Abstract WP414: Comparative Analysis of Clinicoradiological Factors between Asymptomatic Subjects and Stroke Patients with Vertebrobasilar Dolichoectasia in Japan
Background: Vertebrobasilar dolichoectasia (VBD) is a distinct arteriopathy known as stroke risk. We aimed to elucidate etiologic factors for developing stroke in VBD patients.
Methods: A total of 10345 adults (7034 men and 3311 women) underwent healthy check-up and brain magnetic resonance (MR) studies. Seven hundred eighty-one consecutive patients (452 men and 329 women) with acute brain infarct (524 patients) or brain hemorrhage (257 patients) were recruited. We reviewed medical records and MR data in both groups. VBD was defined as the diameter of the basilar artery (BA) ≥ 4.5 mm and the diameter of the intracranial vertebral artery ≥ 4.0 mm on MR angiography. The height and lateral displacement of BA were graded according to scale of Smoker et al (AJNR 1986). Asymptomatic VBD was confirmed by neurological examination. Cardiovascular disease (CVD) risk and radiological variables were analyzed statistically in asymptomatic subjects and stroke patients with VBD.
Results: One hundred thirty-four subjects (118 men and 16 women) had asymptomatic VBD. Mean age (SD) was 60.3 (11.6) years. VBD existed in 60 stroke patients (54 men and 6 women). Mean age (SD) was 65.4 (13.2) years. Prevalence of VBD was 1.3% in physical check-up adults and 7.7% in stroke patients. On univariate analysis, age and the frequency of atrial fibrillation (AF), past CVD history or chronic kidney disease (CKD) defined as proteinuria or estimated glomerular filtration rate < 60 mL/min/m2 were significantly higher in stroke patients than in asymptomatic subjects. Other CVD risk profiles, the score of the BA height and displacement did not differ statistically between both groups. The BA diameter, the frequency of brainstem compression and the number of silent infarct lesions were increased significantly in stroke patients compared to asymptomatic subjects. Multiple logistic regression analysis showed that stroke onset was significantly associated with AF [odds ratio (OR)=1.4], CKD (OR=2.0), past CVD history (OR=1.8), silent infarcts ≥ 3 lesions (OR=2.2) and BA diameter ≥ 4.9 mm (OR=1.3).
Conclusion: The present study clarified independent factors for developing stroke in VBD patients. Intensive management of these clinicoradiological factors could prevent a stroke event in VBD patients.
- © 2012 by American Heart Association, Inc.