Aortic hemodynamics and white matter hyperintensities in normotensive postmenopausal women
Aortic hemodynamics and white matter hyperintensities in normotensive postmenopausal women
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DOI：
10.1007/s00415-017-8476-1
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发表时间：
2017-05-01
影响因子：
6
通讯作者：
Kantarci, Kejal
中科院分区：
文献类型：
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作者：
Barnes, Jill N.;Harvey, Ronee E.;Kantarci, Kejal
高血压与大脑中白质高强度(WMH)的发展有关，而WMH是轻度认知障碍的危险因素。绝经时荷尔蒙的变化会改变血管功能，使女性同时面临高血压和WMH的风险。主动脉血流动力学升高先于临床定义的高血压的出现，但在女性中，主动脉血流动力学与WMH的发展之间的关系尚不清楚。因此，本研究旨在研究绝经后妇女的主动脉血流动力学与WMH的关系。用眼压计测定53例绝经后妇女(60+/-2岁)的主动脉收缩压(BP)、舒张压(BP)、主动脉增厚指数(ALX)和主动脉往返行程时间(T(R))。使用半自动分割算法从液体衰减的反转恢复MRI计算WMH。校正年龄因素后，WMH占白质总体积的比例与主动脉收缩压呈正相关(回归系数=0.018；p=0.04)。此外，在调整年龄因素后，WMH分数与AIX呈正相关(0.025；p=0.04)，与主动脉T(R)呈负相关(-0.015；p=0.04)。我们的结果表明，评估主动脉血流动力学可以确定有加速发展的WMH的风险，并指导早期治疗，以减少WMH负担和未来的认知损害。
Hypertension is associated with development of white matter hyperintensities (WMH) in the brain, which are risk factors for mild cognitive impairment. Hormonal shifts at menopause alter vascular function putting women at risk for both hypertension and WMH. Elevations in aortic hemodynamics precede the appearance of clinically defined hypertension but the relationship of aortic hemodynamics to development of WMH in women is not known. Therefore, this study aimed to characterize aortic hemodynamics in relationship to WMH in postmenopausal women. Aortic systolic and diastolic blood pressure (BP), aortic augmentation index (Alx) and aortic round trip travel time (Aortic T (R)) by tonometry were examined in 53 postmenopausal women (age 60 +/- 2 years). WMH was calculated from fluid-attenuated inversion recovery MRI using a semi-automated segmentation algorithm. WMH as a fraction of total white matter volume positively associated with aortic systolic BP (regression coefficient = 0.018; p = 0.04) after adjusting for age. In addition, WMH fraction was positively associated with AIx (0.025; p = 0.04), and inversely associated with Aortic T (R) (-0.015; p = 0.04) after adjusting for age. Our results suggest that assessing aortic hemodynamics may identify individuals at risk for accelerated development of WMH and guide early treatment to reduce WMH burden and cognitive impairment in the future.