Association between the severity of cerebral small vessel disease, pulsatility of cerebral arteries, and brachial ankle pulse wave velocity in patients with lacunar infarction.

BACKGROUND/AIMS: Stiff arteries cause high pulse pressure and flow to be transmitted to distal organs during systole, damaging the cerebral microvasculatures. We investigated the association between the severity of cerebral small vessel disease (CSVD), the pulsatility of cerebral arteries, and the stiffness of large arteries in patients with lacunar infarction (LI).

METHODS

Subjects included 120 patients with LIs, who underwent MRI, transcranial Doppler ultrasonography, and brachial ankle pulse wave velocity (BaPWV). We compared the severity of CSVD, the pulsatile index (PI) of both middle cerebral arteries (MCAs), and BaPWV.

RESULTS

Patients with higher BaPWV were more likely to have multiple LIs and more severe white matter lesions, and tended to have higher age, systolic blood pressure, pulse pressure, heart rate, and the PI of MCAs. The PI of MCAs significantly correlated with BaPWV (with PI: r = 0.441, p < 0.001) and age (with PI: r = 0.538, p < 0.001). Multiple linear regression analysis indicated that aging (β = 0.008, p < 0.001) and BaPWV (β = 0.001, p = 0.007) were independent determinants of the PI of MCAs after adjustment for sex, pulse pressure, hypertension, and diabetes.

CONCLUSION

These findings suggest that systemic arterial stiffness may be associated with the severity of CSVD and pulsatility of cerebral arteries.