Cerebral Arterial Stiffness as Measured Based on the Pulse Wave Velocity Is Associated With Intracranial Artery Calcification in Patients With Acute Stroke
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background and Purpose By measuring a newly defined parameter, the carotid–cerebral pulse wave velocity (ccPWV), this study aimed to determine the association of intracranial artery calcification (IAC) with arterial stiffness as reflected by the pulse wave velocity between the carotid and middle cerebral arteries using transcranial Doppler sonography in patients with acute stroke. Methods We recruited 146 patients with ischemic stroke from our stroke center. Computed tomography of the head was used to assess the presence and severity of IAC. Arterial stiffness was evaluated using ccPWV. Data are presented as quartiles of ccPWV. A multivariable logistic regression model was used to assess the independent relationship between ccPWV and IAC. Results The IAC prevalence increased with the ccPWV quartile, being 54%, 76%, 83%, and 89% for quartiles 1, 2, 3, and 4, respectively (p<0.001) as did IAC scores, with median [interquartile range] values of 0 [0–2], 3 [2–4], 4 [2–5], and 5 [4–6], respectively (p<0.001). After additionally adjusting for age and hypertension, a significant correlation was only found between quartiles 3 and 4 of ccPWV and IAC scores. The odds ratio (95% confidence interval) for the IAC scores was 1.78 (1.28–2.50) (p=0.001) in quartile 4 of ccPWV and 1.45 (1.07–1.95) (p=0.015) in quartile 3 compared with quartile 1. Conclusions We found that in patients with acute ischemic stroke, ccPWV was positively related to the degree of IAC. Future longitudinal cohort studies may help to identify the potential role of IAC in the progression of cerebral arterial stiffness.
Abstract
Background and Purpose By measuring a newly defined parameter, the carotid–cerebral pulse wave velocity (ccPWV), this study aimed to determine the association of intracranial artery calcification (IAC) with arterial stiffness as reflected by the pulse wave velocity between the carotid and middle cerebral arteries using transcranial Doppler sonography in patients with acute stroke. Methods We recruited 146 patients with ischemic stroke from our stroke center. Computed tomography of the head was used to assess the presence and severity of IAC. Arterial stiffness was evaluated using ccPWV. Data are presented as quartiles of ccPWV. A multivariable logistic regression model was used to assess the independent relationship between ccPWV and IAC. Results The IAC prevalence increased with the ccPWV quartile, being 54%, 76%, 83%, and 89% for quartiles 1, 2, 3, and 4, respectively (p<0.001) as did IAC scores, with median [interquartile range] values of 0 [0–2], 3 [2–4], 4 [2–5], and 5 [4–6], respectively (p<0.001). After additionally adjusting for age and hypertension, a significant correlation was only found between quartiles 3 and 4 of ccPWV and IAC scores. The odds ratio (95% confidence interval) for the IAC scores was 1.78 (1.28–2.50) (p=0.001) in quartile 4 of ccPWV and 1.45 (1.07–1.95) (p=0.015) in quartile 3 compared with quartile 1. Conclusions We found that in patients with acute ischemic stroke, ccPWV was positively related to the degree of IAC. Future longitudinal cohort studies may help to identify the potential role of IAC in the progression of cerebral arterial stiffness.
