosis in intensifying WMH.

scholarly journals Relationship between carotid arterial properties and cerebral white matter hyperintensities

Neurology ◽  
2017 ◽  
Vol 88 (21) ◽  
pp. 2036-2042 ◽  
Author(s):  
Tatjana Rundek ◽  
David Della-Morte ◽  
Hannah Gardener ◽  
Chuanhui Dong ◽  
Matthew S. Markert ◽  
...  
Keyword(s):  
White Matter ◽  
Carotid Artery ◽  
Arterial Compliance ◽  
Cross Sectional Study ◽  
Stiffness Index ◽  
White Matter Hyperintensity ◽  
Cerebral White Matter ◽  
Large Artery ◽  
Cross Sectional ◽  
The Difference

Objective:Since arterial stiffness is a functional measure of arterial compliance and may be an important marker of cerebrovascular disease, we examined the association of carotid artery stiffness with white matter hyperintensity volume (WMHV) in a cross-sectional study of 1,166 stroke-free participants.Methods:Carotid beta stiffness index (STIFF) was assessed by M-mode ultrasound of the common carotid artery and calculated as the ratio of natural log of the difference between systolic and diastolic blood pressure over STRAIN, a ratio of the difference between carotid systolic and diastolic diameter (DD) divided by DD. WMHV was measured by fluid-attenuated inversion recovery MRI. The associations of STIFF, DD, and STRAIN with WMHV were examined using linear regression after adjusting for sociodemographic, lifestyle, and vascular risk factors.Results:In a fully adjusted model, larger carotid DD was significantly associated with greater log-WMHV (β = 0.09, p = 0.001). STIFF and STRAIN were not significantly associated with WMHV. In adjusted analyses stratified by race–ethnicity, STRAIN (β = −1.78, p = 0.002) and DD (β = 0.11, p = 0.001) were both associated with greater log-WMHV among Hispanic participants, but not among black or white participants.Conclusions:Large carotid artery diameters are associated with greater burden of white matter hyperintensity (WMH) in this multiethnic population. The association between increased diameters, decreased STRAIN, and greater WMH burden is more pronounced among Hispanics. These associations suggest a potential important pathophysiologic role of extracranial large artery remodeling in the burden of WMH.

scholarly journals Association between LDL-C/HDL-C Ratio and Carotid Atherosclerosis in an Asymptomatic Japanese Population: A Cross-Sectional Study

2021 ◽  
Author(s):  
Juan Wang ◽  
Jiuling Liu
Keyword(s):  
Japanese Population ◽  
Regression Models ◽  
Carotid Atherosclerosis ◽  
Smoking Status ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Plaque Score ◽  
Logistic Regression Models ◽  
Atherosclerosis Progression

Abstract Background and aims LDL-C/HDL-C ratio predicted atherosclerosis progression better than LDL-C or HDL-C alone. However, the association between LDL-C/HDL-C ratio and Carotid Atherosclerosis(CA) is still controversial. There is a lack of research on this topic in theAsymptomatic Japanese Population. This study aims to provide further results. Methods The study population was a cross-sectional study of 1904 subjects free of cardio-cerebrovascular disease at baseline(mean age 57±11.9 years, 51.9% male). All participant sultrasonography of the carotid artery. The presence of carotid plaque score(PS) aand plaque number (PN) were evaluated by ultrasonography. Multivariate logistic regression models to estimatethe LDL-C/HDL-C ratio and PS relationship. Participants were stratified into three groups based on LDL-C/HDL-C ratio tertiles. Interaction and stratified analyses were conductedaccording to age, sex, smoking status, drinking status, fatty, and histories of diabetes. Results In regression models and after multiple adjustments, the risk of PS was significantly associated with serum LDL-C/HDL-C ratio levels in which LDL-C/HDL-C ratio was included as a categorical variable. It remained significant for the highest vs the first tertile of the LDL-C/HDL-C ratio (OR=1.50, 95% CI 1.04–2.17). Stratified analysis,we found that the association was more significant aged <65 years old, female and non-diabetes subgroups.Interaction analysis showed no interaction between LDL-C/HDL-C ratio and PS in the fatty,smoking, and drinking subgroups. Conclusions In conclusion, LDL-C/HDL-C ratio is an independent risk factor for CA in the Japanese population. A prospective and randomized clinical trial of LDL-C/HDL-C ratio lowering therapy in the Japanese population is needed to assess the causal nature of the relationship.

