Department of Neurology, Yonsei University College of Medicine, Seoul, Korea; Department of Neurology, Ewha Womans University College of Medicine, Seoul, Korea.
Eur J Neurol. 2014 Mar;21(3):463-9. doi: 10.1111/ene.12332. Epub 2013 Dec 16.
Increased arterial stiffness causes vessel damage in the end-organs. Therefore small vessels in the brain may be susceptible to increased arterial stiffness. Cerebral microbleeds (CMBs) are topographically or pathophysiologically categorized as deep or infratentorial type and strictly lobar type. Whether the presence and location of CMBs are associated with brachial-ankle pulse wave velocity (baPWV) which represents a measure of arterial stiffness was investigated.
Between June 2006 and January 2012, 1137 consecutive patients diagnosed with non-cardioembolic acute ischaemic stroke and who underwent baPWV measurement and brain gradient-echo imaging were enrolled. CMBs were classified as deep or infratentorial or strictly lobar according to their location. Severity of leukoaraiosis was determined using the Fazekas scoring system.
CMBs were found in 30.7% of the included patients. These patients were older than those without CMBs. Mean baPWV was higher in patients with CMBs than in those without (20 ± 5 m/s vs. 19 ± 5 m/s; P = 0.001). When comparing baPWV according to the location of the CMB, it was higher in the deep or infratentorial CMB group than in the strictly lobar CMB group (22 ± 5 m/s vs. 20 ± 5 m/s; P = 0.001). In univariate and multivariate multinomial logistic regression analyses, baPWV was found to be independently associated with deep or infratentorial CMBs.
Arterial stiffness was independently associated with deep or infratentorial CMBs but not lobar CMBs. These findings suggest a pathophysiological association between arterial stiffness and CMBs in the deep or infratentorial region.
动脉僵硬度增加会导致终末器官的血管损伤。因此，大脑中的小血管可能容易受到动脉僵硬度增加的影响。脑微出血（CMB）在解剖学或病理生理学上可分为深部或幕下型和严格的脑叶型。我们研究了 CMB 的存在和位置是否与代表动脉僵硬度的臂踝脉搏波速度（baPWV）相关。
2006 年 6 月至 2012 年 1 月期间，连续纳入了 1137 例诊断为非心源性急性缺血性脑卒中且接受了 baPWV 测量和脑梯度回波成像的患者。根据位置将 CMB 分类为深部或幕下型或严格的脑叶型。使用 Fazekas 评分系统确定脑白质疏松症的严重程度。
纳入的患者中 30.7%存在 CMB。这些患者比无 CMB 的患者年龄更大。有 CMB 的患者的平均 baPWV 高于无 CMB 的患者（20±5m/s 比 19±5m/s；P=0.001）。当根据 CMB 的位置比较 baPWV 时，深部或幕下型 CMB 组高于严格的脑叶型 CMB 组（22±5m/s 比 20±5m/s；P=0.001）。在单变量和多变量多项逻辑回归分析中，baPWV 与深部或幕下型 CMB 独立相关。
动脉僵硬度与深部或幕下型 CMB 独立相关，与脑叶型 CMB 不相关。这些发现提示动脉僵硬度与深部或幕下 CMB 之间存在病理生理学关联。
