Relationship Between Central Artery Stiffness, Brain Arterial Dilation, and White Matter Hyperintensities in Older Adults: The ARIC Study-Brief Report.
Relationship Between Central Artery Stiffness, Brain Arterial Dilation, and White Matter Hyperintensities in Older Adults: The ARIC Study-Brief Report.
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老年人中央动脉僵硬、脑动脉扩张和白色高信号之间的关系：ARIC研究简报。
DOI：
10.1161/atvbaha.120.315692
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Heiss G
中科院分区：
文献类型：
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作者：
Caughey MC;Qiao Y;Meyer ML;Palta P;Matsushita K;Tanaka H;Wasserman BA;Heiss G
颅内大动脉的非动脉粥样硬化性外向重塑可能促进过多的主动脉脉动能量传播到脑微循环中，并与不良认知结局相关。我们试图确定老年人中中央动脉硬度、脑动脉直径和白色高信号（WMH）体积之间的关系。我们检查了来自1275名动脉粥样硬化风险社区（ARIC）研究（59%女性，30%黑人，平均年龄77岁）的无卒中参与者的数据，他们接受了颈动脉-股动脉脉搏波速度（cf-PWV）测试和脑磁共振成像（MRI）。cf-PWV >12 m/s被认为升高。在不存在动脉特异性斑块的情况下，分析WMH与大脑中动脉和大脑前动脉M1 A1段动脉直径（以较大者为准）之间的关系，调整颅内体积和潜在混杂因素。平均cf-PWV为11.7 m/s，WMH体积为11.2 cm 3。在cf-PWV升高的受试者中，M1 A1直径每增加0.5 mm，WMH体积增加24%（指数β = 1.24; 95% CI：1.12 - 1.36），相比之下，cf-PWV未升高的受试者WMH体积增加10%（指数β = 1.10; 95% CI：1.01 - 1.19），P-相互作用= 0.04。在对普通人群中的老年人进行的这项检查中，大脑中循环中较大的无斑块动脉直径与较大的WMH体积相关，特别是在中央动脉僵硬度升高的参与者中。降低中央动脉僵硬度的策略可能会减轻脑血管外向重构和微血管损伤之间的关联。
Non-atherosclerotic outward remodeling of the large intracranial arteries may facilitate propagation of excessive aortic pulsatile energy into the cerebral microcirculation and has been associated with adverse cognitive outcomes. We sought to determine the relationship between central artery stiffness, brain arterial diameters, and white matter hyperintensity (WMH) volume in the general population of older adults. We examined data from 1275 stroke-free participants of the Atherosclerosis Risk in Communities (ARIC) study (59% female, 30% Black, mean age 77 years) who underwent carotid-femoral pulse wave velocity (cf-PWV) testing and brain magnetic resonance imaging (MRI). A cf-PWV >12 m/s was considered elevated. Relationships between WMH and arterial diameters at the M1A1 segment of the middle and anterior cerebral arteries (whichever larger) were analyzed in the absence of artery-specific plaque, adjusting for intracranial volume and potential confounders. The average cf-PWV was 11.7 m/s and WMH volume was 11.2 cm3. Each 0.5 mm increment in M1A1 diameter was associated with 24% greater WMH volume in participants with elevated cf-PWV (exponentiated β = 1.24; 95% CI: 1.12 – 1.36), compared to a 10% greater WMH volume in participants without elevated cf-PWV (exponentiated β = 1.10; 95% CI: 1.01 – 1.19), P-interaction = 0.04. In this examination of older adults from the general population, larger, plaque-free arterial diameters in the middle cerebral circulation were associated with greater WMH volume, particularly among participants with elevated central artery stiffness. Strategies to reduce central artery stiffness may mitigate the association between cerebrovascular outward remodeling and microvascular damage.