A 9-Year Longitudinal Study of Basilar Artery Diameter
A 9-Year Longitudinal Study of Basilar Artery Diameter
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基底动脉直径的 9 年纵向研究
DOI：
10.1161/jaha.118.011154
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Mochizuki H.
中科院分区：
文献类型：
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作者：
Takeuchi M;Miwa K;Tanaka M;Zhou Y;Todo K;Sasaki T;Sakaguchi M;Kitagawa K;Mochizuki H.
研究背景基底动脉（basilarartery，BA）扩张被认为是心血管事件（cardiovascular events，CVEs）的预测因子。然而，目前还不清楚，如果BA直径（ΔBA）的纵向变化与CVEs.Methods和ResultsIn一个队列的日本参与者与血管危险因素的观察性研究，我们评估了ΔBA的CVES和BA直径的时间过程的关系。在T2加权成像中，在脑桥中段水平测量BA直径的短轴。脑磁共振成像测量包括脑小血管疾病、腔隙和白色高信号。首先，通过时间依赖性考克斯比例风险模型分析了493例患者，以评价ΔBA与CVE之间的相关性，并对年龄、性别、血管风险因素和磁共振成像参数进行了调整。其次，我们通过线性回归分析评估了164例接受长期随访磁共振成像的患者的纵向ΔBA。在平均8.7年的随访中，105例患者发生了心血管事件。较小的ΔBA与心血管事件的高发生率独立相关（风险比，0.36; 95% CI，0.16-0.78;P=0.010; n=493）。平均间隔9.4年后，平均ΔBA为0.41±0.46 mm（不包括胎儿型Willis环患者）。BA扩张的进展与男性相关，但与初始BA直径和胎儿型Willis环呈负相关（n=164）.ConclusionsBA直径随时间增加（不包括胎儿型Willis环患者），而ΔBA与CVE的发生率呈负相关。
BackgroundDilatation of the basilar artery (BA) has been recognized as a predictor of cardiovascular events (CVEs). However, it is unclear if the longitudinal change in BA diameter (ΔBA) is associated with CVEs.Methods and ResultsIn a cohort of Japanese participants with vascular risk factors in an observational study, we evaluated the relationship of ΔBA to CVEs and the time course of the BA diameter. The short axis of the BA diameter was measured at the midpons level in T2‐weighted images. Brain magnetic resonance imaging measurements included cerebral small‐vessel disease, lacunars, and white matter hyperintensities. First, 493 patients were analyzed by the time‐dependent Cox proportional hazards model to evaluate the association between ΔBA and CVEs, with adjustment for age, sex, vascular risk factors, and magnetic resonance imaging parameters. Second, we assessed the longitudinal ΔBA in 164 patients who underwent long‐term follow‐up magnetic resonance imaging, by linear regression analysis. In the mean follow‐up of 8.7 years, 105 patients developed CVEs. A smaller ΔBA was independently associated with the high incidence of CVEs (hazard ratio, 0.36; 95% CI, 0.16–0.78;P=0.010; n=493). After a mean interval of 9.4 years, the average ΔBA was 0.41±0.46 mm (excluding patients with fetal‐type circle of Willis). Progression of BA dilatation was associated with men but inversely associated with initial BA diameter and fetal‐type circle of Willis (n=164).ConclusionsBA diameter increased over time (excluding the patients with fetal‐type circle of Willis), whereas ΔBA was inversely associated with the incidence of CVEs.