Li Xuelong, Du Heng, Li Jia, Li Xianliang, Gao Qingchun, Chen Xiangyan
Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China.
Department of Neurology, Wuhan No.1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Clin Neurol. 2023 Jul;19(4):338-343. doi: 10.3988/jcn.2022.0209. Epub 2023 Mar 13.
By measuring a newly defined parameter, the carotid-cerebral pulse wave velocity (ccPWV), this study aimed to determine the association of intracranial artery calcification (IAC) with arterial stiffness as reflected by the pulse wave velocity between the carotid and middle cerebral arteries using transcranial Doppler sonography in patients with acute stroke.
We recruited 146 patients with ischemic stroke from our stroke center. Computed tomography of the head was used to assess the presence and severity of IAC. Arterial stiffness was evaluated using ccPWV. Data are presented as quartiles of ccPWV. A multivariable logistic regression model was used to assess the independent relationship between ccPWV and IAC.
The IAC prevalence increased with the ccPWV quartile, being 54%, 76%, 83%, and 89% for quartiles 1, 2, 3, and 4, respectively (<0.001) as did IAC scores, with median [interquartile range] values of 0 [0-2], 3 [2-4], 4 [2-5], and 5 [4-6], respectively (<0.001). After additionally adjusting for age and hypertension, a significant correlation was only found between quartiles 3 and 4 of ccPWV and IAC scores. The odds ratio (95% confidence interval) for the IAC scores was 1.78 (1.28-2.50) (=0.001) in quartile 4 of ccPWV and 1.45 (1.07-1.95) (=0.015) in quartile 3 compared with quartile 1.
We found that in patients with acute ischemic stroke, ccPWV was positively related to the degree of IAC. Future longitudinal cohort studies may help to identify the potential role of IAC in the progression of cerebral arterial stiffness.
通过测量一个新定义的参数——颈动脉-脑脉搏波速度(ccPWV),本研究旨在利用经颅多普勒超声确定急性卒中患者颅内动脉钙化(IAC)与颈动脉和大脑中动脉之间脉搏波速度所反映的动脉僵硬度之间的关联。
我们从卒中中心招募了146例缺血性卒中患者。采用头部计算机断层扫描评估IAC的存在情况和严重程度。使用ccPWV评估动脉僵硬度。数据以ccPWV的四分位数表示。采用多变量逻辑回归模型评估ccPWV与IAC之间的独立关系。
IAC患病率随ccPWV四分位数增加而升高,四分位数1、2、3和4的患病率分别为54%、76%、83%和89%(<0.001),IAC评分也如此,其四分位数间距的中位数分别为0[0 - 2]、3[2 - 4]、4[2 - 5]和5[4 - 6](<0.001)。在进一步调整年龄和高血压因素后,仅发现ccPWV的四分位数3和4与IAC评分之间存在显著相关性。与四分位数1相比,ccPWV四分位数4的IAC评分的比值比(95%置信区间)为1.78(1.28 - 2.50)(P = 0.001),四分位数3为1.45(1.07 - 1.95)(P = 0.015)。
我们发现,在急性缺血性卒中患者中,ccPWV与IAC程度呈正相关。未来的纵向队列研究可能有助于确定IAC在脑动脉僵硬度进展中的潜在作用。