Cerebral Small Artery Diseases may be Associated with Aortic Arch Calcification in Stroke Patients

Ueno, Yoshio; Okuzumi, Ayami; Watanabe, Masayuki; Tanaka, Yasutaka; Shimada, Yoshiaki; Yamashiro, Kazuo; Tanaka, Ryota; Urabe, Takao

doi:10.5551/jat.22483

Cited by 9 publications

(10 citation statements)

References 32 publications

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“…On the other hand, the effects of diabetes on SVD, especially WMH and microbleeds, have yet to be clarified 26 ) . This is in contrast to hypertension, which is well known to be an established risk factor for ischemic strokes involving both large arteries and small vessels 27 ) . Even on neuroimaging analysis of 7 T MRI, microvascular brain lesions were not found to be significantly more common in elderly subjects with type 2 diabetes than in normal controls 28 ) .…”

Section: Discussionmentioning

confidence: 92%

Evaluation of Lenticulostriate Arteries Changes by 7 T Magnetic Resonance Angiography in Type 2 Diabetes

Yashiro

Kameda

Chida

et al. 2018

J Atheroscler Thromb

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Aim: Progress in neuroimaging techniques allows us to investigate the microvasculature characteristics including lenticulostriate arteries (LSA), which are closely associated with lacunar infarction. Because ischemic stroke is a more critical health problem in East Asian than in other populations, in order to clarify pathological changes underlying cerebral small vessel disease (SVD), we projected an imaging analysis of LSA using high-resolution brain magnetic resonance imaging (MRI) in middle-aged Japanese subjects with type 2 diabetes.Methods: Twenty-five subjects with type 2 diabetes and 25 non-diabetic control subjects underwent 7 Tesla (7 T) brain MRI. The prevalences of SVD and LSA structural changes were determined in each group.Results: SVD prevalence did not differ significantly between the type 2 diabetes and control groups. The average numbers of stems, as well as numbers of branches, of LSA were significantly smaller in diabetic subjects than non-diabetic control subjects. The signal intensity of LSA was markedly decreased, indicating reduced blood flow in type 2 diabetes.Conclusion: In spite of the prevalence of SVD being similar, structural changes and decreased signal intensity of LSA were highly detected in diabetic subjects compared with non-diabetic controls, suggesting that 7 T MRA enables us to determine LSA impairment prior to the development of SVD. Early detection of LSA impairment allows us earlier interventions aimed at the prevention of atherosclerotic events.

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Section: Discussionmentioning

confidence: 92%

Evaluation of Lenticulostriate Arteries Changes by 7 T Magnetic Resonance Angiography in Type 2 Diabetes

Yashiro

Kameda

Chida

et al. 2018

J Atheroscler Thromb

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Section: Discussionmentioning

confidence: 99%

“…However, despite the large number of studies addressing the correlation between AAC and cardiovascular disease, few reports have examined the correlation between AAC and cerebrovascular disorders [ 7 , 31 ]. Using magnetic resonance imaging on ischemic stroke patients not receiving dialysis, AAC was reportedly associated with cerebral small-artery occlusion and white matter disease [ 7 ]; therefore, such vascular disorders might directly influence the cerebral circulation. Furthermore, cerebral circulation dysregulation leads to a decrease in regional cerebral blood flow [ 32 ] and leukoaraiosis, an indicator of cerebral ischemia with a high prevalence in the anterior circulation of the brain, has also been reported as an independent risk factor for stroke [ 33 ] in dialysis patients.…”

Section: Discussionmentioning

confidence: 99%

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Deterioration of Cerebral Oxygenation by Aortic Arch Calcification Progression in Patients Undergoing Hemodialysis: A Cross-Sectional Study

