Large-vessel correlates of cerebral small-vessel disease
Large-vessel correlates of cerebral small-vessel disease
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DOI：
10.1212/wnl.0b013e318281ccc2
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发表时间：
2013-02-01
期刊：
影响因子：
9.9
通讯作者：
Debette, Stephanie
中科院分区：
文献类型：
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作者：
Brisset, Marion;Boutouyrie, Pierre;Debette, Stephanie
目的：我们的目的是探讨脑缺血性小血管疾病的MRI标记物与颈动脉结构和功能的关系：该研究包括1,800名参与者（年龄72.5 +/- 4.1岁，59.4%的女性），来自3C-第戎研究，一项以人群为基础的前瞻性队列研究，谁经历了定量脑MRI和颈动脉超声。我们采用多变量逻辑回归和线性回归分析，校正年龄、性别和血管危险因素。结果：颈动脉斑块的存在和颈动脉管腔直径的增加（但不包括颈总动脉内膜中层厚度）与腔隙性梗死的患病率较高相关：比值比（OR）= 1.60（95%置信区间[CI]：1.09-2.35），p = 0.02和OR = 1.24（95% CI：1.02-1.50），p = 0.03（SD增加）。颈动脉斑块还与大白色高信号体积（WMHV）（WMHV分布的年龄特异性前四分位数）相关：OR = 1.32（95% CI：1.04-1.67），p = 0.02，与血管风险因素无关。增加杨氏弹性模量和更高的周壁应力，反映了颈动脉僵硬度的增加，与WMHV增加相关（效应估计值[β] +/-标准误：0.0003 +/- 0.0001，p = 0.024; β +/-标准误：0.005 +/- 0.002，p = 0.008）。大WMHV还与杨氏弹性模量增加（OR = 1.22 [95% CI：1.04-1.42]，p = 0.01）和扩张系数降低（OR = 0.83 [95% CI：0.69-0.99]，p = 0.04）相关，与血管风险因素无关。颈动脉管腔直径与腔隙性梗死和颈动脉硬度标记物与WMHV的关联独立于颈动脉斑块。结论：除了颈动脉斑块之外，颈动脉管腔直径和颈动脉硬度标记物的增加分别与腔隙性梗死和WMHV的患病率增加相关。神经病学（R）2013;80：662-669
Objective: Our aim was to investigate the relationship of carotid structure and function with MRI markers of cerebral ischemic small-vessel disease.Methods: The study comprised 1,800 participants (aged 72.5 +/- 4.1 years, 59.4% women) from the 3C-Dijon Study, a population-based, prospective cohort study, who had undergone quantitative brain MRI and carotid ultrasound. We used multivariable logistic and linear regression adjusted for age, sex, and vascular risk factors.Results: Presence of carotid plaque and increasing carotid lumen diameter (but not common carotid artery intima-media thickness) were associated with higher prevalence of lacunar infarcts: odds ratio (OR) = 1.60 (95% confidence interval [CI]: 1.09-2.35), p = 0.02 and OR = 1.24 (95% CI: 1.02-1.50), p = 0.03 (by SD increase). Carotid plaque was also associated with large white matter hyperintensity volume (WMHV) (age-specific top quartile of WMHV distribution): OR = 1.32 (95% CI: 1.04-1.67), p = 0.02, independently of vascular risk factors. Increasing Young elastic modulus and higher circumferential wall stress, reflecting augmented carotid stiffness, were associated with increasing WMHV (effect estimate [beta] +/- standard error: 0.0003 +/- 0.0001, p = 0.024; beta +/- standard error: 0.005 +/- 0.002, p = 0.008). Large WMHV was also associated with increasing Young elastic modulus (OR = 1.22 [95% CI: 1.04-1.42], p = 0.01) and with decreasing distensibility coefficient (OR = 0.83 [95% CI: 0.69-0.99], p = 0.04), independently of vascular risk factors. Associations of carotid lumen diameter with lacunar infarcts and of carotid stiffness markers with WMHV were independent of carotid plaque.Conclusions: In addition to and independently of carotid plaque, increasing carotid lumen diameter and markers of carotid stiffness were associated with increasing prevalence of lacunar infarcts and increasing WMHV, respectively. Neurology (R) 2013;80:662-669