Del Brutto Oscar H, Mera Robertino M
School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador.
Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Eur Neurol. 2018;79(1-2):86-89. doi: 10.1159/000486308. Epub 2018 Jan 9.
BACKGROUND/AIMS: Pathogenetic mechanisms involved in enlargement of basal ganglia perivascular spaces (BG-PVSs) are controversial. Here, we assessed whether pulsatile or steady components of blood pressure (BP) are associated with enlarged BG-PVS.
We evaluated the association between BG-PVS and pulsatile and steady components of BP in Atahualpa residents aged ≥60 years, by the use of regression models and receiver operator characteristics (ROC) curve analysis, after taking into account the effect of demographics, cardiovascular risk factors, and other signatures of cerebral small vessel disease (SVD).
Of 437 candidates, 363 (83%) were included. MRI showed >10 enlarged BG-PVS in 103 (28%) subjects. In univariate analysis, the association between enlarged BG-PVS and systolic pressure (SP) and pulse pressure (PP) were highly significant, while the association with diastolic pressure (DP) was not. ROC curve analysis showed a higher area under the curve for PP than for DP (p < 0.05). The area under the curve for SP was also higher than that of DP, but not significantly better due to overlapping 95% CI.
Enlarged BG-PVS are associated with pulsatile components of BP, although some of the effect is taken away by the strong interaction between BG-PVS and other signatures of SVD.
背景/目的:基底节区血管周围间隙(BG-PVSs)扩大所涉及的发病机制存在争议。在此,我们评估血压(BP)的搏动性或稳定性成分是否与扩大的BG-PVS相关。
在考虑人口统计学、心血管危险因素和脑小血管病(SVD)的其他特征的影响后,我们通过回归模型和受试者工作特征(ROC)曲线分析,评估了≥60岁的阿塔瓦尔帕居民中BG-PVS与BP的搏动性和稳定性成分之间的关联。
在437名候选人中,363人(83%)被纳入。MRI显示103名(28%)受试者的BG-PVS扩大>10个。在单因素分析中,扩大的BG-PVS与收缩压(SP)和脉压(PP)之间的关联高度显著,而与舒张压(DP)的关联不显著。ROC曲线分析显示,PP的曲线下面积高于DP(p<0.05)。SP的曲线下面积也高于DP,但由于95%CI重叠,差异不显著。
扩大的BG-PVS与BP中的搏动性成分相关,尽管BG-PVS与SVD的其他特征之间的强相互作用消除了部分影响。