Ookawara

Okochi

et al. 2017

BioMed Research International

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Background Near-infrared spectroscopy revealed that the regional saturation of oxygen (rSO2) in cerebral tissue is lower in hemodialysis (HD) patients than in healthy subjects. However, no study has examined the changes in cerebral oxygenation by aortic arch calcification (AAC) progression in HD patients. Methods A total of 104 HD patients were divided into four groups by AAC grade determined using chest radiography: 23 patients at grade 0, 24 at grade 1, 30 at grade 2, and 27 at grade 3. Differences in clinical parameters, including cerebral rSO2, among AAC grades were investigated and atherosclerotic parameters affecting cerebral rSO2 values were identified. Results Cerebral rSO2 significantly decreased as AAC progressed (AAC grade 3 versus grade 0, p < 0.01 versus grade 1, p < 0.05). Multivariate logistic regression analysis was performed using parameters with p values < 0.20 in univariate analysis between cerebral rSO2 values less than the mean and atherosclerotic parameters. AAC grades 2 and 3, serum phosphate level, and history of smoking were factors associated with the cerebral rSO2 decrease. Conclusions Cerebral rSO2 significantly decreased as AAC progressed and was independently associated with higher AAC grade, serum phosphate level, and history of smoking.

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“…Aortic arch calcification upon chest radiography and white matter lesions upon magnetic resonance imaging (MRI) are related to the development of ischemic stroke 8 , 9 ) . We previously showed a close relationship between aortic arch calcification and cerebral white matter lesions for patients with acute ischemic stroke 10 ) , and the association of age and atherosclerotic vascular risk factors with those pathological lesions has been reported 11 – 14 ) . However, we could not detect any potential biomarkers for such lesions 10 ) .…”

Section: Introductionmentioning

confidence: 89%

Age Stratification and Impact of Eicosapentaenoic Acid and Docosahexaenoic Acid to Arachidonic Acid Ratios in Ischemic Stroke Patients

Ueno

Tanaka

Yamashiro

et al. 2018

J Atheroscler Thromb

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Aim: We focused on the ratios of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) to arachidonic acid (AA) and explored the significance of these ratios relative to clinical characteristics by age in ischemic stroke patients.Methods: We enrolled patients with acute ischemic stroke who underwent radiological investigations and laboratory examinations, including measurement of serum EPA, DHA, and AA levels, and controls. Patients were classified according to age (< 65, 65–74, and ≥ 75 years) and the tertile of EPA/AA and DHA/AA ratios, and clinical aspects were compared with these factors.Results: We analyzed 373 patients (age 70.2 ± 13.4 years; 245 males) and 105 controls. Among stroke patients, patients aged < 65 years had the lowest EPA/AA (0.35 ± 0.23, p = 0.006) and DHA/AA (0.73 ± 0.27, p < 0.001) ratios. Compared with controls, patients aged < 65 years showed lower EPA/AA (vs. 0.49 ± 0.25, p < 0.001) and DHA/AA (vs. 0.82 ± 0.26, p = 0.009) ratios. From logistic regression analysis, the EPA/AA (odds ratio 0.18, 95% confidence interval 0.04–0.81, p = 0.026) and DHA/AA (odds ratio 0.09, 95% confidence interval 0.02–0.33, p < 0.001) ratios were inversely related to patients aged < 65 years. According to age-stratified analyses, we found an association of aortic arch calcification with a lower EPA/AA ratio for patients aged ≥ 75 years and an association of multiple infarctions and cerebral white matter lesions with a lower EPA/AA ratio for patients aged 65–74 years (p < 0.05).Conclusions: The ratios of EPA/AA and DHA/AA could be specific markers for younger stroke patients. The EPA/AA ratio may be related to aortic arch calcification for elderly stroke patients and to multiple infarctions and cerebral white matter disease for middle-aged stroke patients.

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Cerebral Small Artery Diseases may be Associated with Aortic Arch Calcification in Stroke Patients

Cited by 9 publications

References 32 publications

Evaluation of Lenticulostriate Arteries Changes by 7 T Magnetic Resonance Angiography in Type 2 Diabetes

Evaluation of Lenticulostriate Arteries Changes by 7 T Magnetic Resonance Angiography in Type 2 Diabetes

Deterioration of Cerebral Oxygenation by Aortic Arch Calcification Progression in Patients Undergoing Hemodialysis: A Cross-Sectional Study

Age Stratification and Impact of Eicosapentaenoic Acid and Docosahexaenoic Acid to Arachidonic Acid Ratios in Ischemic Stroke Patients

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