Significance of Haemodynamic and Haemostatic Factors in the Course of Different Manifestations of Cerebral Small Vessel Disease: The SHEF-CSVD Study—Study Rationale and Protocol

Abstract

Rationale. This paper describes the rationale and design of the SHEF-CSVD Study, which aims to determine the long-term clinical and radiological course of cerebral small vessel disease (CSVD) and to evaluate haemostatic and haemodynamic prognostic factors of the condition. Design. This single-centre, prospective, non-interventional cohort study will follow 150 consecutive patients with different clinical manifestations of CSVD (lacunar ischaemic stroke, vascular dementia, vascular parkinsonism or spontaneous deep, intracerebral haemorrhage) and 50 age- and sex-matched controls over a period of 24 months. The clinical and radiological course will be evaluated basing on a detailed neurological, neuropsychological and MRI examinations. Haemodynamic (cerebral vasoreactivity, 24 h blood pressure control) and haemostatic factors (markers of endothelial and platelet dysfunction, brachial artery flow-mediated dilatation test) will be determined. Discussion. The scheduled study will specifically address the issue of haemodynamic and haemostatic prognostic factors and their course over time in various clinical manifestations of CSVD. The findings may aid the development of prophylactic strategies and individualised treatment plans, which are critical during the early stages of the disease.

Risk of vascular events or death in different manifestations of cerebral small vessel disease: a 2-year follow-up study with a control group

“…Mean age and sex distribution were similar in CSVD and CG but patients with CSVD were less likely to have CAD (19% vs 40%, p=0,02) and tended to have higher prevalence of diabetes (54% vs 37%, p=0,11). The risk of vascular events or death was increased in CSVD (4,56; 95%CI 1,(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)9) vs CG, in patients with moderate to severe white matter lesions at baseline MRI (HR 2,0; 95%CI 0,85-7,2), and it was similar in LS and HS (HR 4,70; 95%CI 1,(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)2) and VaD and VaP (HR 4,59; 95%CI 1,[3][4][5][6][7][8][9][10][11][12][13][14][15]7).…”

“…The present investigation is embedded in the SHEF-CSVD Study (Significance of HEmodynamic and hemostatic Factors in the course of different manifestations of Cerebral Small Vessel Disease) [3]. The study group consisted of 150 consecutive patients with symptomatic CSVD and 55 controls (CG) without cerebrovascular disease but with high atherothrombotic risk.…”

Risk factor profile of different clinical manifestations of cerebral small vessel disease - data from SHEF-CSVD Study

“…The present investigation is nested in the of SHEF-CSVD Study (Significance of HEmodynamic and hemostatic Factors in the course of different manifestations of Cerebral Small Vessel Disease) [5]. The study group consisted of 150 consecutive patients: with first-ever recent LS (n=52) or deep HS (n=20), VaP (n=28) and VaD (n=50) and 55 controls (CG).…”

“…The study protocol and methods have been thoroughly described elsewhere [5]. In brief, SVD group consisted of consecutive patients with a first ever recent LS or HS or newly diagnosed VaD and VaP presumed to be caused by SVD with evidence of typical findings on neuroimaging (MRI), who were independent (total Barthel Index >80 points) and had no severe dementia (MMSE≥12 points) [6].…”

Морфометричні Показники Серця У Гострому Періоді Лакунарного Інсульту

“…Було виявлено дуже міцний зв'язок гіпертензі та ЛІ проти нелакунарного інсульту (RR 1,11; 95 % СІ від 1,04 до 1,19) [4]. Гемодинамічні чинники, як відомо, грають значну роль при гострому ЛІ [7]. В дослідженні С. Si erra і співавт.…”