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中心动脉僵硬度与颅内动脉粥样硬化:社区动脉粥样硬化风险研究-神经认知研究(ARIC-NCS):主动脉僵硬度与颅内动脉粥样硬化。

Central arterial stiffening and intracranial atherosclerosis: the atherosclerosis risk in communities neurocognitive study (ARIC-NCS): Aortic stiffness & intracranial atherosclerosis.

机构信息

Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.

Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.

出版信息

J Stroke Cerebrovasc Dis. 2024 Jan;33(1):107477. doi: 10.1016/j.jstrokecerebrovasdis.2023.107477. Epub 2023 Nov 15.

Abstract

OBJECTIVES

Previous studies suggest an association between central arterial stiffness (CAS) and intracranial atherosclerotic disease (ICAD) among Asian participants with stroke or hypertension; this association has not been evaluated in United States populations. We assessed the cross-sectional association of CAS with ICAD presence and burden in late-life, and differences in association by age, sex, and race.

MATERIALS AND METHODS

We conducted a cross-sectional analysis of 1,285 Atherosclerosis Risk in Communities Study participants [mean age 75 (standard deviation: 5) years, 38 % male, 20  % Black] at Visit 5 (2011-2013). CAS was measured as carotid-femoral pulse wave velocity (cfPWV) using the Omron VP-1000 Plus. ICAD was assessed using high-resolution vessel wall MRI and MR angiography. We evaluated associations of a 1 standard deviation (SD) cfPWV (3.02 m/s) and high vs. non-high cfPWV (≥ 13.57 m/s vs. < 13.57 m/s) with presence of plaques (yes/no) and plaque number (0, 1-2, and >2) using multivariable logistic and ordinal logistic regression models adjusted for covariates.

RESULTS

Each one SD greater cfPWV was associated with higher odds of plaque presence (odds ratio (OR)=1.32, 95 % confidence interval (CI): 1.22, 1.43), and an incrementally higher odds of number of plaques (OR 1-2 vs. 0 plaques = 1.21, 95 % CI: 1.10, 1.33; OR >2 vs. 0 plaques = 1.51, 95 % CI: 1.33,1.71). Results suggested differences by race, with greater magnitude associations among Black participants.

CONCLUSIONS

CAS was positively associated with ICAD presence and burden; cfPWV may be a useful subclinical vascular measure for identification of individuals who are at high risk for cerebrovascular disease.

摘要

目的

先前的研究表明,亚洲中风或高血压患者的中心动脉僵硬(CAS)与颅内动脉粥样硬化性疾病(ICAD)之间存在关联;而这种关联尚未在美国人群中得到评估。我们评估了 CAS 与晚年 ICAD 存在和负担的横断面关联,并按年龄、性别和种族评估了关联的差异。

材料和方法

我们对 1285 名动脉粥样硬化风险社区研究参与者(平均年龄 75 岁[标准差:5 岁],38%为男性,20%为黑人)在第五次(2011-2013 年)就诊时进行了横断面分析。CAS 采用欧姆龙 VP-1000 Plus 测量颈股脉搏波速度(cfPWV)。使用高分辨率血管壁 MRI 和 MR 血管造影评估 ICAD。我们使用多变量逻辑回归和有序逻辑回归模型评估了 1 个标准差(SD)cfPWV(3.02 m/s)和高 vs. 非高 cfPWV(≥13.57 m/s vs. <13.57 m/s)与斑块存在(是/否)和斑块数量(0、1-2 和>2)的相关性,调整了协变量。

结果

cfPWV 每增加 1 个 SD,斑块存在的可能性就会增加(优势比(OR)=1.32,95%置信区间(CI):1.22,1.43),并且斑块数量(OR 1-2 与 0 个斑块=1.21,95%CI:1.10,1.33;OR>2 与 0 个斑块=1.51,95%CI:1.33,1.71)的可能性也会呈递增趋势。结果表明,种族之间存在差异,黑人参与者的关联幅度更大。

结论

CAS 与 ICAD 的存在和负担呈正相关;cfPWV 可能是一种有用的亚临床血管测量方法,可用于识别患有脑血管疾病风险较高的个体。

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