Department of Radiology, University of Washington, Seattle, WA, USA.
Department of Radiology, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.
J Cereb Blood Flow Metab. 2021 Jun;41(6):1390-1397. doi: 10.1177/0271678X20956950. Epub 2020 Oct 20.
Vascular dysfunctions, including arterial stiffness and endothelial dysfunction, are prevalent in hypertensive subjects. We aimed to study their relations to subclinical intracranial vascular health in this study. A total of 200 older hypertensive males without overt cardiovascular or cerebrovascular diseases were recruited. Arterial elasticity was measured as carotid-femoral pulse wave velocity (cfPWV) and endothelial function was measured as digital reactive hyperemia index (RHI). Cerebrovascular health was evaluated using MRI in four aspects: intracranial atherosclerosis, brain perfusion as cerebral blood flow (CBF), vascular rarefaction analyzed as visible arterial branches on angiography using a custom-developed analysis technique and small vessel disease measured as white matter hyperintensity (WMH). There was a significant negative association between cfPWV and CBF, suggesting a link between arterial stiffness and CBF decline. Higher cfPWV was also associated with presence of intracranial stenotic plaque and greater WMH volume. RHI was positively related to CBF, indicating that endothelial dysfunction was associated with reduced CBF. All the associations remained significant after adjustment for confounding variables. Arterial stiffness and endothelial dysfunction are associated with reduced brain perfusion in older hypertensive males. Arterial stiffness is also associated with global cerebral vascular injury, affecting both small and medium-to-large arteries.
血管功能障碍，包括动脉僵硬度和内皮功能障碍，在高血压患者中很常见。在这项研究中，我们旨在研究它们与亚临床颅内血管健康的关系。共招募了 200 名无明显心血管或脑血管疾病的老年男性高血压患者。动脉弹性通过颈股脉搏波速度（cfPWV）测量，内皮功能通过数字反应性充血指数（RHI）测量。使用 MRI 从四个方面评估脑血管健康：颅内动脉粥样硬化、脑灌注（CBF）、血管稀疏程度（通过一种自定义的分析技术在血管造影上作为可见动脉分支进行分析）和小血管疾病（WMH）。cfPWV 与 CBF 呈显著负相关，表明动脉僵硬度与 CBF 下降之间存在关联。较高的 cfPWV 也与颅内狭窄斑块的存在和更大的 WMH 体积有关。RHI 与 CBF 呈正相关，表明内皮功能障碍与 CBF 减少有关。在调整混杂变量后，所有关联仍然显著。动脉僵硬度和内皮功能障碍与老年男性高血压患者的脑灌注减少有关。动脉僵硬度也与全身性脑血管损伤有关，影响小动脉和中-大动脉。
