Abstract T P152: Correlates of Dolichoectasia in an Urban, Stroke-free Cohort: Results From the Northern Manhattan Study
Introduction: Dolichoectasia (DE) is an arteriopathy characterized by tortuosity and/or dilatation of an artery. Some risk factors for atherosclerosis, such as male sex, age and hypertension are shared with DE, but the association of DE with subclinical measures, such as carotid plaque, is not clear. The objective of this study is to evaluate the frequency and determinants of DE in an unselected population.
Methods: Surviving stroke-free participants from the Northern Manhattan Study cohort were invited to undergo brain MRI and MRA. Demographic, clinical and radiological data were collected in consented subjects. Arterial diameters were measured with semi-automated software in the proximal segments of 14 large brain arteries. Dolichoectasia was defined as an arterial diameter 2 SD above the head-size adjusted mean. Logistic and linear regressions were used to determine statistical significance between DE and baseline factors with a P value < 0.05.
Results: A total of 718 NOMAS participants had MRA data available (mean age± SD, 71.6± 8.0 years), 40% were men, 61% Hispanic, 20% black, 19% white, 68% had hypertension, 19% had diabetes mellitus, and 16% had a history of cardiac disease. Arterial diameters were available in 6,863 intracranial arteries. Dolichoectasia of at least one artery was classified in 19% of the sample and a third of these had two or more affected arteries. Adjusting for demographic and vascular risk factors, the odds of DE were greater in older participants (OR 1.31, per 10 years, 95% CI 1.0-1.7) and in women (OR 3.1, 95% CI 1.8-5.3) but lower in those with ultrasound defined extracranial carotid plaque (OR 0.5, 0.3-0.8). Stratified analyses by anterior or posterior circulation DE did not alter our findings; with the exception that hypertension was associated with posterior circulation DE, although this was not significant (OR 1.9, 95% CI 0.9-4.2).
Conclusions: Intracranial DE was found in a fifth of this urban, multicultural cohort. The prevalence of DE increases with age and is more common in women. Our data suggest carotid plaque may be linked in some way to DE as measured by intracranial arterial diameters. Understanding the mechanisms leading to arterial dilatation might open new ways for potential treatments in patients with DE.
Author Disclosures: J. Gutierrez: None. A. Bagci: None. V. Del Brutto: None. P. Gervasi-Franklin: None. T. Rundek: None. M.S. Elkind: None. N. Alperin: None. R.L. Sacco: None. C.B. Wright: None.
- © 2014 by American Heart Association, Inc.