Arterial Stiffness and Cerebral Small Vessel Disease

Fei-Fei Zhai; Yi-Cong Ye; Si-Yu Chen; Fa-Ming Ding; Fei Han; Xing-Lin Yang; Quan Wang; Li-Xin Zhou; Jun Ni; Ming Yao; Ming-Li Li; Zheng-Yu Jin; Li-Ying Cui; Shu-Yang Zhang; Yi-Cheng Zhu

doi:10.3389/fneur.2018.00723

Arterial Stiffness and Cerebral Small Vessel Disease

Front Neurol. 2018 Aug 28:9:723. doi: 10.3389/fneur.2018.00723. eCollection 2018.

Authors

Fei-Fei Zhai¹, Yi-Cong Ye², Si-Yu Chen¹, Fa-Ming Ding², Fei Han¹, Xing-Lin Yang², Quan Wang¹, Li-Xin Zhou¹, Jun Ni¹, Ming Yao¹, Ming-Li Li³, Zheng-Yu Jin³, Li-Ying Cui¹, Shu-Yang Zhang², Yi-Cheng Zhu¹

Affiliations

¹ Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
² Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
³ Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Abstract

Background and Objective: Studies on relations between arterial stiffness and full spectrum of radiological features of cerebral small vessel disease (CSVD) are scarce. We aim to investigate the association of arterial stiffness with lacunes, white matter hyperintensities (WMH), microbleeds (CMBs), dilated perivascular spaces (PVS), and brain atrophy in a community-based sample. Methods: A total of 953 participants (55.7 ± 9.4 years) who underwent brachial-ankle pulse wave velocity (baPWV) and brain magnetic resonance imaging were included. Lacunes, CMBs, and PVS were visually rated. Brain structure and WMH were automatically segmented. Brain parenchyma fraction (BPF), a surrogate index of brain atrophy, was calculated as a ratio of brain parenchyma volume to total intracranial volume. Multivariable logistic and linear regressions were used to investigate the associations between baPWV and CSVD. Subsequently, we explored these associations in strata of age. Results: Increased baPWV was associated with severe PVS in white matter (OR, 1.09; 95%CI, 1.01-1.17; p = 0.022), larger WMH volume (β, 0.08; 95%CI, 0.04-0.12; p < 0.001), lower BPF (β, -0.09; 95%CI, -0.15- -0.03; p = 0.007), and marginally associated with strictly lobar CMBs (OR, 1.11; 95%CI, 1.00-1.23; p = 0.055), but not with lacunes. WMH volume mediated the relation between baPWV and BPF. In age subgroup analysis, the association of baPWV with PVS in white matter was stronger among those aged <55 years, whereas the association with brain atrophy was more prominent among those aged ≥55 years. Increased baPWV was associated with larger WMH volume in both younger and older individuals. Conclusions: Increased arterial stiffness was associated with most of imaging markers of CSVD, including PVS in white matter, larger WMH volume, strictly lobar CMBs, and brain atrophy, but not lacunes. The mechanisms underlying these associations and their potential clinical significances warrant further investigations.

Keywords: arterial stiffness; brain atrophy; cerebral small vessel disease; dilated perivascular spaces; lacunes; microbleeds; pulse wave velocity; white matter hyperintensities.