White Matter Hyperintensities: Use of Aortic Arch Pulse Wave Velocity to Predict Volume Independent of Other Cardiovascular Risk Factors

Abstract

Purpose:To evaluate the relationship between pulse wave velocity (PWV) from the aortic arch and subsequent cerebral microvascular disease independent of other baseline cardiovascular risk factors among the participants in the multiethnic Dallas Heart Study. Materials and Methods:Each subject gave written consent to participate in this HIPAA-compliant, institutional review board-approved prospective study. Aortic arch PWV was measured with phase-contrast magnetic resonance (MR) imaging in a population sample (n = 1270) drawn from the probabilitybased Dallas Heart Study. Seven years later, the volume of white matter hyperintensities (WMHs) was determined from brain MR images. Linear regression was conducted with aortic arch PWV, 15 other cardiovascular risk factors, and age, sex, and ethnicity included as predictors of WMH. The authors implemented a smoothly clipped absolute deviation-penalized variable selection method to evaluate an optimal predictive risk factor model. Results:Aortic arch PWV helped predict WMH volume independent of the other demographic and cardiovascular risk factors (regression coefficient: 0.29; standard error: 0.06; 95% confidence interval: 0.17, 0.42; P , .0001). The optimal predictor variables of subsequent WMH volume adjusted for sex and ethnicity included aortic arch PWV, age, systolic blood pressure, hypertension treatment, and congestive heart failure. The authors estimated that a 1% increase in aortic arch PWV (in meters per second) is related to a 0.3% increase in subsequent WMH volume (in milliliters) when all other variables in the model are held constant. Conclusion:Aortic arch PWV measured with phase-contrast MR imaging is a highly significant independent predictor of subsequent WMH volume, with a higher standardized effect than any other cardiovascular risk factor assessed except for age. In an optimal predictive model of subsequent WMH burden, aortic arch PWV provides a distinct contribution along with systolic blood pressure, hypertension treatment, congestive heart failure, and age.

Association of arterial stiffness with progression of subclinical brain and cognitive disease

“…Lastly, the FHS consists of predominantly white participants of Western European ancestry, potentially limiting the generalizability of our findings to people of other ethnicities. However, our results are consistent with studies incorporating other races and ethnicities, which have reported associations of arterial stiffness with future WMHV 28,29 and with cognitive impairment by Mini-Mental State Examination. 32 Future confirmation of our results in larger population samples and with longer follow-up is warranted.…”

“…In earlier cross-sectional analyses, baseline blood pressure and aortic PWV similarly predicted WMHV several years later in population-based cohorts. [28][29][30] In our sample, CFPWV was associated with WMHV, predominantly in participants aged 65 years or older, in cross-sectional analyses, 11 but was not associated with progression of WMHV. A possible explanation for this finding might be that our middle-aged cohort was relatively healthy and younger than other cohorts 10,28 in which associations between arterial stiffness and WMH have been observed.…”

Microstructural Brain Tissue Damage in Metabolic Syndrome

“…Gray and white matter volumes were calculated as previously described (16), and lacunar infarcts and cerebral microbleeds were evaluated as previously reported (17). White matter lesion volume in millimeters was automatically quantified by using a previously validated method (18). In short, after initial tissue segmentation (18), white matter masks generated by FSL were spatially transformed to FLAIR images by using the FLIRT tool (19).…”

Association of Depressive Symptoms with Hippocampal Volume in 1936 Adults

“…DHS-2 was conducted from September 2007 to December 2009. For more information about DHS-2 please see these references (King et al, 2013;Kozlitina and Garcia, 2012;Lucarelli et al, 2013).…”