Abstract 2882: The Combined Impact of Glucose Abnormality and Blood Pressure Category on Carotid Atherosclerosis in a General Urban Japanese Population: The Suita Study

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Kaoru Endo ◽  
Yoshihiro Kokubo ◽  
Kazunori Toyoda ◽  
Masatoshi Koga ◽  
Kazuo Minematsu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Carotid Artery ◽  
Japanese Population ◽  
Carotid Atherosclerosis ◽  
Serum Glucose ◽  
External Carotid ◽  
P Value ◽  
Cross Sectional ◽  
The Mean ◽  
The Impact

Introduction: Diabetes Mellitus (DM) and hypertension (HT) have been proven to be risk factors for cardiovascular diseases and stroke. However, few studies have examined the relationships of carotid artery intima-media thickness (IMT) with combination of glucose abnormality and blood pressure (BP) categories in a general population. We assessed the hypothesis that the effect of the risks of these factors on carotid atherosclerosis was more accentuated with combination of higher categories on glucose and BP in a general urban Japanese population. Methods: Participants (35-93 years of age; 1,844 women and 1,602 men) who gave written informed consent were randomly selected from a general urban population (between 2002 and 2004). Carotid atherosclerosis was evaluated by high-resolution ultrasonography (7.5MHz) with atherosclerotic indexes of IMT in the common carotid artery (CCA), carotid artery bulb (Bulb), and internal and external carotid arteries. Mean IMT was defined as the mean of the IMT of the proximal and distal walls for both sides of the CCA at a point 10 mm proximal to the beginning of the dilation of each Bulb. Maximum IMT was assessed in the entire scanned area. Stenosis (>=25%) was defined as a condition in which a plaque occupied more than 25% of the lumen circumference of an artery on a cross-sectional scan. Serum glucose categories (normoglycemia, impaired fasting glucose [IFG] and DM) were defined according to the 2003 ADA recommendations. BP categories (optimal, normal, high-normal BP and HT) were defined on the basis of the ESH-ESC 2007 criteria. The association of serum glucose categories with the carotid atherosclerotic indexes was investigated through logistic regression analysis considering potential confounding risk variables including BP category. Results: Compared with normoglycemic subjects, the mean and maximum IMTs were significantly greater in women with DM (mean: 0.836 vs 0.802 p=0.001, maximum: 1.370 vs 1.205 p<0.001) and in men with IFG (mean: 0.858 vs 0.838 p=0.004, maximum: 1.511 vs 1.439 p=0.038) and DM (mean: 0.885 vs 0.838 p<0.001, maximum: 1.631 vs 1.439 p<0.001). Compared with normoglycemic subjects, the odds ratios (OR) (95% confidence intervals [CI]) for stenosis was 1.67 (1.22-2.30) in subjects with DM. Compared with optimal BP subjects, the OR (95% CI) for stenosis was 1.52 (1.15-2.01) in subjects with HT. In combination, the OR for stenosis with optimal, normal, high-normal BP and HT were 1(reference), 1.96, 2.48 and 2.71 with normoglycemia, 1.99, 1.83, 2.26 and 2.88 with IFG and 7.04, 2.18, 3.42 and 4.09 with DM (P-value for interaction=0.049). Conclusion: Compared with normoglycemic subjects, the mean and maximum IMTs were significantly greater in women with DM and in men with IFG and DM and stenosis was significantly greater in subjects with DM. The impact of each glucose category on the stenosis was more evident in subjects with a higher BP category.

scholarly journals Dilatation of common carotid artery is strongly associated with cerebral ischemic stroke with or without the presence of carotid atherosclerosis

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 365-365
Author(s):  
Jiunn-Rong Chen ◽  
Chyi-Huey Bai ◽  
Hou-Chang Chiu ◽  
Wen-Harn Pan
Keyword(s):  
Ischemic Stroke ◽  
Alcohol Consumption ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Carotid Atherosclerosis ◽  
Previous History ◽  
External Carotid ◽  
Compensatory Mechanism ◽  
Plaque Score ◽  
Diabetes Status

