Aparicio Hugo J, Petrea Rodica E, Massaro Joseph M, Manning Warren J, Oyama-Manabe Noriko, Beiser Alexa S, Kase Carlos S, D'Agostino Ralph B, Wolf Philip A, Vasan Ramachandran S, DeCarli Charles, O'Donnell Christopher J, Seshadri Sudha
Department of Neurology, Boston University School of Medicine, 72 East Concord Street, C-3, Boston, MA 02118, USA; National Heart, Lung, and Blood Institute's Framingham Study, 73 Mt. Wayte Avenue, Suite 2, Framingham, MA 01702, USA.
Department of Neurology, Boston University School of Medicine, 72 East Concord Street, C-3, Boston, MA 02118, USA; National Heart, Lung, and Blood Institute's Framingham Study, 73 Mt. Wayte Avenue, Suite 2, Framingham, MA 01702, USA; Department of Neurology, Creighton University School of Medicine, 601 North 30th Street, Suite 5300, Omaha, NE 68131, USA.
Atherosclerosis. 2017 Oct;265:305-311. doi: 10.1016/j.atherosclerosis.2017.06.919. Epub 2017 Jun 23.
Aortic atherosclerosis is an aggregate marker of vascular risk factor exposure and has been associated with intracranial atherosclerosis and stroke. We hypothesized that atherosclerosis of the descending aorta (DAo) could be a risk marker for brain aging and injury.
We evaluated 1527 participants (mean age 59.9 years, 53.5% women) in the Framingham Offspring cohort who underwent both aortic and brain MRI. Participants were free of clinical stroke, dementia, or other neurological illness at the time of axial MRI of the thoracic and abdominal DAo and subsequent brain MRI. We related the prevalence and burden of aortic plaque to total cerebral brain volume (TCBV) and white matter hyperintensity volume (WMHV). An additional analysis compared incidence of stroke or TIA in participants with and without DAo plaques.
Presence of thoracic DAo plaque (8%) was associated with decreased TCBV in sex-pooled analysis (-0.77, SE 0.25, p = 0.002, equivalent to 4.5 years of aging) and with increased WMHV only in men (0.26, SE 0.12, p = 0.032, equivalent to 6.5 years aging). We observed similar associations of DAo plaque burden with TCBV and WMHV. There were 43 strokes and 11 TIAs in prospective follow-up (median 7 years). Presence of DAo plaque was not associated with subsequent stroke or TIA.
In this cross-sectional community-based study, we found DAo plaque is associated with accelerated brain aging. These data underscore the potential implications of incidentally identified subclinical aortic atherosclerosis and question whether targeted intervention in these high risk individuals can modulate cognitive decline.
主动脉粥样硬化是血管危险因素暴露的综合标志物，与颅内动脉粥样硬化和中风相关。我们假设降主动脉（DAo）粥样硬化可能是脑老化和损伤的风险标志物。
我们评估了弗雷明汉后代队列中的1527名参与者（平均年龄59.9岁，53.5%为女性），他们均接受了主动脉和脑部MRI检查。在进行胸腹部DAo的轴向MRI及随后的脑部MRI检查时，参与者无临床中风、痴呆或其他神经系统疾病。我们将主动脉斑块的患病率和负担与全脑总体积（TCBV）和白质高信号体积（WMHV）相关联。另一项分析比较了有和没有DAo斑块的参与者中风或短暂性脑缺血发作（TIA） 的发生率。
在合并性别分析中，胸段DAo斑块的存在（8%）与TCBV降低相关（-0.77，标准误0.25，p = 0.002，相当于4.5年的脑老化），并且仅在男性中与WMHV增加相关（0.26，标准误0.12，p = 0.032，相当于6.5年脑老化）。我们观察到DAo斑块负担与TCBV和WMHV之间存在类似关联。在中位7年的前瞻性随访中有43例中风和11例TIA。DAo斑块的存在与随后的中风或TIA无关。
在这项基于社区的横断面研究中，我们发现DAo斑块与脑老化加速相关。这些数据强调了偶然发现的亚临床主动脉粥样硬化的潜在影响，并质疑对这些高危个体进行靶向干预是否能调节认知衰退。
