Background Low cerebral blood flow (CBF) has been associated with the presence of white matter lesions (WMLs). However, the power of these studies was insufficient (n = 20- 35) to determine whether flow is associated ...Background Low cerebral blood flow (CBF) has been associated with the presence of white matter lesions (WMLs). However, the power of these studies was insufficient (n = 20- 35) to determine whether flow is associated with WMLs. Purpose The aim of this study was to investigate whether total cerebral blood flow (tCBF) is associated with the severity of white matter lesions (WMLs) in a large patient sample. Subjects and methods 228 patients with clinical symptoms of cardiovascular disease had MRI of the brain, consisting of a T2- w FLAIR and a 2D phasecontrast flow measurement of the internal carotid arteries and the basilar artery. WMLs were graded according to prevalence and size of deep and periventricular WMLs. To determine the relation between tCBF and WMLs we used linear and logistic regression analysis adjusted for age, gender, intima media thickness and hypertension. Results We observed an inverse association between the tCBF and the total number of WMLs adjusted for age, gender, intima media thickness and hypertension [B = - 1,0 WML 95 % CI (- 2.0 to 0.0, p = 0.045) per 100 mL increase in tCBF]. The adjusted odds ratio for the presence of severe WMLs in patients with high tCBF ( > 675 mL/min) was 0.5 (95% CI 0.2- 1.0) compared with patients with normal tCBF. Conclusion In this study we found that high tCBF is associated with a decrease in presence and severity of WMLs.展开更多
Aims: To study whether arterial stiffness is related to risk of new vascular events in patients with manifest arterial disease and to examine whether this relation varies between patients who differ with respect to ba...Aims: To study whether arterial stiffness is related to risk of new vascular events in patients with manifest arterial disease and to examine whether this relation varies between patients who differ with respect to baseline vascular risk, arterial stiffness, or systolic blood pressure(SBP). Methods and results: The study was performed in the first consecutive 2183 patients with manifest arterial disease enrolled in the SMART study(Second Manifestations of ARTerial disease), a cohort study among patients with manifest arterial disease or cardiovascular risk factors. Common carotid distension(i.e. the change in carotid diameter in systole relative to diastole) was measured at baseline by ultrasonography. With the distension, several stiffness parameters were determined. In the entire cohort, none of the carotid artery stiffness parameters was related to the occurrence of vascular events. However, decreased stiffness was related to decreased vascular risk in subjects with low baseline SBP. The relation of carotid stiffness with vascular events did not differ between tertiles of baseline risk and carotid stiffness. Conclusion: Carotid artery stiffness is no independent risk factor for vascular events in patients with manifest arterial disease. However, in patients with low SBP, decreased carotid stiffness may indicate a decreased risk of vascular events.展开更多
文摘Background Low cerebral blood flow (CBF) has been associated with the presence of white matter lesions (WMLs). However, the power of these studies was insufficient (n = 20- 35) to determine whether flow is associated with WMLs. Purpose The aim of this study was to investigate whether total cerebral blood flow (tCBF) is associated with the severity of white matter lesions (WMLs) in a large patient sample. Subjects and methods 228 patients with clinical symptoms of cardiovascular disease had MRI of the brain, consisting of a T2- w FLAIR and a 2D phasecontrast flow measurement of the internal carotid arteries and the basilar artery. WMLs were graded according to prevalence and size of deep and periventricular WMLs. To determine the relation between tCBF and WMLs we used linear and logistic regression analysis adjusted for age, gender, intima media thickness and hypertension. Results We observed an inverse association between the tCBF and the total number of WMLs adjusted for age, gender, intima media thickness and hypertension [B = - 1,0 WML 95 % CI (- 2.0 to 0.0, p = 0.045) per 100 mL increase in tCBF]. The adjusted odds ratio for the presence of severe WMLs in patients with high tCBF ( > 675 mL/min) was 0.5 (95% CI 0.2- 1.0) compared with patients with normal tCBF. Conclusion In this study we found that high tCBF is associated with a decrease in presence and severity of WMLs.
文摘Aims: To study whether arterial stiffness is related to risk of new vascular events in patients with manifest arterial disease and to examine whether this relation varies between patients who differ with respect to baseline vascular risk, arterial stiffness, or systolic blood pressure(SBP). Methods and results: The study was performed in the first consecutive 2183 patients with manifest arterial disease enrolled in the SMART study(Second Manifestations of ARTerial disease), a cohort study among patients with manifest arterial disease or cardiovascular risk factors. Common carotid distension(i.e. the change in carotid diameter in systole relative to diastole) was measured at baseline by ultrasonography. With the distension, several stiffness parameters were determined. In the entire cohort, none of the carotid artery stiffness parameters was related to the occurrence of vascular events. However, decreased stiffness was related to decreased vascular risk in subjects with low baseline SBP. The relation of carotid stiffness with vascular events did not differ between tertiles of baseline risk and carotid stiffness. Conclusion: Carotid artery stiffness is no independent risk factor for vascular events in patients with manifest arterial disease. However, in patients with low SBP, decreased carotid stiffness may indicate a decreased risk of vascular events.