P147 Background: Dilatation of common carotid artery (CCA) was related to age, sex, and body height in population studies. It was also considered a compensatory mechanism to carotid atherosclerotic stenosis. The present study examined the risk of CCA dilatation associated with ischemic stroke (IS) and its relations to carotid atherosclerosis, hypertension, hyperglycemia, fibrinogen, cholesterol, HDL-cholesterol (HDL-C), smoking, and alcohol consumption. Methods: A case-control study was carried on 251 first-ever IS patients (age≥40) excluding previous history of myocardial infarction and cancer and 242 non-stroke outpatients. Intraluminal diameter of middle portion of CCA, and plaque thickness in CCA, bulb, internal and external carotid arteries were measured. Information on hypertension and diabetes status and data of life-styles such as smoking and alcohol consumption were collected. Levels of fibrinogen, factor VIIIc, cholesterol, HDL-C and glucose were obtained. Results: CCA dilatation was a strong factor for IS (OR=4.13, P=0.0001). It was also associated with hypertension, hyperglycemia, smoking, alcohol consumption, low HDL-C, and high levels of fibrinogen, factor VIIIc, cholesterol, and plaque score. The association remained significant with or without each of the following conditions: hypertension (p=0.0001, p=0.0007), hyperglycemia (p=0.0446, p=0.0001), elevated fibrinogen (p=0.0104, p=0.0001) or factor VIIIc (p=0.2458, p=0.0001), hypercholesterolemia (p=0.0238, p=0.0001), decreased HDL-C (p=0.0012, p=0.0001) and presence of plaque score (p=0.0263, p=0.0003). Adjusting above risk factors, odds ratios of elevated diameter could associated with IS, before (OR=2.21, P=0.0066) and after (OR=6.63, p=0.0055) excluding subjects with plaque. Conclusion: Dilatation of CCA is a strong risk factor for IS. The fact the association remained significant without ultrasonic evidence of carotid plaque indicates that IS in Chinese involved a mechanism of active vasculopathy, not just a passive compensatory process to extracranial atherosclerosis.

Abstract TMP58: Determinants of White Matter Hyperintensity in Acute Ischemic Stroke Patients: The MRI-GENIE Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Anne-Katrin Giese ◽  
Markus D Schirmer ◽  
Adrian V Dalca ◽  
Ramesh Sridharan ◽  
Lisa Cloonan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Ischemic Stroke ◽  
White Matter ◽  
Stroke Risk ◽  
Smoking Status ◽  
Vascular Risk Factors ◽  
White Matter Hyperintensity ◽  
Vascular Risk ◽  
Prior Stroke

Introduction: White matter hyperintensity (WMH) is a highly heritable trait and a significant contributor to stroke risk and severity. Vascular risk factors contribute to WMH severity; however, knowledge of the determinants of WMH in acute ischemic stroke (AIS) is still limited. Hypothesis: WMH volume (WMHv) varies across AIS subtypes and is modified by vascular risk factors. Methods: We extracted WMHv from the clinical MRI scans of 2683 AIS subjects from the MRI-Genetics Interface Exploration (MRI-GENIE) study using a novel fully-automated, volumetric analysis pipeline. Demographic data, stroke risk factors and stroke subtyping for the Causative Classification of Stroke (CCS) were performed at each of the 12 international study sites. WMHv was natural log-transformed for linear regression analyses. Results: Median WMHv was 5.7cm 3 (interquartile range (IQR): 2.2-12.8cm 3 ). In univariable analysis, age (63.1 ± 14.7 years, β=0.04, SE=0.002), prior stroke (10.2%, β=0.66, SE=0.08), hypertension (65.4%, β=0.75, SE=0.05), diabetes mellitus (23.1%, β=0.35, SE=0.06), coronary artery disease (17.6%, β=0.04, SE=0.002), and atrial fibrillation (14.6%, β=0.48, SE=0.07) were significant predictors of WMHv (all p<0.0001), as well as smoking status (52.2%, β=0.15, SE=0.05, p=0.005), race (16.5% Non-Caucasian, β=0.25, SE=0.07) and ethnicity (8.2% Hispanic, β=0.30, SE=0.11) (all p<0.01). In multivariable analysis, age (β=0.04, SE=0.002), prior stroke (β=0.56, SE=0.08), hypertension (β=0.33, SE=0.05), smoking status (β=0.16, SE=0.05), race (β=0.42, SE=0.06), and ethnicity (β=0.34, SE=0.09) were independent predictors of WMHv (all p<0.0001), as well as diabetes mellitus (β=0.13, SE=0.06, p=0.02). WMHv differed significantly (p<0.0001, unadjusted) across CCS stroke subtypes: cardioembolic stroke (8.0cm 3 , IQR: 4.2-15.4cm 3 ), large-artery stroke (6.9cm 3 , IQR: 3.1-14.7cm 3 ), small-vessel stroke (5.8cm 3 , IQR: 2.5-13.5cm 3 ), stroke of undetermined (4.7cm 3 , IQR: 1.6-11.0cm 3 ) or other (2.55cm 3 , IQR: 0.9-8.8cm 3 ) causes. Conclusion: In this largest-to-date, multicenter hospital-based cohort of AIS patients with automated WMHv analysis, common vascular risk factors contribute significantly to WMH burden and WMHv varies by CCS subtype.

