Caliber of Intracranial Arteries as a Marker for Cerebral Small Vessel Disease.
Caliber of Intracranial Arteries as a Marker for Cerebral Small Vessel Disease.
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颅内动脉口径作为脑小血管疾病的标志
DOI：
10.3389/fneur.2020.558858
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发表时间：
2020
影响因子：
3.4
通讯作者：
Xu G
中科院分区：
文献类型：
--
作者：
Chen Z;Li H;Wu M;Chang C;Fan X;Liu X;Xu G
背景：颅内大动脉管径扩张，可能将更多的血流动力学负担转移至下游脑毛细血管，长远来看，导致脑小血管病（CSVD）。本研究旨在探讨颅内动脉管径与小血管疾病之间的关系。方法：通过南京脑卒中登记项目纳入首例腔隙性脑梗死亚型缺血性脑卒中患者。颅内动脉 Z 评分，称为脑动脉重塑 (BAR) 评分，是通过对七个主要颅内动脉的管径进行平均来计算的。入组患者中，BAR评分<-1 SD的患者被视为颅内动脉管径较小； BAR评分>1 SD的患者被认为颅内动脉管径较大，BAR评分在1 SD之间的患者被认为颅内动脉管径正常。对 CSVD 的影像学标志物，包括腔隙、白质高信号 (WMH)、血管周围间隙扩大 (EPVS) 和脑微出血 (CMB) 进行评分，然后求和以获得 CSVD 总评分。结果：本研究共纳入312例患者，BAR评分>1 SD的患者年龄较大（P = 0.039），更容易有心肌梗死病史（P = 0.033）。 BAR 评分与 CSVD 总评分之间的 Spearman 等级相关系数为 0.320 (P < 0.001)。二元逻辑回归发现，BAR 评分 >1 SD 与缺陷相关（OR = 1.987；95% CI，1.037–3.807；P = 0.039）；重度 WMH（OR = 1.994；95% CI，1.003–3.964；P = 0.049）；严重 EPVS（OR = 2.544；95% CI，1.299–4.983；P = 0.006）和 CSVD（OR = 2.997；95% CI 1.182–7.599；P = 0.021）。序数逻辑回归分析发现，年龄（OR = 1.028；95% CI，1.007–1.049；P = 0.009）、高血压（OR = 3.514；95% CI，2.114–5.769；P < 0.001）和 BAR 评分 >1 SD（OR = 2.418；95% CI， 1.350–4.330；P = 0.003) 与总数相关 CSVD 评分。结论：颅内动脉管径较大的患者脑小血管病负担可能较重。这种关联的机制值得进一步研究。
Background: The dilation of intracranial large arteries caliber, may transfer more hemodynamic burden to the downstream brain capillaries, which, in the long run, results in cerebral small vessel disease (CSVD). This study aimed to investigate the relationship between intracranial artery calibers and small vessel disease. Methods: Patients with first-ever ischemic stroke of lacunar infarction subtype were enrolled via Nanjing Stroke Registry Program. An intracranial arterial Z-score, named the brain arterial remodeling (BAR) score, was calculated by averaging the calibers of the seven main intracranial arteries. Among the enrolled patients, those with a BAR score < −1 SD were deemed to have small intracranial artery calibers; those with a BAR score >1 SD were deemed to have large intracranial artery calibers and those with a between BAR score were deemed to have normal intracranial artery calibers. Imaging markers of CSVD, including lacuna, white matter hyperintensity (WMH), enlarged perivascular spaces (EPVS) and cerebral microbleeds (CMBs) were rated and then summed to obtain a total CSVD score. Results: A total of 312 patients were involved in this study, patients with BAR score >1 SD were older (P = 0.039), and more prone to having a history of myocardial infarction (P = 0.033). The Spearman's rank correlation coefficient between the BAR score and total CSVD score is 0.320 (P < 0.001). Binary logistic regression found that BAR score >1 SD was correlated with lacuna (OR = 1.987; 95% CI, 1.037–3.807; P = 0.039); severe WMH (OR = 1.994; 95% CI, 1.003–3.964; P = 0.049); severe EPVS (OR = 2.544; 95% CI, 1.299–4.983; P = 0.006) and CSVD (OR = 2.997; 95% CI 1.182–7.599; P = 0.021). Ordinal logistic regression analysis found that age (OR = 1.028; 95% CI, 1.007–1.049; P = 0.009), hypertension (OR = 3.514; 95% CI, 2.114–5.769; P < 0.001) and BAR score >1 SD (OR = 2.418; 95% CI, 1.350–4.330; P = 0.003) were correlated with the total CSVD score. Conclusions: Patients with large intracranial arterial calibers may have heavier CSVD burden. The mechanisms of this association warrant further study.
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影响因子：
5.1
作者：
Park, J. -M.;Koo, J. -S.;Bae, H. -J.
通讯作者：
Bae, H. -J.
影响因子：
6.3
作者：
Shi, Yulu;Thrippleton, Michael J.;Wardlaw, Joanna M.
通讯作者：
Wardlaw, Joanna M.
影响因子：
8.3
作者：
Thijs, Vincent;Grittner, Ulrike;Enzinger, Christian
通讯作者：
Enzinger, Christian
影响因子：
9.9
作者：
Brisset, Marion;Boutouyrie, Pierre;Debette, Stephanie
通讯作者：
Debette, Stephanie
影响因子：
48
作者：
Greenberg, Steven M.;Vernooij, Meike W.;Cordonnier, Charlotte;Viswanathan, Anand;Salman, Rustorn Al-Shahi;Warach, Steven;Launer, Lenore J.;Van Buchem, Mark A.;Breteler, Monique M. B.
通讯作者：
Breteler, Monique M. B.