This Article Full Text Full Text (PDF) All Versions of this Article: 38/9/2453    most recent STROKEAHA.107.483073v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bos, M. J. Articles by Breteler, M. M.B. Search for Related Content PubMed PubMed Citation Articles by Bos, M. J. Articles by Breteler, M. M.B. Pubmed/NCBI databases Medline Plus Health Information Stroke Related Collections Cerebrovascular disease/stroke Doppler ultrasound, Transcranial Doppler etc. Risk Factors for Stroke Epidemiology

(Stroke. 2007;38:2453.)
© 2007 American Heart Association, Inc.

Original Contributions

Transcranial Doppler Hemodynamic Parameters and Risk of Stroke

The Rotterdam Study

Michiel J. Bos, MD, MSc; Peter J. Koudstaal, MD, PhD; Albert Hofman, MD, PhD; Jacqueline C.M. Witteman, PhD Monique M.B. Breteler, MD, PhD

From the Departments of Epidemiology & Biostatistics (M.J.B., A.H., J.C.M.W., M.M.B.B.) and Neurology (M.J.B., P.J.K.), Erasmus Medical Center, Rotterdam, The Netherlands.

Correspondence to Prof Dr Monique M.B. Breteler, Department of Epidemiology & Biostatistics, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands. E-mail m.breteler{at}erasmusmc.nl

Background and Purpose— We explored the association between transcranial Doppler hemodynamic parameters and the risk of stroke in the general population.

Methods— At baseline, we assessed mean flow velocity, peak systolic flow velocity, end diastolic flow velocity, and vasomotor reactivity with transcranial Doppler in 2022 Rotterdam Study participants aged 61 years and over in both middle cerebral arteries. All participants, who at baseline were free from previous stroke, were subsequently followed for occurrence of stroke (average follow-up time 5.1 years). We calculated hazard ratios for the association between hemodynamic parameters and risk of stroke using Cox proportional hazards models with adjustment for age, sex, systolic blood pressure, antihypertensive drug use, diabetes mellitus, ever smoking, current smoking, carotid intima media thickness, and carotid distensibility.

Results— Risk of stroke (n=122) and ischemic stroke (n=89) increased with increasing middle cerebral artery flow velocity; when comparing the tertile with highest velocity to the tertile with lowest velocity, the hazard ratio was 1.74 (95% CI: 1.09 to 2.77) for the association between mean flow velocity and stroke, 1.63 (95% CI: 1.03 to 2.58) for end diastolic flow velocity and stroke, and 1.33 (95% CI: 0.86 to 2.08) for peak systolic flow velocity and stroke. These estimates increased 10% to 26% when only ischemic strokes were included. The side of highest flow velocity was not associated with the side of stroke. We found no associations between vasomotor reactivity and risk of stroke.

Conclusions— Risk of stroke increased strongly with increasing middle cerebral artery flow velocity as measured with transcranial Doppler in the general population.

Key Words: cerebral infarct • cerebrovascular disease • risk factors • stroke • TCD

This article has been cited by other articles:

				Hemodynamic Parameters and Stroke Risk Journal Watch Neurology, January 29, 2008; 2008(129): 2 - 2. [Full Text]