참고문헌 (29)
- Chen XY, "The frequency and determinants of calcification in intracranial arteries in Chinese patients who underwent computed tomography examinations", Cerebrovasc Dis, 21, pp.91~97 (2006)
- Yang WJ, "Understanding the clinical implications of intracranial arterial calcification using brain CT and vessel wall imaging", Front Neurol, 12, pp.619233~ (2021)
- Tábuas-Pereira M, "Intracranial internal carotid artery wall calcification in ischemic strokes treated with thrombolysis", Eur Neurol, 79, pp.21~26 (2018)
- Wu X, "Intracranial arterial calcification relates to long-term risk of recurrent stroke and post-stroke mortality", Front Neurol, 11, pp.559158~ (2020)
- Magdič J, "Intracranial vertebrobasilar calcification in patients with ischemic stroke is a predictor of recurrent stroke, vascular disease, and death : a case-control study", Int J Environ Res Public Health, 17, pp.2013~ (2020)
- Zhang F, "Spotty calcium on cervicocerebral computed tomography angiography associates with increased risk of ischemic stroke", Stroke, 50, pp.859~866 (2019)
- Hernández-Pérez M, "Intracranial carotid artery calcification relates to recanalization and clinical outcome after mechanical thrombectomy", Stroke, 48, pp.342~347 (2017)
- Yang WJ, "Postmortem study exploring distribution and patterns of intracranial artery calcification", Stroke, 49, pp.2767~2769 (2018)
- Fu X, "A new method for cerebral arterial stiffness by measuring pulse wave velocity using transcranial Doppler", J Atheroscler Thromb, 23, pp.1004~1010 (2016)
- Babiarz LS, "Cavernous carotid artery calcification and white matter ischemia", AJNR Am J Neuroradiol, 24, pp.872~877 (2003)
- Chen XY, "Intracranial artery calcification : a newly identified risk factor of ischemic stroke", J Neuroimaging, 17, pp.300~303 (2007)
- Babiarz LS, "Middle cerebral artery infarction : relationship of cavernous carotid artery calcification", AJNR Am J Neuroradiol, 26, pp.1505~1511 (2005)
- Fu X, "Association of cerebral arterial stiffness with initial severity in acute ischemic stroke", J Atheroscler Thromb, 26, pp.1092~1101 (2019)
- Fu X, "Cerebral arterial stiffness as a new marker of early stage atherosclerosis of the cerebral large artery in acute stroke", J Atheroscler Thromb, 26, pp.783~791 (2019)
- Zeng X, "Association between carotid-cerebral pulse wave velocity and acute ischemic stroke : clinical trial protocol", J Stroke Cerebrovasc Dis, 28, pp.2580~2584 (2019)
- Leopold JA, "Vascular calcification : an age-old problem of old age", Circulation, 127, pp.2380~2382 (2013)
- Lee SY, "Vascular calcification as an underrecognized risk factor for frailty in 1783 community-dwelling elderly individuals", J Am Heart Assoc, 9, pp.e017308~ (2020)
- Hyun YY, "Arterial stiffness as a risk factor for subclinical coronary artery calcification in predialysis chronic kidney disease : from the KNOW-CKD study", Kidney Blood Press Res, 44, pp.426~434 (2019)
- Guo J, "Increased aortic calcification is associated with arterial stiffness progression in multiethnic middle-aged men", Hypertension, 69, pp.102~108 (2017)
- Cainzos-Achirica M, "Brachial-ankle pulse wave velocity is associated with coronary calcium in young and middle-aged asymptomatic adults : the Kangbuk Samsung Health Study", Atherosclerosis, 241, pp.350~356 (2015)
- Takasu J, "Relationship between common carotid intima-media thickness and thoracic aortic calcification : the multi-ethnic study of atherosclerosis", Atherosclerosis, 209, pp.142~146 (2010)
- Park KY, "Association between cerebral arterial calcification and brachial-ankle pulse wave velocity in patients with acute ischemic stroke", Eur Neurol, 61, pp.364~370 (2009)
- Zhang J, "Arterial stiffness and asymptomatic intracranial large arterial stenosis and calcification in hypertensive chinese", Am J Hypertens, 24, pp.304~309 (2011)
- Nelson AJ, "Targeting vascular calcification in chronic kidney disease", JACC Basic Transl Sci, 5, pp.398~412 (2020)
- Lanzer P, "Medial vascular calcification revisited : review and perspectives", Eur Heart J, 35, pp.1515~1525 (2014)
- Vos A, "Risk factors for atherosclerotic and medial arterial calcification of the intracranial internal carotid artery", Atherosclerosis, 276, pp.44~49 (2018)
- Van den Bergh G, "The vicious cycle of arterial stiffness and arterial media calcification", Trends Mol Med, 25, pp.1133~1146 (2019)
- Bos D, "Intracranial carotid artery atherosclerosis : prevalence and risk factors in the general population", Stroke, 43, pp.1878~1884 (2012)
- Bugnicourt JM, "High prevalence of intracranial artery calcification in stroke patients with CKD : a retrospective study", Clin J Am Soc Nephrol, 4, pp.284~290 (2009)