Abstract 3719: Large Vessel Correlates of Cerebral Small Vessel Disease
Background: MRI-markers of ischemic cerebral small vessel disease (white matter hyperintensities [WMH] and lacunar infarcts) are common in the general population and are associated with an increased risk of stroke, dementia and mortality. The mechanisms underlying these lesions are poorly understood. Our aim was to investigate the relationship of carotid structure and function with MRI-markers of ischemic cerebral small vessel disease.
Methods: The study population comprised 1847 community-based participants (mean age 72.5±4.1 years, 60.1% women), from the 3C-Dijon Study, who had undergone both quantitative brain MRI and carotid ultrasound examination. We used multivariable logistic and linear regression models adjusted for age, gender and vascular risk factors.
Results: Presence of carotid plaques and increasing luminal carotid diameter were associated with a higher prevalence of lacunar infarcts (OR=1.68[95%CI:1.12-2.52], p=0.01 and OR=1.24[1.02-1.52], p=0.03 respectively), and extensive WMH volume (EXT-WMHV, OR=1.37[1.07-1.74], p=0.01 and OR=1.19[1.04-1.36], p=0.01, respectively), independently of vascular risk factors and of each other. There was a graded association of carotid plaques and luminal carotid diameter with increasing severity of ischemic cerebral small vessel disease. Increasing Young’s elastic modulus and carotid circumferential wall stress were associated with EXT-WMHV (OR=1.18[1.02-1.37], p=0.02 and OR=1.20[1.03-1.40], p=0.02 respectively), and there was a significant inverse association of carotid distension with WMH volume (beta±SE: -0.021±0.008, p=0.01), independent of vascular risk factors.
Conclusion: Our results suggest that, in addition to the established association of carotid plaques with MRI-markers of ischemic brain injury, increasing luminal carotid diameter and markers of carotid stiffness, reflecting large artery arteriosclerosis, are associated with an increased prevalence of ischemic cerebral small vessel disease.
- © 2012 by American Heart Association, Inc.