Influence of Chronic Hyperglycemia on Cerebral Microvascular Remodeling
An In Vivo Study Using Perfusion Computed Tomography in Acute Ischemic Stroke Patients
Background and Purpose—To investigate the effect of chronic hyperglycemia on cerebral microvascular remodeling using perfusion computed tomography.
Methods—We retrospectively identified 26 patients from our registry of 2453 patients who underwent a perfusion computed tomographic study and had their hemoglobin A1c (HbA1c) measured. These 26 patients were divided into 2 groups: those with HbA1c>6.5% (n=15) and those with HbA1c≤6.5% (n=11). Perfusion computed tomographic studies were processed using a delay-corrected, deconvolution-based software. Perfusion computed tomographic values were compared between the 2 patient groups, including mean transit time, which relates to the cerebral capillary architecture and length.
Results—Mean transit time values in the nonischemic cerebral hemisphere were significantly longer in the patients with HbA1c>6.5% (P=0.033), especially in the white matter (P=0.005). Significant correlation (R=0.469; P=0.016) between mean transit time and HbA1c level was observed.
Conclusions—Our results from a small sample suggest that chronic hyperglycemia may be associated with cerebral microvascular remodeling in humans. Additional prospective studies with larger sample size are required to confirm this observation.
- Received August 9, 2013.
- Accepted August 15, 2013.
- © 2013 American Heart Association, Inc.