scholarly journals Arterial stiffness and dementia pathology

Neurology ◽  
2018 ◽  
Vol 90 (14) ◽  
pp. e1248-e1256 ◽  
Author(s):  
Timothy M. Hughes ◽  
Lynne E. Wagenknecht ◽  
Suzanne Craft ◽  
Akiva Mintz ◽  
Gerardo Heiss ◽  
...  
Keyword(s):  
White Matter ◽  
Arterial Stiffness ◽  
Small Vessel Disease ◽  
Brain Mri ◽  
Volume Ratio ◽  
Cognitive Testing ◽  
White Matter Hyperintensity ◽  
Cross Sectional ◽  
Brain Volumes ◽  
Atherosclerosis Risk In Communities

ObjectiveArterial stiffness has been associated with evidence of cerebral small vessel disease (cSVD) and fibrillar β-amyloid (Aβ) deposition in the brain. These complex relationships have not been examined in racially and cognitively diverse cohorts.MethodsThe Atherosclerosis Risk in Communities (ARIC)–Neurocognitive Study collected detailed cognitive testing for adjudication of dementia and mild cognitive impairment (MCI), brain MRI, and arterial stiffness by pulse wave velocity (PWV, carotid-femoral [cfPWV] and heart-carotid [hcPWV]). The ARIC-PET ancillary study added Aβ imaging using florbetapir ([18F]-AV-45) to obtain standardized uptake volume ratios and defined global Aβ-positivity as standardized uptake volume ratio >1.2. One-SD increase in PWV was related to brain volume, MRI-defined cSVD (e.g., cerebral microbleeds and white matter hyperintensity), and cortical Aβ deposition adjusted for age, body mass index, sex, race, and APOE ε4 status. We examined the cross-sectional relationships including interactions by race, APOE ε4 status, and cognition.ResultsAmong the 320 ARIC-PET participants (76 [5] years, 45% black, 27% MCI), greater central stiffness (hcPWV) was associated with greater Aβ deposition (odds ratio [OR] = 1.31, 95% confidence interval [CI] 1.01–1.71). Greater central stiffness (cfPWV) was significantly associated with having lower brain volumes in Alzheimer disease–susceptible regions (in mm3, β = −1.5 [0.7 SD], p = 0.03) and high white matter hyperintensity burden (OR = 1.6, 95% CI 1.2–2.1). Furthermore, cfPWV was associated with a higher odds of concomitant high white matter hyperintensity and Aβ-positive scans (OR = 1.4, 95% CI 1.1–2.1). These associations were strongest among individuals with MCI and did not differ by race or APOE ε4 status.ConclusionsArterial stiffness, measured by PWV, is an emerging risk factor for dementia through its repeated relationships with cognition, cSVD, and Aβ deposition.

Metabolic Syndrome is Associated with White Matter Hyperintensity in Stroke Patients

2017 ◽  
Vol 18 (3) ◽  
pp. 277-283
Author(s):  
Zheng Zhang ◽  
Wan-Li Zhang ◽  
Jia Li ◽  
Mei-Juan Xiao
Keyword(s):  
Metabolic Syndrome ◽  
White Matter ◽  
Acute Stroke ◽  
Old Age ◽  
Univariate Analysis ◽  
Serum Triglyceride ◽  
White Matter Hyperintensity ◽  
Acute Ischemia ◽  
Stroke Patients ◽  
Cross Sectional

Some risk factors of stroke may play a role in white matter hyperintensity (WMH). Metabolic syndrome (MetS) is a recognised risk factor of stroke, but it is controversial whether MetS is also associated with WMH. We examined the association of MetS with the prevalence of WMH in acute stroke patients. We conducted a cross-sectional study in 246 acute ischemia stroke patients. The patients with acute stroke were clinically evaluated, including waistline circumference, blood pressure, glycaemia, serum triglyceride and high density lipoprotein cholesterol level. The degree of WMH was assessed by Fluid-attenuated inversion recovery (FLAIR) sequence of magnetic resonance imaging (MRI) scans. MetS was diagnosed using the criteria by the National Cholesterol Education Adult Treatment Panel III. MetS was the independent variable evaluated in Binary regression analyses. It is found that old age (>60 years old), MetS and smoking were significantly associated with WMH in univariate analysis (p < .05). Spearman rank correlation showed that old age and MetS are related to WMH (r = 0.18, p = .005 and r = 0.18, p = .004, respectively). Hypertension is weakly but not significantly associated with WMH in correlation analysis (r = 0.11, p = .08). In multiple regression analysis, age and MetS remained independently associated with WMH (OR = 7.6, 95% CI 0.2–0.7 and OR = 11.7, 95% CI 0.1–0.5). Hypertension and hyperglycaemia tend to be associated but not significantly with WMH (p = .07, p = .08). Other MetS components such as large waist circumference and dyslipidaemia showed no association with WMH. After adjustment for age, WMH is significantly associated with MetS in stroke patients. Hypertension and hyperglycaemia tend to associated but not significantly with WMH in stroke patients.

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