Evelyn F. McKnight Brain Institute, University of Miami Miami FL.
Department of Biomedical Engineering University of Miami Miami FL.
J Am Heart Assoc. 2024 Aug 6;13(15):e035691. doi: 10.1161/JAHA.124.035691. Epub 2024 Jul 18.
Pulse-wave velocity is a measure of arterial stiffness and a risk factor for cardiovascular disease. Recently, an estimated pulse-wave velocity (ePWV) was introduced that was predictive of increased risk of cardiovascular disease. Our objective was to determine whether ePWV was associated with cerebral small-vessel disease on magnetic resonance imaging.
We included 1257 participants from the NOMAS (Northern Manhattan Study). The ePWV values were calculated using a nonlinear function of age and mean arterial blood pressure. The association between ePWV and white matter hyperintensity volume was assessed. Modification by race and ethnicity was evaluated. Associations between ePWV and other cerebral small-vessel disease markers, covert brain infarcts, cerebral microbleeds, and enlarged perivascular spaces, were explored as secondary outcomes. Mean±SD age of the cohort was 64±8 years; 61% were women; 18% self-identified as non-Hispanic Black, 67% as Hispanic, and 15% as non-Hispanic White individuals. Mean±SD ePWV was 11±2 m/s in the total NOMAS population and was similar across race and ethnic groups. The ePWV was significantly associated with white matter hyperintensity volume (β=0.23 [95% CI, 0.20-0.26]) after adjustment. Race and ethnicity modified the association between ePWV and white matter hyperintensity volume, with stronger associations in Hispanic and non-Hispanic Black individuals. Significant associations were found between ePWV and covert brain infarcts, cerebral microbleeds, and perivascular spaces after adjustment.
The ePWV function may provide a vascular mechanism for deleterious cerebrovascular outcomes in individuals with cerebral small-vessel disease and is particularly apparent in the racial and ethnic minorities represented in the NOMAS cohort.
脉搏波速度是动脉僵硬度的一种衡量标准，也是心血管疾病的一个风险因素。最近，引入了一种估算脉搏波速度（ePWV），该速度可预测心血管疾病风险增加。我们的目的是确定 ePWV 是否与磁共振成像上的脑小血管疾病有关。
我们纳入了来自 NOMAS（北曼哈顿研究）的 1257 名参与者。ePWV 值使用年龄和平均动脉血压的非线性函数计算。评估了 ePWV 与脑白质高信号体积之间的关系。评估了种族和民族的修饰作用。将 ePWV 与其他脑小血管疾病标志物、隐匿性脑梗死、脑微出血和扩大的血管周围间隙的关系作为次要结局进行了探讨。队列的平均年龄±标准差为 64±8 岁；61%为女性；18%自认为是非西班牙裔黑人，67%为西班牙裔，15%为非西班牙裔白人。NOMAS 总人群的平均 ePWV±标准差为 11±2m/s，且在不同种族和民族群体中相似。在调整后，ePWV 与脑白质高信号体积显著相关（β=0.23 [95%CI，0.20-0.26]）。种族和民族修饰了 ePWV 与脑白质高信号体积之间的关系，在西班牙裔和非西班牙裔黑人中相关性更强。调整后，ePWV 与隐匿性脑梗死、脑微出血和血管周围间隙之间存在显著相关性。
ePWV 函数可能为脑小血管疾病患者的有害脑血管结局提供一个血管机制，并且在 NOMAS 队列中代表的种族和少数民族中尤为明显。
